Introduction
This study examines the associations of neighborhood environments with BMI, HbA1c,
and diabetes across 6 years in Hispanic/Latino adults.
Methods
Participants from the Hispanic Community Health Study/Study of Latinos San Diego site
(n=3,851, mean age=39.4 years, 53.3% women, 94.0% Mexican heritage) underwent assessment
of metabolic risk factors and diabetes status (categorized as normoglycemia, prediabetes,
and diabetes) at baseline (2008–2011) and approximately 6 years later (2014–2017).
In the Study of Latinos Community and Surrounding Areas Study ancillary study (2015–2020),
participant baseline addresses were geocoded, and neighborhoods were defined using 800-meter circular buffers. Neighborhood variables representing
socioeconomic deprivation, residential stability, social disorder, walkability, and
greenness were created using Census and other public databases. Analyses were conducted
in 2020–2021.
Results
Complex survey regression analyses revealed that greater neighborhood socioeconomic
deprivation was associated with higher BMI (β=0.14, p<0.001) and HbA1c (β=0.08, p<0.01) levels and a higher odds of worse diabetes status (i.e., having prediabetes
versus normoglycemia and having diabetes versus prediabetes; OR=1.25, 95% CI=1.06,
1.47) at baseline. Greater baseline neighborhood deprivation also was related to increasing
BMI (β=0.05, p<0.01) and worsening diabetes (OR=1.27, 95% CI=1.10, 1.46) statuses, whereas social
disorder was related to increasing BMI levels (β=0.05, p<0.05) at Visit 2. There were no associations of expected protective factors of walkability,
greenness, or residential stability.
Conclusions
Neighborhood deprivation and disorder were related to worse metabolic health in San
Diego Hispanic/Latino adults of mostly Mexican heritage. Multilevel interventions
emphasizing individual and structural determinants may be most effective in improving
metabolic health among Hispanic/Latino individuals.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
MA Villarroel, DL Blackwell, A Jen. Tables of summary health statistics for U.S. Adults: 2018 National Health Interview Survey. National Center for Health Statistics. ftp://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2018_SHS_Table_A-18.pdf. Published 2019. Accessed September 15, 2020.
- Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Diabetes Care. 2014; 37: 2233-2239https://doi.org/10.2337/dc13-2939
- Detecting prediabetes among Hispanics/Latinos from diverse heritage groups: does the test matter? Findings from the Hispanic Community Health Study/Study of Latinos.Prev Med. 2017; 95: 110-118https://doi.org/10.1016/j.ypmed.2016.12.009
- Is acculturation related to obesity in Hispanic/Latino adults? Results from the Hispanic Community Health Study/Study of Latinos.J Obes. 2015; 2015186276https://doi.org/10.1155/2015/186276
- Social determinants of health and diabetes: a scientific review.Diabetes Care. 2020; 44: 258-279https://doi.org/10.2337/dci20-0053
- Structural racism and health inequities in the USA: evidence and interventions.Lancet. 2017; 389: 1453-1463https://doi.org/10.1016/S0140-6736(17)30569-X
- Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association.Circulation. 2020; 142: e454-e468https://doi.org/10.1161/CIR.0000000000000936
- Growing Smarter: Achieving Livable Communities, Environmental Justice, and Regional Equity.MIT Press, Cambridge, MA2007
- Environmental risk factors for developing type 2 diabetes mellitus: a systematic review.Int J Environ Res Public Health. 2018; 15: 78https://doi.org/10.3390/ijerph15010078
- Built environmental characteristics and diabetes: a systematic review and meta-analysis [published correction appears in BMC Med. 2021;19(1):63].BMC Med. 2018; 16: 12https://doi.org/10.1186/s12916-017-0997-z
- Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies.Obes Rev. 2019; 20: 41-54https://doi.org/10.1111/obr.12759
- Built environment, selected risk factors and major cardiovascular disease outcomes: a systematic review.PLoS One. 2016; 11e0166846https://doi.org/10.1371/journal.pone.0166846
- Neighborhoods and health.Ann N Y Acad Sci. 2010; 1186: 125-145https://doi.org/10.1111/j.1749-6632.2009.05333.x
- Environmental risk factors of type 2 diabetes-an exposome approach.Diabetologia. 2022; 65: 263-274https://doi.org/10.1007/s00125-021-05618-w
- A review of the health benefits of greenness.Curr Epidemiol Rep. 2015; 2: 131-142https://doi.org/10.1007/s40471-015-0043-7
- Nature and health.Annu Rev Public Health. 2014; 35: 207-228https://doi.org/10.1146/annurev-publhealth-032013-182443
- The neighborhood environment and obesity: understanding variation by race/ethnicity.Prev Med. 2018; 111: 371-377https://doi.org/10.1016/j.ypmed.2017.11.029
- Influence of neighbourhood socioeconomic position on the transition to type II diabetes in older Mexican Americans: the Sacramento Area Longitudinal Study on Aging.BMJ Open. 2016; 6e010905https://doi.org/10.1136/bmjopen-2015-010905
- The impact of neighborhood socioeconomic position on prevalence of diabetes and prediabetes in older Latinos: the Sacramento Area Latino Study on Aging.Hisp Health Care Int. 2015; 13: 77-85https://doi.org/10.1891/1540-4153.13.2.77
- Association of Social adversity with comorbid diabetes and depression symptoms in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study: a syndemic framework.Ann Behav Med. 2019; 53: 975-987https://doi.org/10.1093/abm/kaz009
- Sample design and cohort selection in the Hispanic Community Health Study/Study of Latinos.Ann Epidemiol. 2010; 20: 642-649https://doi.org/10.1016/j.annepidem.2010.05.006
- The Hispanic Community Health Study/Study of Latinos Community and Surrounding Areas Study: sample, design, and procedures [published correction appears in Ann Epidemiol. 2019;32:78].Ann Epidemiol. 2019; 30: 57-65https://doi.org/10.1016/j.annepidem.2018.11.002
Robinson NP, Allred BW, Jones MO, et al. A dynamic landsat derived Normalized Difference Vegetation Index (NDVI) product for the conterminous United States. Remote Sens (Basel). 2017;9(8):863. https://doi.org/10.3390/rs9080863.
