Neighbourhood deprivation and outlet density for tobacco, alcohol and fast food: First hints to obesogenic and addictive environments in Germany

Abstract

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 neighborhoods to provide access to addictive substances and fast food. Design: In this ecological study, the total number of tobacco, alcohol and fast food outlets was recorded and visualized using a Geographic Information System. Setting: 18 Social areas in Cologne, Germany. Subjects: A total of 18 social areas in 4 districts of Cologne, Germany, including 92,000 inhabitants, were analyzed. Results: In the investigation area 339 tobacco, 353 alcohol and 67 fast food outlets were identified. The higher the deprivation indicators in a district, the higher the availability of cigarettes (Kendall’s tau =0.433; p=0.012), alcohol (Kendall’s tau =0.341, p=0.049) and fast food (Kendall’s tau =0.473; p=0.009). Conclusions: The availability of addictive substances and fast food can be seen as having a contextual influence on the individual’s lifestyle and can, as a physical exposition in form of obesogenic and addictive environments, contribute to a culmination of health risks.