Journal of Urban Health

, Volume 93, Issue 4, pp 627–638 | Cite as

Still Separate, Still Unequal: Social Determinants of Playground Safety and Proximity Disparities in St. Louis

  • Cassandra Arroyo-Johnson
  • Krista Woodward
  • Laurel Milam
  • Nicole Ackermann
  • Goldie Komaie
  • Melody S Goodman
  • J. Aaron Hipp


Physical activity among youth is shaped by the natural and built environment within which they live; however, few studies have focused on assessing playground safety and proximity in detail as part of the built environment for youth physical activity. We analyzed data on 100 publicly accessible playgrounds from Play Across St. Louis, a community-partnered study of the built environment for youth physical activity. Outcomes included overall playground safety, maintenance, and construction scores; distance to nearest playground; and distance to nearest top playground. Independent variables included neighborhood % youth, % black residents, % owner-occupied units, and % vacant units. Playgrounds in the city have varying degrees of safety and proximity. Mean overall playground safety score was 67.0 % (CI = 63.5, 70.4). Neighborhood % youth and % black residents were inversely associated with overall playground safety (p = 0.03 and p < 0.01) and maintenance (p < 0.01 and p < 0.0001). Mean distance to nearest playground was 638.1 and 1488.3 m to nearest top playground. Clusters of low safety scores were found in the northern and central areas while all high safety score clusters were found in the southern part of St. Louis. Public playground safety and proximity vary across St. Louis neighborhoods, especially by neighborhood demographics. Disparities in playground safety and proximity reveal an opportunity to develop community-wide interventions focused on playgrounds for youth activity. Further work is needed to examine the association between playground safety, proximity, and use and youth physical activity and weight.


Playground safety Health disparities Built environment Youth physical activity 



This manuscript is dedicated to the Youth Council of Old North and their tireless advocacy for playground repairs in Northern St. Louis. We would like to thank the City of St. Louis Healthy Eating Active Living Partnership; City of St. Louis Department of Health—Health Promotion, Education, and Marketing Division, Community Research Fellows Training Program Community Advisory Board; St. Louis Patient Research Advisory Board; City of St. Louis Department of Parks, Recreation, and Forestry; and the residents of St. Louis for their local expertise and feedback. We would also like to acknowledge the contributions of Ms. Noemi Lopez, Ms. Dayana Delgado, and Ms. Ruth Gallego for their assistance with data collection.

Compliance with Ethical Standards

Funding Source

This study was supported by the Robert Wood Johnson Foundation’s New Connections Mid-career Consultant grant awarded to C.A-J.; the National Cancer Institute (U54CA155496) award; the Foundation for Barnes-Jewish Hospital; Alvin J. Siteman Cancer Center; and Washington University School of Medicine Department of Surgery.

Financial Disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflicts of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© The New York Academy of Medicine 2016

Authors and Affiliations

  1. 1.Department of Surgery, Division of Public Health SciencesWashington University School of Medicine in St. LouisSt. LouisUSA
  2. 2.George Warren Brown School of Social WorkWashington University in St. LouisSt. LouisUSA
  3. 3.Evaluation and Analysis, Patient-Centered Outcomes Research InstituteWashingtonUSA
  4. 4.Department of Parks, Recreation, & TourismNorth Carolina State UniversityRaleighUSA

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