Qualitative approach to urban health in three different socioeconomic status neighbourhoods and its relationship with alcohol consumption and smoking
Author: Ignacio de Loyola González-Salgado, igsdeloyola@gmail.com
Department: Sociology
University: University of Salamanca, Spain
Supervisor: Jesús Rivera-Navarro
Year of completion: 2021
Language of dissertation: Spanish
Keywords:
smoking
, alcohol
, health inequalities
, urban environment
Areas of Research:
Health
, Environment and Society
, Clinical Sociology
Abstract
In this doctoral dissertation, we studied using a qualitative approach, alcohol consumption and smoking, which are two of the most relevant risk health behaviours for developing noncommunicable chronic diseases worldwide. The objective of this doctoral dissertation was to explore the social factors that conditioned and influenced smoking and alcohol consumption in three neighbourhoods with different socioeconomic status (SES) from the city of Madrid (Spain). As a secondary aim, we explored the differences between the three neighbourhoods studied regarding smoking and alcohol consumption. Three distinctive SES neighbourhoods of the city of Madrid were selected to conduct this research: San Diego (low SES neighbourhood), El Pilar (medium SES neighbourhood) and New Spain (high SES neighbourhood). Purposeful sampling was conducted in two stages: 1) reputational sampling was conducted to select key informants and 2) maximum-variation sampling was conducted to select participants from the 3 neighbourhoods studied. Finally, 37 semi-structured interviews and 29 focus groups were conducted between the 3 selected neighbourhoods. Coding strategies from the Charmaz’s constructivist grounded theory (smoking) and from the Corbin and Strauss’s grounded theory (alcohol consumption) informed the data analysis. Perceptions of participants showed that alcohol consumption and smoking differed between the three neighborhoods studied. Regarding smoking, we found that since the enactment of the Spain’s smoke-free law (Law 42/2010), tobacco use has been denormalized (with differences according to the neighborhood SES) and there was also a reduction in exposure to second-hand smoke. Bus stops were perceived as places where smoking should be banned. In addition, in the high NSE neighborhood, smokers were stigmatized due to social pressure related to the low perception of smokers in the urban environment of that neighborhood. Regarding alcohol consumption, we found that there were social, cultural, and economic factors that influenced its consumption. The amount of convenience stores selling alcohol and its long opening hours increased accessibility to and availability of alcohol. In addition, the place where alcohol is consumed had strong importance in the perception of such behavior. While consumption in licensed venues is socially accepted and normalized, consumption in unlicensed public spaces was perceived as a source of problems (which unequally affected neighborhoods according to their NSE) and it was associated with socially vulnerable groups. Following our results, we proposed future interventions aimed at reducing exposure to second-hand smoke and alcohol consumption and improve the health of the population living in the urban environment by: 1) regulating bus stops as smoke-free areas; 2) regulating smoking in outdoor areas near school centres; 3) limiting the perception of alcohol as a conductor of social relationships; 4) controlling alcohol sales in convenience stores by establishing licenses to sell this product; and 5) strengthening the existing controls regarding underage alcohol sales.
