Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, NSW, Australia.
School of Population Health, University of New South Wales, Sydney, NSW, Australia.
J Epidemiol Community Health. 2021 Feb;75(2):120-127. doi: 10.1136/jech-2020-214175. Epub 2020 Sep 23.
We examined to what extent perceived neighbourhood crime moderates, associations between type 2 diabetes mellitus (T2DM) and perceived local amenities, recreational facilities, footpaths and public transit, and potential mediation of environmental characteristics-T2DM association by physical activity, social contact, sleep and body mass index (BMI).
The 45 and Up Study data of 36, 224 individuals collected from 2010 to 2015 were analysed in 2019 using multilevel logistic regression to examine the association between T2DM and clustering of unfavourable built environment, and any difference in the association with increasing unfavourable environment and area disadvantage. We performed causal mediation analyses stratified by crime to examine whether crime moderated the strength of identified local amenities-T2DM pathways.
The results showed that irrespective of crime, perceived lack of local amenities was associated with increased odds of developing T2DM, and BMI mediated 40% and 30.3% of this association among those who reported unsafe and safe daytime crime, respectively. The proportion mediated by BMI among those who reported unsafe and safe night-time crime was 27.3% and 35.1%, respectively. Walking mediated 5.7% of the local amenities-T2DM association among those who reported safe daytime crime. The odds of T2DM increased with rising unfavourable environment and area disadvantage.
The results suggest that the availability of neighbourhood amenities may lower T2DM risk by increasing walking and reducing BMI regardless of area crime. Policies to enhance access to local amenities and prevent crime, especially in disadvantaged areas, may support healthy behaviour and physical health that can potentially reduce T2DM risk.
我们研究了感知邻里犯罪在多大程度上调节了 2 型糖尿病（T2DM）与感知当地便利设施、娱乐设施、人行道和公共交通之间的关联，以及环境特征与 T2DM 之间的关联是否可以通过身体活动、社会接触、睡眠和体重指数（BMI）来解释。
我们于 2019 年使用多层次逻辑回归分析了 2010 年至 2015 年收集的 36224 名参与者的 45 岁及以上研究数据，以检验 T2DM 与不利的建筑环境聚类之间的关联，以及随着不利环境和地区劣势的增加，这种关联的差异。我们进行了因果中介分析，按犯罪分层，以检验犯罪是否调节了确定的当地便利设施与 T2DM 之间的关系。
结果表明，无论犯罪情况如何，感知缺乏当地便利设施与 T2DM 的发病几率增加有关，而 BMI 分别在报告不安全和安全日间犯罪的人群中解释了该关联的 40%和 30.3%。在报告不安全和安全夜间犯罪的人群中，BMI 解释的比例分别为 27.3%和 35.1%。在报告安全日间犯罪的人群中，步行解释了当地便利设施与 T2DM 关联的 5.7%。T2DM 的发病几率随着不利环境和地区劣势的增加而增加。
结果表明，无论地区犯罪情况如何，提供邻里便利设施可能会通过增加步行和降低 BMI 来降低 T2DM 的风险。增强获得当地便利设施和预防犯罪的政策，特别是在贫困地区，可以支持健康行为和身体健康，从而有可能降低 T2DM 的风险。
