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

Equity Focus

This study targets the food environment around schools in the city of Madrid, Spain. It investigated the relationship between socio-economic status at neighbourhood level and spatial access to unhealthy food around schools.

Case Summary

This project 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. After adjusting for population density, NSES remained inversely associated with unhealthy food availability. Schools located in low-NSES areas showed, on average, 29% more counts of unhealthy retailers compared with schools in middle-NSES areas. Schools in high-NSES areas were farther from unhealthy food sources than those schools located in middle-NSES areas.

Lessons Learned

• Regulating the school food environment (within and beyond school boundaries) may be a promising direction to prevent and reduce childhood obesity.
  

LINK TO CASE STUDY