Abstract
BackgroundIdentifying socioeconomic determinants that are associated with access to and availability of exercise facilities is fundamental to supporting physical activity engagement in urban populations, which in turn, may reduce health inequities. This study analysed the relationship between area-level socioeconomic status (SES) and access to, and availability of, exercise facilities in Madrid, Spain.MethodsArea-level SES was measured using a composite index based on seven sociodemographic indicators. Exercise facilities were geocoded using Google Maps and classified into four types: public, private, low-cost and sessional. Accessibility was operationalized as the street network distance to the nearest exercise facility from each of the 125,427 residential building entrances (i.e. portals) in Madrid. Availability was defined as the count of exercise facilities in a 1000 m street network buffer around each portal. We used a multilevel linear regression and a zero inflated Poisson regression analyses to assess the association between area-level SES and exercise facility accessibility and availability.ResultsLower SES areas had a lower average distance to the closest facility, especially for public and low-cost facilities. Higher SES areas had higher availability of exercise facilities, especially for private and seasonal facilities.ConclusionPublic and low-cost exercise facilities were more proximate in low SES areas, but the overall number of facilities was lower in these areas compared with higher SES areas. Increasing the number of exercise facilities in lower SES areas may be an intervention to improve health equity.
Highlights
Identifying socioeconomic determinants that are associated with access to and availability of exercise facilities is fundamental to supporting physical activity engagement in urban populations, which in turn, may reduce health inequities
All portals had two or more exercise facilities of any type located within 1000 m, and half of the portals had at least five facilities available at this distance
Exercise facility accessibility and socioeconomic status (SES) Overall, there was a social gradient in public, private and sessional facilities, where portals in low SES areas have better accessibility to the nearest exercise facility compared with higher SES areas (Fig. 1b–d)
Summary
Identifying socioeconomic determinants that are associated with access to and availability of exercise facilities is fundamental to supporting physical activity engagement in urban populations, which in turn, may reduce health inequities. Population approaches [7] seek to change the distribution of risk factors within a population, through changing social determinants or environmental factors An example of this is the neighbourhood built environment [8, 9]. Access to physical activity resources may vary according to the sociodemographic characteristics of the neighbourhood, such as the predominant ethnic group, the median income level, deprivation or the ageing distribution [10,11,12,13,14]. These may contribute to some of the differences shown
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