Journal article
Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain
Journal of epidemiology and community health (1979), pjech-2023-221198
07 Mar 2024
PMID: 38453450
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundEvidence has shown contradicting results on how the density of urban green spaces may reduce socioeconomic inequalities in type 2 diabetes (equigenic hypothesis). The aim of this study is to test whether socioeconomic inequalities in diabetes prevalence are modified by park density.MethodsWe designed a population-wide cross-sectional study of all adults registered in the primary healthcare centres in the city of Madrid, Spain (n=1 305 050). We obtained georeferenced individual-level data from the Primary Care Electronic Health Records, and census-tract level data on socioeconomic status (SES) and park density. We modelled diabetes prevalence using robust Poisson regression models adjusted by age, country of origin, population density and including an interaction term with park density, stratified by gender. We used this model to estimate the Relative Index of Inequality (RII) at different park density levels.FindingsWe found an overall RII of 2.90 (95% CI 2.78 to 3.02) and 4.50 (95% CI 4.28 to 4.74) in men and women, respectively, meaning that the prevalence of diabetes was three to four and a half times higher in low SES compared with high SES areas. These inequalities were wider in areas with higher park density for both men and women, with a significant interaction only for women (p=0.008).InterpretationWe found an inverse association between SES and diabetes prevalence in both men and women, with wider inequalities in areas with more parks. Future works should study the mechanisms of these findings, to facilitate the understanding of contextual factors that may mitigate diabetes inequalities.
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Details
- Title
- Modifying effect of urban parks on socioeconomic inequalities in diabetes prevalence: a cross-sectional population study of Madrid City, Spain
- Creators
- Elena Plans-Beriso - Instituto de Salud Carlos IIIPedro Gullon - Universidad de AlcaláMario Fontan-Vela - Public Health and Epidemiology Research Group, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcala de Henares, Alcala de Henares, SpainManuel Franco - Departamento de SaludBeatriz Perez-Gomez - CIBERESP (CIBER of Epidemiology and Public Health), Madrid, SpainMarina Pollan - Centro de Investigación Biomédica en Red de Epidemiología y Salud PúblicaIsabel Cura-Gonzalez - Instituto de Salud Carlos IIIUsama Bilal - Drexel University
- Publication Details
- Journal of epidemiology and community health (1979), pjech-2023-221198
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- PI18/00782 / Instituto de Salud Carlos III (http://dx.doi.org/10.13039/501100004587)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:001181907700001
- Scopus ID
- 2-s2.0-85187717182
- Other Identifier
- 991021861876904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health