Association of community types and features in a case-control analysis of new onset type 2 diabetes across a diverse geography in Pennsylvania.
diabetes & endocrinology
epidemiology
public health
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
13 01 2021
13 01 2021
Historique:
entrez:
14
1
2021
pubmed:
15
1
2021
medline:
14
4
2021
Statut:
epublish
Résumé
To evaluate associations of community types and features with new onset type 2 diabetes in diverse communities. Understanding the location and scale of geographic disparities can lead to community-level interventions. Nested case-control study within the open dynamic cohort of health system patients. Large, integrated health system in 37 counties in central and northeastern Pennsylvania, USA. We used electronic health records to identify persons with new-onset type 2 diabetes from 2008 to 2016 (n=15 888). Persons with diabetes were age, sex and year matched (1:5) to persons without diabetes (n=79 435). We used generalised estimating equations to control for individual-level confounding variables, accounting for clustering of persons within communities. Communities were defined as (1) townships, boroughs and city census tracts; (2) urbanised area (large metro), urban cluster (small cities and towns) and rural; (3) combination of the first two; and (4) county. Community socioeconomic deprivation and greenness were evaluated alone and in models stratified by community types. Borough and city census tract residence (vs townships) were associated (OR (95% CI)) with higher odds of type 2 diabetes (1.10 (1.04 to 1.16) and 1.34 (1.25 to 1.44), respectively). Urbanised areas (vs rural) also had increased odds of type 2 diabetes (1.14 (1.08 to 1.21)). In the combined definition, the strongest associations (vs townships in rural areas) were city census tracts in urban clusters (1.41 (1.22 to 1.62)) and city census tracts in urbanised areas (1.33 (1.22 to 1.45)). Higher community socioeconomic deprivation and lower greenness were each associated with increased odds. Urban residence was associated with higher odds of type 2 diabetes than for other areas. Higher community socioeconomic deprivation in city census tracts and lower greenness in all community types were also associated with type 2 diabetes.
Identifiants
pubmed: 33441365
pii: bmjopen-2020-043528
doi: 10.1136/bmjopen-2020-043528
pmc: PMC7812110
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
e043528Subventions
Organisme : NCCDPHP CDC HHS
ID : U01 DP006293
Pays : United States
Organisme : NCCDPHP CDC HHS
ID : U01 DP006296
Pays : United States
Organisme : ACL HHS
ID : U01DP006293
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Epidemiology. 2016 Mar;27(2):163-72
pubmed: 26426945
Int J Environ Res Public Health. 2016 Mar 11;13(3):
pubmed: 26978381
Ann Epidemiol. 2018 Jan;28(1):20-25.e2
pubmed: 29233722
Diabet Med. 2013 Mar;30(3):e78-86
pubmed: 23127142
Health Aff (Millwood). 2019 Dec;38(12):1985-1992
pubmed: 31794304
Am J Prev Med. 2018 Mar;54(3):430-439
pubmed: 29241724
MMWR Surveill Summ. 2017 Nov 17;66(23):1-9
pubmed: 29145359
Am J Public Health. 2019 Jan;109(1):155-162
pubmed: 30496008
Diabetes Care. 2014;37(1):197-201
pubmed: 24026544
Am J Epidemiol. 2014 Jan 1;179(1):27-38
pubmed: 24100956
PLoS One. 2017 Mar 7;12(3):e0173428
pubmed: 28267760
Int J Health Geogr. 2019 Mar 27;18(1):6
pubmed: 30917821
Diabetes Care. 2018 Mar;41(3):461-468
pubmed: 29258994
Health Place. 2010 May;16(3):547-56
pubmed: 20129809
Public Health. 2012 Oct;126(10):813-20
pubmed: 22922043
Stat Methods Med Res. 2012 Feb;21(1):31-54
pubmed: 21030422
Eur J Public Health. 2020 Feb 1;30(1):189-194
pubmed: 31114865
Prev Chronic Dis. 2015 Jan 22;12:E08
pubmed: 25611797
J Urban Health. 2014 Apr;91(2):272-92
pubmed: 24366854
Pediatr Diabetes. 2014 Dec;15(8):573-84
pubmed: 24913103
J Diabetes Investig. 2020 Mar;11(2):315-324
pubmed: 31579986
Curr Epidemiol Rep. 2015 Jun;2(2):131-142
pubmed: 26185745
Int J Health Geogr. 2011 May 15;10:34
pubmed: 21575162
Int J Environ Res Public Health. 2019 Apr 28;16(9):
pubmed: 31035336
BMJ Open. 2018 Jan 21;8(1):e019062
pubmed: 29358439
Soc Sci Med. 2007 Nov;65(9):1953-64
pubmed: 17719709
Soc Sci Med. 2008 Sep;67(6):891-9
pubmed: 18599174
Am J Epidemiol. 2013 Jul 15;178(2):221-30
pubmed: 23648804
Am J Prev Med. 2011 Oct;41(4):e17-28
pubmed: 21961475
Health Aff (Millwood). 2019 Dec;38(12):2019-2026
pubmed: 31794313
J Rural Health. 2017 Apr;33(2):167-179
pubmed: 27557442
Obes Res. 2005 Jan;13(1):118-22
pubmed: 15761170
PLoS One. 2014 Feb 27;9(2):e89661
pubmed: 24586945
Am J Public Health. 2014 Nov;104(11):2122-9
pubmed: 25211763
MMWR Surveill Summ. 2017 Jan 13;66(2):1-7
pubmed: 28081057
Obesity (Silver Spring). 2015 Jan;23(1):207-12
pubmed: 25324223