Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada.
Diabetes Care. 2009 Nov;32(11):1998-2004. doi: 10.2337/dc09-0838. Epub 2009 Aug 12.
The objective of the present study was to analyze the association between neighborhood deprivation and self-reported disability in a community sample of people with type 2 diabetes.
Random digit dialing was used to select a sample of adults with self-reported diabetes aged 18-80 years in Quebec, Canada. Health status was assessed by the World Health Organization Disability Assessment Schedule II. Material and social deprivation was measured using the Pampalon index, which is based on the Canadian Census. Potential risk factors for disability included sociodemographic characteristics, socioeconomic status, social support, lifestyle-related factors (smoking, physical activity, and BMI), health care-related problems, duration of diabetes, insulin use, and diabetes-specific complications.
There was a strong association between disability and material and social deprivation in our sample (n = 1,439): participants living in advantaged neighborhoods had lower levels of disability than participants living in disadvantaged neighborhoods. The means +/- SD disability scores for men were 7.8 +/- 11.8, 12.0 +/- 11.8, and 18.1 +/- 19.4 for low, medium, and high deprivation areas, respectively (P < 0.001). The disability scores for women were 13.4 +/- 12.4, 14.8 +/- 15.9, and 18.9 +/- 16.2 for low, medium, and high deprivation areas, respectively (P < 0.01). Neighborhood deprivation was associated with disability even after controlling for education, household income, sociodemographic characteristics, race, lifestyle-related behaviors, social support, diabetes-related variables, and health care access problems.
The inclusion of neighborhood characteristics might be an important step in the identification and interpretation of risk factors for disability in diabetes.
本研究旨在分析社区 2 型糖尿病患者人群中，邻里剥夺与自我报告残疾之间的关联。
在加拿大魁北克，通过随机数字拨号选择了年龄在 18-80 岁之间、自我报告患有糖尿病的成年人作为样本。健康状况通过世界卫生组织残疾评估表 II 进行评估。物质和社会剥夺程度通过基于加拿大人口普查的 Pampalon 指数进行衡量。残疾的潜在风险因素包括社会人口统计学特征、社会经济地位、社会支持、生活方式相关因素（吸烟、身体活动和 BMI）、医疗保健相关问题、糖尿病病程、胰岛素使用情况以及糖尿病特异性并发症。
在我们的样本中（n=1439），残疾与物质和社会剥夺之间存在很强的关联：居住在有利邻域的参与者的残疾程度低于居住在不利邻域的参与者。男性的残疾评分分别为低、中、高剥夺区的 7.8+/-11.8、12.0+/-11.8 和 18.1+/-19.4（P<0.001）。女性的残疾评分分别为低、中、高剥夺区的 13.4+/-12.4、14.8+/-15.9 和 18.9+/-16.2（P<0.01）。即使在控制了教育程度、家庭收入、社会人口统计学特征、种族、生活方式相关行为、社会支持、糖尿病相关变量以及医疗保健获取问题后，邻里剥夺仍与残疾相关。
纳入邻里特征可能是识别和解释糖尿病残疾风险因素的重要步骤。
