Logo image
Back
Impact of land use and food environment on risk of type 2 diabetes: A national study of veterans, 2008–2018
Journal article   Open access   Peer reviewed

Impact of land use and food environment on risk of type 2 diabetes: A national study of veterans, 2008–2018

Sandra India-Aldana, Rania Kanchi, Samrachana Adhikari, Priscilla Lopez, Mark D. Schwartz, Brian D. Elbel, Pasquale E. Rummo, Melissa A. Meeker, Gina S. Lovasi, Karen R. Siegel, …
Environmental research, v 212(Pt A), 113146
Sep 2022
DOI: https://doi.org/10.1016/j.envres.2022.113146
PMID: 35337829
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424702View
Accepted (AM)Open Access (License Unspecified),  Open
url
https://doi.org/10.1016/j.envres.2022.113146View
Published, Version of Record (VoR) Open

Abstract

Food environment Land use environment Type 2 diabetes Veterans
Large-scale longitudinal studies evaluating influences of the built environment on risk for type 2 diabetes (T2D) are scarce, and findings have been inconsistent. To evaluate whether land use environment (LUE), a proxy of neighborhood walkability, is associated with T2D risk across different US community types, and to assess whether the association is modified by food environment. The Veteran's Administration Diabetes Risk (VADR) study is a retrospective cohort of diabetes-free US veteran patients enrolled in VA primary care facilities nationwide from January 1, 2008, to December 31, 2016, and followed longitudinally through December 31, 2018. A total of 4,096,629 patients had baseline addresses available in electronic health records that were geocoded and assigned a census tract-level LUE score. LUE scores were divided into quartiles, where a higher score indicated higher neighborhood walkability levels. New diagnoses for T2D were identified using a published computable phenotype. Adjusted time-to-event analyses using piecewise exponential models were fit within four strata of community types (higher-density urban, lower-density urban, suburban/small town, and rural). We also evaluated effect modification by tract-level food environment measures within each stratum. In adjusted analyses, higher LUE had a protective effect on T2D risk in rural and suburban/small town communities (linear quartile trend test p-value <0.001). However, in lower density urban communities, higher LUE increased T2D risk (linear quartile trend test p-value <0.001) and no association was found in higher density urban communities (linear quartile trend test p-value = 0.317). Particularly strong protective effects were observed for veterans living in suburban/small towns with more supermarkets and more walkable spaces (p-interaction = 0.001). Among veterans, LUE may influence T2D risk, particularly in rural and suburban communities. Food environment may modify the association between LUE and T2D.

Metrics

21 Record Views
6 citations in Web of Science
7 citations in Scopus

Details

UN Sustainable Development Goals (SDGs)

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

#3 Good Health and Well-Being

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

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