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Association of insulin resistance with distance to wealthy areas: The Multi-Ethnic Study of Atherosclerosis
Journal article   Open access   Peer reviewed

Association of insulin resistance with distance to wealthy areas: The Multi-Ethnic Study of Atherosclerosis

Amy H. Auchincloss, Ana V. Diez Roux, Daniel G. Brown, Ellen S. O'Meara and Trivellore E. Raghunathan
American journal of epidemiology, v 165(4), pp 389-397
15 Feb 2007
PMID: 17148499
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1093/aje/kwk028View
Published, Version of Record (VoR) Open

Abstract

Diabetes mellitus, type 2 Environment Insulin resistance Poverty Residence characteristics Socioeconomic factors Geographic Information Systems
Little is known about environmental determinants of type 2 diabetes. The authors hypothesized that insulin resistance is positively related to distance to a wealthy area and to local neighborhood poverty. Data were derived from The Multi-Ethnic Study of Atherosclerosis, a study of adults aged 45–84 years in six US locales, and the 2000 US Census. The homeostasis model assessment (HOMA) index was used to measure insulin resistance. Linear regression was used to estimate associations between area characteristics and insulin resistance after adjustment for age, sex, income, education, and race/ethnicity and for the potential mediators diet, physical activity, and body mass index (n = 4,821). Among persons not treated for diabetes, distance to a wealthy area was associated with HOMA independent of local poverty and person-level covariates: per 4.4-km change, the relative increase in HOMA was 13% (95% confidence interval: 7%, 19%), similar to the effect of a body mass index increase of 1.7 kg/m2 on HOMA. This association was reduced after adjustment for physical activity, diet, and body mass index (relative increase = 9%, 95% confidence interval: 3%, 15%). Local neighborhood poverty was also positively, but more weakly associated with insulin resistance, with no association after adjustment for race/ethnicity. This study shows that proximity to resources in high-income areas is related to insulin resistance.

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#10 Reduced Inequalities
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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