Outdoor and in-store food advertising: food and health-related advertisements in neighbourhoods of low- and middle-socioeconomic status in Stockholm, Sweden.

内容摘要

This study examined the prevalence of outdoor and in-store food and health-related advertisements, and whether their distribution differed by neighbourhood socioeconomic status (SES) in Stockholm, Sweden. A cross-sectional observational design was employed using EPOCH-an adapted tool with pre-defined categories to collect data on outdoor and in-store advertising in 10 lower-SES and 12 middle-SES neighbourhoods in Stockholm. Outdoor advertisement distributions were compared between SES categories using the Mann-Whitney U test, while in-store advertisement counts were analysed using regression models tailored to outcome distributions. Most advertisements featured energy-dense, nutrient-poor (EDNP) foods and sugar-sweetened beverages (SSBs)-59 percent of outdoor advertisements and 65 percent of in-store advertisements. Although differences in the prevalence of outdoor and in-store advertisements were noted between low- and middle-SES neighbourhoods, these associations were not statistically significant following correction for multiple testing. Across all neighbourhoods, advertisements were dominated by unhealthy products, particularly EDNP foods and SSBs. Similar levels of exposure in low- and middle-SES neighbourhoods suggest that neighbourhood SES is not a key predictor of advertising patterns in Stockholm. These findings highlight a widespread exposure to unhealthy food advertising, underscoring the need for public health strategies to address environmental drivers of diet-related outcomes.