Neighbourhood deprivation and outlet density for tobacco, alcohol and fast food: first hints of obesogenic and addictive environments in Germany.
OBJECTIVE
The current discussion regarding ‘place effects on health’ is increasingly focusing on the characteristics of a specific physical environment. Our study investigated whether socially deprived residential areas are more likely than affluent neighbourhoods to provide access to addictive substances and fast food.


METHODS
In this ecological study the total number of tobacco, alcohol and fastfood outlets was recorded and visualized using a geographic information system. Area affluence was measured through the percentage of parents with children of kindergarten or school age with joint annual taxable income ,h12 272.


METHODS
Eighteen social areas in Cologne, Germany.


METHODS
All social areas in four districts in Cologne, Germany, with a total of 92 000 inhabitants, were analysed.


RESULTS
In the investigation area, 339 tobacco, 353 alcohol and sixty-seven fastfood outlets were identified. As area affluence declined the availability of the following potentially health damaging sources increased: cigarettes (Kendall’s tau50?433; P50?012), alcohol (Kendall’s tau50?341, P50?049) and fast food (Kendall’s tau50?473; P50?009).


CONCLUSIONS
The availability of addictive substances and fast food can be seen to have a contextual influence on an individual’s lifestyle and can, in the form of physical exposure to obesogenic and addictive environments, contribute to a culmination of health risks.
Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Mannheim, Germany. sven.schneider@medma.uni-heidelberg.de
Sven
S
Schneider
Johannes
J
Gruber
D000428:Alcohol Drinking; D004777:Environment; D057140:Fast Foods / Q000706:statistics & numerical data*; D005523:Food Supply / Q000706:statistics & numerical data; D040362:Geographic Information Systems / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D008019:Life Style; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012147:Restaurants / Q000706:statistics & numerical data; D012307:Risk Factors; D012574:Schools / Q000706:statistics & numerical data; D012907:Smoking; D012931:Social Environment; D012959:Socioeconomic Factors