Department of Geography, University of Utah, Salt Lake City, UT, USA.
Department of Geography, University of Utah, Salt Lake City, UT, USA.
Soc Sci Med. 2021 Jun;278:113952. doi: 10.1016/j.socscimed.2021.113952. Epub 2021 Apr 19.
Type 1 Diabetes (T1D) poses an increasing threat to public health, as incidence rates continue to rise globally. However, the etiology of T1D is still poorly understood, especially from the perspective of geography. The objective of this research is to examine the incidence of T1D among youth and to identify high-risk clusters and their association with socio-demographic and geographic variables. The study area was the entire state of Utah and included youth with T1D from birth to 19 years of age from 1998 to 2015 (n = 4161). Spatial clustering was measured both globally and locally using the Moran's I statistic and spatial scan statistic. Ordinary least squares (OLS) regression was used to measure the association of high-risk clusters with certain risk factors at the Census Block Group (CBG) level. The mean age at diagnosis was 9.3 years old. The mean incidence rate was 25.67 per 100,000 person-years (95% CI, 24.57-26.75). The incidence rate increased by 14%, from 23.94 per100,000 person-years in 1998 to 27.98 per 100,000 person-years in 2015, with an annual increase of 0.80%. The results of the spatial scan statistic found 42 high-risk clusters throughout the state. OLS regression analysis found a significant association with median household income, population density, and latitude. This study provides evidence that incidence rates of T1D are increasing annually in the state of Utah and that significant geographic high-risk clusters are associated with socio-demographic and geographic factors.
1 型糖尿病（T1D）对公共健康构成的威胁日益增加，全球发病率持续上升。然而，T1D 的病因仍不清楚，特别是从地理角度来看。本研究旨在调查青少年 T1D 的发病情况，并确定高危聚集区及其与社会人口学和地理变量的关系。研究区域为犹他州全境，包括 1998 年至 2015 年期间出生至 19 岁的 T1D 青少年（n=4161）。使用 Moran's I 统计量和空间扫描统计量分别从全局和局部测量空间聚类。使用普通最小二乘法（OLS）回归测量高危聚集区与人口普查街区组（CBG）层面特定危险因素的关联。诊断时的平均年龄为 9.3 岁。平均发病率为 25.67/100000 人年（95%CI，24.57-26.75）。发病率增加了 14%，从 1998 年的 23.94/100000 人年增加到 2015 年的 27.98/100000 人年，年增长率为 0.80%。空间扫描统计量的结果在全州范围内发现了 42 个高危聚集区。OLS 回归分析发现与家庭中位数收入、人口密度和纬度有显著关联。本研究表明，犹他州 T1D 的发病率每年都在增加，且显著的地理高危聚集区与社会人口学和地理因素有关。
