Journal article
Longitudinal Associations Between Neighborhood Physical and Social Environments and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)
JAMA internal medicine, v 175(8), pp 1311-1320
Aug 2015
PMID: 26121402
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Neighborhood environments may influence the risk for developing type 2 diabetes mellitus (T2DM), but, to our knowledge, no longitudinal study has evaluated specific neighborhood exposures.
To determine whether long-term exposures to neighborhood physical and social environments, including the availability of healthy food and physical activity resources and levels of social cohesion and safety, are associated with incident T2DM during a 10-year period.
We used data from the Multi-Ethnic Study of Atherosclerosis, a population-based cohort study of adults aged 45 to 84 years at baseline (July 17, 2000, through August 29, 2002). A total of 5124 participants free of T2DM at baseline underwent 5 clinical follow-up examinations from July 17, 2000, through February 4, 2012. Time-varying measurements of neighborhood healthy food and physical activity resources and social environments were linked to individual participant addresses. Neighborhood environments were measured using geographic information system (GIS)- and survey-based methods and combined into a summary score. We estimated hazard ratios (HRs) of incident T2DM associated with cumulative exposure to neighborhood resources using Cox proportional hazards regression models adjusted for age, sex, income, educational level, race/ethnicity, alcohol use, and cigarette smoking. Data were analyzed from December 15, 2013, through September 22, 2014.
Incident T2DM defined as a fasting glucose level of at least 126 mg/dL or use of insulin or oral antihyperglycemics.
During a median follow-up of 8.9 years (37,394 person-years), 616 of 5124 participants (12.0%) developed T2DM (crude incidence rate, 16.47 [95% CI, 15.22-17.83] per 1000 person-years). In adjusted models, a lower risk for developing T2DM was associated with greater cumulative exposure to indicators of neighborhood healthy food (12%; HR per interquartile range [IQR] increase in summary score, 0.88 [95% CI, 0.79-0.98]) and physical activity resources (21%; HR per IQR increase in summary score, 0.79 [95% CI, 0.71-0.88]), with associations driven primarily by the survey exposure measures. Neighborhood social environment was not associated with incident T2DM (HR per IQR increase in summary score, 0.96 [95% CI, 0.88-1.07]).
Long-term exposure to residential environments with greater resources to support physical activity and, to a lesser extent, healthy diets was associated with a lower incidence of T2DM, although results varied by measurement method. Modifying neighborhood environments may represent a complementary, population-based approach to prevention of T2DM, although further intervention studies are needed.
Metrics
Details
- Title
- Longitudinal Associations Between Neighborhood Physical and Social Environments and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA)
- Creators
- Paul J Christine - Department of Epidemiology, University of Michigan School of Public Health, Ann ArborAmy H Auchincloss - Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PennsylvaniaAlain G Bertoni - Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North CarolinaMercedes R Carnethon - Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IllinoisBrisa N Sánchez - Department of Biostatistics, University of Michigan School of Public Health, Ann ArborKari Moore - Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PennsylvaniaSara D Adar - Department of Epidemiology, University of Michigan School of Public Health, Ann ArborTamara B Horwich - Department of Medicine and Cardiology, David Geffen School of Medicine, University of California, Los AngelesKarol E Watson - Department of Medicine and Cardiology, David Geffen School of Medicine, University of California, Los AngelesAna V Diez Roux - Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, Pennsylvania
- Publication Details
- JAMA internal medicine, v 175(8), pp 1311-1320
- Publisher
- American Medical Association; United States
- Grant note
- R01 HL071759 / NHLBI NIH HHS N01HC95169 / NHLBI NIH HHS N01 HC095164 / NHLBI NIH HHS UL1 RR025005 / NCRR NIH HHS N01-HC-95168 / NHLBI NIH HHS N01-HC-95165 / NHLBI NIH HHS UL1-RR-025005 / NCRR NIH HHS N01-HC-95160 / NHLBI NIH HHS N01 HC095165 / NHLBI NIH HHS N01-HC-95162 / NHLBI NIH HHS N01-HC-95169 / NHLBI NIH HHS N01HC95159 / NHLBI NIH HHS UL1-RR-024156 / NCRR NIH HHS N01-HC-95159 / NHLBI NIH HHS N01 HC095159 / NHLBI NIH HHS N01-HC-95166 / NHLBI NIH HHS UL1 RR024156 / NCRR NIH HHS N01 HC095166 / NHLBI NIH HHS N01-HC-95163 / NHLBI NIH HHS N01-HC-95161 / NHLBI NIH HHS N01-HC-95167 / NHLBI NIH HHS N01-HC-95164 / NHLBI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Epidemiology and Biostatistics
- Web of Science ID
- WOS:000361057700013
- Scopus ID
- 2-s2.0-84939840005
- Other Identifier
- 991014877780004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health