Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Department of Urban Studies and Planning, Massachusetts Institute of Technology, Cambridge, MA, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
Prev Med. 2023 May;170:107477. doi: 10.1016/j.ypmed.2023.107477. Epub 2023 Mar 12.
In prior research, perceived low neighborhood social cohesion (nSC) has been associated with prevalence of type 2 diabetes mellitus (T2DM); however, few studies have investigated the nSC-T2DM relationship among a large, racially/ethnically diverse, and nationally representative sample of the U.S. population. We used National Health Interview Survey (2013-2018) data to determine overall, age-, sex/gender-, and racial/ethnic-specific associations between nSC and T2DM among 170,432 adults. Self-reported nSC was categorized as low, medium, and high. T2DM was determined by participants being told they had diabetes by a health professional. We used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CI) while adjusting for confounders. Mean age was 47.4 ± 0.1 years, 52% were women, and 69% self-identified as Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of T2DM (PR = 1.22 [95% CI: 1.16-1.27]), after adjustment. A higher prevalence of T2DM was observed among participants 31-49 years old who perceived low vs. high nSC (PR = 1.36 [95% CI: 1.20-1.54]) and among participants ≥50 years old (PR = 1.18 [95% CI: 1.13-1.24]). Hispanic/Latinx women 18-30 years old in neighborhoods with low vs. high social cohesion had a higher prevalence of T2DM (PR = 3.70 [95% CI: 1.40-9.80]), whereas NH-Black women 18-30 years old in neighborhoods with medium vs. high social cohesion had a lower prevalence of T2DM (PR = 0.35 [95% CI: 0.14-0.89]). Our findings support the literature by demonstrating an association between neighborhood environment and T2DM as well as extend it by identifying determinants for intervention for T2DM.
在先前的研究中,感知到的邻里社会凝聚力低(nSC)与 2 型糖尿病(T2DM)的流行有关;然而,很少有研究调查过美国人口中大量、种族/民族多样化和具有全国代表性的样本中的 nSC-T2DM 关系。我们使用国家健康访谈调查(2013-2018 年)的数据,确定了 nSC 与 170432 名成年人的 T2DM 之间的总体、年龄、性别/性别和种族/民族特异性关联。自我报告的 nSC 分为低、中、高。T2DM 通过参与者被告知他们患有糖尿病的健康专业人员确定。我们使用具有稳健方差的泊松回归来估计患病率比(PR)和 95%置信区间(CI),同时调整混杂因素。平均年龄为 47.4±0.1 岁,52%为女性,69%自认为是非西班牙裔(NH)-白人。调整后,与高 nSC 相比,低 nSC 与 T2DM 的患病率较高相关(PR=1.22[95%CI:1.16-1.27])。在感知到低 nSC 的参与者中,年龄在 31-49 岁的参与者比年龄在高 nSC 的参与者中观察到 T2DM 的患病率更高(PR=1.36[95%CI:1.20-1.54]),而年龄在 50 岁以上的参与者中(PR=1.18[95%CI:1.13-1.24])。与高社会凝聚力相比,18-30 岁的西班牙裔/拉丁裔女性在社会凝聚力低的社区中 T2DM 的患病率较高(PR=3.70[95%CI:1.40-9.80]),而 18-30 岁的 NH-黑人女性在社会凝聚力中等的社区中 T2DM 的患病率较低(PR=0.35[95%CI:0.14-0.89])。我们的研究结果支持文献,证明邻里环境与 T2DM 之间存在关联,并通过确定 T2DM 的干预决定因素来扩展它。