Deprivation amplification due to structural disadvantage? Playgrounds as important physical activity resources for children and adolescents.

OBJECTIVES: The deprivation amplification hypothesis postulates that the socially disadvantaged are exposed to further structural deprivation by their residential environment such that social inequalities are therefore amplified. To date, no publication has investigated deprivation amplification solely using playgrounds; the present health geography study investigates this hypothesis with regard to the availability of playgrounds in a typical large German city.

STUDY DESIGN: Between July 2016 and January 2017, all playgrounds in the city of Mannheim, Germany, were identified and evaluated by systematic audits. The playground attributes such as availability, accessibility, surface area, and provided amenities were operationalized using well-established, validated instruments.

METHODS: Geo-information about playgrounds was digitalized in ArcGIS 10.2-10.4 and linked to socioeconomic indicators on the meso-level, that is, on the level of 44 social areas. Availability and accessibility of playgrounds were quantified by calculating kernel density and Euclidean distance, respectively. Playground surface area and equipment provided were linked to the number of children and adolescents in the particular social area. The association between availability and accessibility of playgrounds and area-level indicators were assessed using bivariate and multiple Poisson regressions on the meso-level.

RESULTS: In the city of Mannheim, which covers 145 km2 and is home to 311,000 inhabitants, 271 playgrounds were identified. Bivariate and multiple analyses showed no association between availability and accessibility of playgrounds and area-level indicators. However, significant negative associations were found in the bivariate analyses between playground area and amenities provided per child and various area-level indicators, but not in multiple models.

CONCLUSIONS: Children are provided with different opportunities to play and to be physically active, depending upon the population density of their social neighborhood. At least in our study area, many socially disadvantaged families are forced to move to densely populated areas for economic reasons. Against that background, the phenomenon of 'deprivation amplification' was not confirmed for availability and accessibility of playgrounds but for playground area and number of amenities provided.