- The development of a walkability index: application to the Neighborhood Quality of Life Study.Br J Sports Med. 2010; 44: 924-933https://doi.org/10.1136/bjsm.2009.058701
- Design and implementation of the Hispanic Community Health Study/Study of Latinos.Ann Epidemiol. 2010; 20: 629-641https://doi.org/10.1016/j.annepidem.2010.03.015
- Mplus.Mplus User’s Guide. 8th. Muthén & Muthén, Los Angeles, CA1998-2012
- Applied Missing Data Analysis.Guilford Press, New York, NY2010
- Elucidating the multidimensionality of socioeconomic status in relation to metabolic syndrome in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Int J Behav Med. 2020; 27: 188-199https://doi.org/10.1007/s12529-020-09847-y
- Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States.JAMA. 2012; 308: 1775-1784https://doi.org/10.1001/jama.2012.14517
- Change in walking and body mass index following residential relocation: the Multi-ethnic Study of Atherosclerosis.Am J Public Health. 2014; 104: e49-e56https://doi.org/10.2105/AJPH.2013.301773
- Diez Roux AV. Walkability and cardiometabolic risk factors: cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis.Health Place. 2016; 39: 9-17https://doi.org/10.1016/j.healthplace.2016.02.006
- Longitudinal associations between neighborhood physical and social environments and incident type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis (MESA).JAMA Intern Med. 2015; 175: 1311-1320https://doi.org/10.1001/jamainternmed.2015.2691
- Neighborhood walkability and pre-diabetes incidence in a multiethnic population.BMJ Open Diabetes Res Care. 2020; 8e000908https://doi.org/10.1136/bmjdrc-2019-000908
- Neighborhood greenness and chronic health conditions in Medicare beneficiaries.Am J Prev Med. 2016; 51: 78-89https://doi.org/10.1016/j.amepre.2016.02.008
- Effect of greening vacant land on mental health of community-dwelling adults: a cluster randomized trial [published correction appears in JAMA Netw Open. 2018;1(4):e182583].JAMA Netw Open. 2018; 1e180298https://doi.org/10.1001/jamanetworkopen.2018.0298
- Greening vacant lots to reduce violent crime: a randomised controlled trial.Inj Prev. 2013; 19: 198-203https://doi.org/10.1136/injuryprev-2012-040439
- Neighborhood interventions to reduce violence.Annu Rev Public Health. 2018; 39: 253-271https://doi.org/10.1146/annurev-publhealth-040617-014600
- Neighborhood socioeconomic status and health: context or composition?.City Commun. 2008; 7: 163-179https://doi.org/10.1111/j.1540-6040.2008.00251.x
- The (mis)estimation of neighborhood effects: causal inference for a practicable social epidemiology.Soc Sci Med. 2004; 58: 1929-1952https://doi.org/10.1016/j.socscimed.2003.08.004
- National Diabetes Statistics Report.Centers for Disease Control and Prevention, January 18, 2022 (HHS. https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed February 1, 2022)
- The next generation of diabetes translation: a path to health equity.Annu Rev Public Health. 2019; 40: 391-410https://doi.org/10.1146/annurev-publhealth-040218-044158
- The National Diabetes Education Program at 20 years: lessons learned and plans for the future [published correction appears in Diabetes Care. 2018;41(5):1116].Diabetes Care. 2018; 41: 209-218https://doi.org/10.2337/dc17-0976
Article Info
Publication History
Published online: March 29, 2022
Identification
Copyright
© 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
