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Exercise facility availability and incidence of type 2 diabetes and complications in Spain: A population-based retrospective cohort 2015-2018
Journal article   Open access   Peer reviewed

Exercise facility availability and incidence of type 2 diabetes and complications in Spain: A population-based retrospective cohort 2015-2018

Luis Cereijo, Pedro Gullón, Isabel Del Cura, David Valadés, Usama Bilal, Manuel Franco and Hannah Badland
Health & place, v 81, 103027
May 2023
DOI: https://doi.org/10.1016/j.healthplace.2023.103027
PMID: 37087897
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.healthplace.2023.103027View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Type 2 diabetes Social determinants of health Diabetes complications Inequalities Cardiovascular diseases Electronic medical records Exercise Urban Health
To study the association between exercise facility availability and type 2 diabetes incidence and its complications, and to explore effect modification by socioeconomic status (SES) and sex in the Madrid adult population. A multilevel longitudinal design, based on a population-based retrospective cohort including 1,214,281 residents of Madrid (Spain) aged 40-75 years from 2015 to 2018. Outcomes were type 2 diabetes incidence and macrovascular (cardiac ischemia and/or stroke) and microvascular (chronic kidney disease, retinopathy, and/or peripheral vascular disease) complications in those with diabetes at baseline. Exercise facility availability was defined as the count of exercise facilities in a 1000 m street network buffer around each participant's residence. Poisson regression models with robust standard errors were used to estimate the risk ratios (RR). Interactions were explored with SES tertiles and by sex. Residents living in areas with lower exercise facility availability showed higher risk of type 2 diabetes (RR  = 1.25, CI95% 1.21-1.30) as well as macrovascular (RR  = 1.09 CI95% 1.00-1.19), and microvascular (RR  = 1.10 CI95% 1.01-1.19) complications. Associations were strongest in low SES areas for type 2 diabetes (RR  = 1.22, CI95% 1.12-1.32; RR  = 0.91, CI95% 0.85-0.98) and microvascular complications (RR  = 1.12, CI95% 0,94-1,33; RR  = 0.88, CI95% 0.73-1.05). Living in areas with lower availability of exercise facilities was associated with a greater risk of type 2 diabetes and its complications. Increasing exercise opportunities, particularly in low SES areas, could help reduce the social gradient of diabetes and its complications.

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UN Sustainable Development Goals (SDGs)

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

#3 Good Health and Well-Being

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