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    Original Investigation
    Public Health
    October 4, 2019

    Association of Number of Indoor Tanning Salons With Neighborhoods With Higher Concentrations of Male-Male Partnered Households

    Author Affiliations
    • 1Weill Cornell Medical College, New York, New York
    • 2Department of Dermatology, Stanford University Medical Center and Cancer Institute, Palo Alto, California
    • 3Center for Geospatial Analytics, North Carolina State University, Raleigh
    • 4Stanford Prevention Research Center, Stanford School of Medicine, Palo Alto, California
    • 5Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
    • 6Stanford Health Research and Policy, Stanford School of Medicine, Palo Alto, California
    JAMA Netw Open. 2019;2(10):e1912443. doi:10.1001/jamanetworkopen.2019.12443
    Key Points español 中文 (chinese)

    Question  Are indoor tanning salons more likely to be located in neighborhoods with higher proportions of gay men?

    Findings  In this cross-sectional study of 10 US cities with the largest proportion of lesbian, gay, bisexual, and transgender populations, the odds of indoor tanning salons being located in census tracts with higher concentrations of male-male partnered households were approximately 2-fold higher than in areas with lower concentrations of male-male partnered households. After sensitivity analyses, the association remained significant.

    Meaning  The results of this study suggest that tanning salons may be more common in areas with higher populations of male-male partnered households in US cities, possibly contributing to the disproportionate use of indoor tanning by sexual-minority men.

    Abstract

    Importance  Both indoor tanning and skin cancer are more common among sexual-minority men, defined as gay and bisexual men, than among heterosexual men. Convenient access to indoor tanning salons may influence use patterns.

    Objective  To investigate whether indoor tanning salons are disproportionately located in areas with higher concentrations of gay men.

    Design, Setting, and Participants  This cross-sectional study used geographic information systems to integrate census data and business location data obtained from ArcGIS and Google Maps for the 10 US cities with the largest lesbian, gay, bisexual, and transgender populations in 2010, ie, Los Angeles, California; Chicago, Illinois; San Francisco, California; Seattle, Washington; San Diego, California; Dallas, Texas; Phoenix, Arizona; Washington, DC; Portland, Oregon; and Denver, Colorado. The association of indoor tanning salon locations with proportions of gay men, using the concentration of male-male partnered households as a proxy measure for the latter, was examined. Data analysis was performed in October 2018.

    Exposures  Census tracts with at least 1%, 5%, or 10% male-male partnered households, adjusting for median household income, percentage young women, and percentage non-Hispanic white residents.

    Main Outcomes and Measures  Presence of 1 or more indoor tanning salons within census tracts.

    Results  Across the 10 cities and 4091 census tracts in this study, there were 482 823 unmarried partnered households, of which 35 164 (7.3%) were male-male. The median (interquartile range) percentage of male-male partnered households per census tract was 0% (0%-10.6%). Odds of indoor tanning salon presence in areas with at least 10% male-male households were more than twice those of areas with less than 10% male-male households (odds ratio, 2.17; 95% CI, 1.59-2.97). When sensitivity analyses using a 1-mile euclidian buffer around each tanning salon were conducted, this association remained significant (odds ratio, 2.48; 95% CI, 2.14-2.88). After adjusting for median household income, percentage young women, and percentage non-Hispanic white residents, the odds of an indoor tanning salon being within 1 mile of a census tract with at least 10% male-male households remained twice that of census tracts with less than 10% male-male households (odds ratio, 2.00; 95% CI, 1.71-2.35).

    Conclusions and Relevance  In this study, indoor tanning salons were more likely to be located near neighborhoods with higher concentrations of male-male partnered households, possibly contributing to the disproportionate use of indoor tanning by sexual-minority men.

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