Neighborhood environmental health conditions as risk factors for type 2 diabetes among older adults

BACKGROUND: Type 2 diabetes imposes a growing burden in industrialized and developing countries alike. Physical and social factors in the neighborhood environment may influence the incidence and prevalence of diabetes through such risk factors as inactivity, poor diet, and obesity. The chronic stress of living in an unsafe or deprived neighborhood may lead to insulin resistance and metabolic syndrome, which can increase the risk of Type 2 diabetes. This study investigates how neighborhood environmental factors affect the risk of Type 2 diabetes. METHODS: This research uses data from a nationally representative, longitudinal study of around 12,000 older people and their partners living in the community in England. The data include responses from face-to-face interviews as well as physical measurements and biological samples (e.g. fasting blood sugar and glycosylated hemoglobin). Neighborhood-level variables include vandalism, graffiti, and the perception of whether the neighborhood is safe for walking alone after dark. Two waves of questionnaire data were merged with the physical data. Multivariate regression models were used to examine relationships between neighborhood-level variables and incidence of diabetes. RESULTS: After adjustment for individual-level characteristics (including age, gender, education, race, BMI, history of heart attack and stroke), neighborhood conditions were found to be associated with a higher incidence of Type 2 diabetes. CONCLUSIONS: The association between physical and social conditions of the neighborhood environment and Type 2 diabetes among older adults deserves further investigation.