Moreno Gerardo, Morales Leo S, Nuñez de Jaimes Fatima, Tseng Chi-Hong, Isiordia Marilu, Noguera Christine, Mangione Carol M
Department of Family Medicine, UCLA, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA,
J Community Health. 2014 Dec;39(6):1077-84. doi: 10.1007/s10900-014-9854-6.
Little is known about how neighborhood perceptions are related to diabetes outcomes among Latinos living in rural agricultural communities. Our objective was to examine the association between perceived neighborhood problems and diabetes outcomes. This is a cross-sectional survey study with medical record reviews of a random sample of 250 adult Latinos with type 2 diabetes. The predictor was a rating of patient ratings of neighborhood problems (crime, trash and litter, lighting at night, and access to exercise facilities, transportation, and supermarkets). The primary outcomes were the control of three intermediate outcomes [LDL-cholesterol (LDL-c) < 100 mg/dl, AlC < 9.0 %, and blood pressure (BP) < 140/80 mmHg], and body mass index (BMI) < 30 kg/m(2). Secondary outcomes were participation in self-care activities (physical activity, healthy eating, medication adherence, foot checks, and glucose checks). We used regression analysis and adjusted for age, gender, education, income, years with diabetes, insulin use, depressive symptoms, and co-morbidities. Forty-eight percent of patients perceived at least one neighborhood problem and out of the six problem areas, crime was most commonly perceived as a problem. Perception of neighborhood problems was independently associated with not having a BP < 140/80 [Adjusted odds ratio (AOR) = 0.45; 95 % CI 0.22, 0.92], and BMI < 30 (AOR = 0.43; 95 % CI 0.24, 0.77), after controlling for covariates. Receipt of recommended processes of care was not associated with perception of neighborhood. Perception of neighborhood problems among low-income rural Latinos with diabetes was independently associated with a higher BMI and BP.
对于居住在农村农业社区的拉丁裔人群，邻里认知与糖尿病预后之间的关系鲜为人知。我们的目标是研究感知到的邻里问题与糖尿病预后之间的关联。这是一项横断面调查研究，对250名成年2型糖尿病拉丁裔患者的随机样本进行病历回顾。预测因素是患者对邻里问题（犯罪、垃圾和乱扔杂物、夜间照明以及获得健身设施、交通和超市的机会）的评分。主要结局是三项中间结局的控制情况[低密度脂蛋白胆固醇（LDL-c）<100mg/dl、糖化血红蛋白（AlC）<9.0%和血压（BP）<140/80mmHg]，以及体重指数（BMI）<30kg/m²。次要结局是参与自我护理活动（体育锻炼、健康饮食、药物依从性、足部检查和血糖检查）。我们使用回归分析，并对年龄、性别、教育程度、收入、糖尿病病程、胰岛素使用、抑郁症状和合并症进行了校正。48%的患者感知到至少一个邻里问题，在六个问题领域中，犯罪最常被视为一个问题。在控制协变量后，邻里问题的感知与血压未<140/80[校正比值比（AOR）=0.45；95%置信区间0.22，0.92]以及BMI<30（AOR=0.43；95%置信区间0.24，0.77）独立相关。接受推荐的护理流程与邻里感知无关。低收入农村糖尿病拉丁裔人群对邻里问题的感知与较高的BMI和血压独立相关。
