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

Public Health Nutr. 2013 Jul;16(7):1168-77. doi: 10.1017/S1368980012003321. Epub 2012 Jul 10.


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.

Design: 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.

Setting: Eighteen social areas in Cologne, Germany.

Subjects: 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.

MeSH terms

  • Alcohol Drinking*
  • Environment*
  • Fast Foods / statistics & numerical data*
  • Food Supply / statistics & numerical data
  • Geographic Information Systems / statistics & numerical data
  • Germany
  • Humans
  • Life Style
  • Residence Characteristics / statistics & numerical data*
  • Restaurants / statistics & numerical data
  • Risk Factors
  • Schools / statistics & numerical data
  • Smoking*
  • Social Environment
  • Socioeconomic Factors