Next Article in Journal
Guava (Psidium guajava) Fruit Extract Prepared by Supercritical CO2 Extraction Inhibits Intestinal Glucose Resorption in a Double-Blind, Randomized Clinical Study
Next Article in Special Issue
The Contribution of Preschool Meals to the Diet of Finnish Preschoolers
Previous Article in Journal
Use of an Extract of Annona muricata Linn to Prevent High-Fat Diet Induced Metabolic Disorders in C57BL/6 Mice
Previous Article in Special Issue
Fruit, Vegetable, and Fibre Intake among Finnish Preschoolers in Relation to Preschool-Level Facilitators and Barriers to Healthy Nutrition
Open AccessArticle

Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context

1
Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, 28801 Madrid, Spain
2
Department of Surgery, Medical and Social Science, School of Medicine, Universidad de Alcalá, 28801 Madrid, Spain
3
Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY 10027, USA
4
Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA 19104, USA
5
Department of Epidemiology and Biostatistics, Drexel Dornsife School of Public Health, Philadelphia, PA 19104, USA
6
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
*
Author to whom correspondence should be addressed.
Nutrients 2019, 11(7), 1511; https://doi.org/10.3390/nu11071511
Received: 24 May 2019 / Revised: 25 June 2019 / Accepted: 2 July 2019 / Published: 3 July 2019
  |  
PDF [1619 KB, uploaded 3 July 2019]
  |  

Abstract

Across Europe, excess body weight rates are particularly high among children and adolescents living in Southern European contexts. In Spain, current food policies appeal to voluntary self-regulation of the food industry and parents’ responsibility. However, there is no research (within Spain) assessing the food environment surrounding schools. We examined the association between neighborhood-level socioeconomic status (NSES) and the spatial access to an unhealthy food environment around schools using both counts and distance measures, across the city of Madrid. We conducted a cross-sectional study citywide (n = 2443 census tracts). In 2017, we identified all schools (n = 1321) and all food retailers offering unhealthy food and beverages surrounding them (n = 6530) using publicly available data. We examined both the counts of retailers (within 400 m) and the distance (in meters) from the schools to the closest retailer. We used multilevel regressions to model the association of neighborhood-level socioeconomic status (NSES) with both measures, adjusting both models for population density. Almost all schools (95%) were surrounded by unhealthy retailers within 400 m (median = 17 retailers; interquartile range = 8–34). After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas (two lowest quintiles) showed, on average, 29% (IRR (Incidence Rate Ratio) = 1.29; 95% CI (Confidence Interval) = 1.12, 1.50) and 62% (IRR = 1.62; 95% CI = 1.35, 1.95) more counts of unhealthy retailers compared with schools in middle-NSES areas (ref.). Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas (β = 0.35; 95% CI = 0.14, 0.47). Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity. View Full-Text
Keywords: children; adolescents; schools; food environment; health inequalities; socioeconomic status; spatial exposure; Spain children; adolescents; schools; food environment; health inequalities; socioeconomic status; spatial exposure; Spain
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material

SciFeed

Share & Cite This Article

MDPI and ACS Style

Díez, J.; Cebrecos, A.; Rapela, A.; Borrell, L.N.; Bilal, U.; Franco, M. Socioeconomic Inequalities in the Retail Food Environment around Schools in a Southern European Context. Nutrients 2019, 11, 1511.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top