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. 2023 Jul 10;23(1):1321.
doi: 10.1186/s12889-023-16251-0.

Association of service facilities and amenities with adolescent birth rates in Mexican cities

Ariela Braverman-Bronstein  1 , Dèsirée Vidaña-Pérez  2 , Ana V Diez Roux  1 , Carolina Pérez Ferrer  3 , Brisa N Sánchez  1 , Tonatiuh Barrientos-Gutiérrez  4
Affiliations

Association of service facilities and amenities with adolescent birth rates in Mexican cities

Ariela Braverman-Bronstein et al. BMC Public Health. .

Abstract

Background: The association of the built environment and the structural availability of services/amenities with adolescent birth rates (ABR) has been overlooked in Latin America. We investigated the association of the availability, and changes in the availability, of services/amenities with ABR in 92 Mexican cities.

Methods: We estimated ABR using data on live birth registration linked to municipality of residence at the time of birth from 2008-2017. The number of services/amenities were obtained from the National Statistical Directory of Economic Units in 2010, 2015, and 2020 and grouped as follows: education, health care, pharmacies, recreation, and on- and off-premises alcohol outlets. Data were linearly interpolated to obtain yearly estimates. We estimated densities per square km by municipality. We fitted negative binomial hybrid models, including a random intercept for municipality and city, and adjusted for other social environment variables.

Results: After adjustment a 1-unit increase in the density of recreation facilities, pharmacies, and off-premises alcohol outlets within municipalities was associated with a 5%, 4% and 12% decrease in ABR, respectively. Municipalities with higher density of education, recreational and health care facilities had a lower ABR; in contrast, municipalities with a higher density of on-premises alcohol experienced a higher ABR.

Conclusion: Our findings highlight the importance of economic drivers and the need to invest in infrastructure, such as pharmacies, medical facilities, schools, and recreation areas and limit the availability of alcohol outlets to increase the impact of current adolescent pregnancy prevention programs.

Keywords: Adolescent pregnancy; Mexico; Structural availability; Urban environment.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Distribution of adolescent birth rates by year. Each boxplot contains the adolescent birth rates for the 406 municipalities included in the study. The red line corresponds to the mean adolescent birth rate across the study period for all the Mexican cities included
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