Neighborhood Environment and Metabolic Risk in Hispanics/Latinos From the Hispanic Community Health Study/Study of Latinos


      This study examines the associations of neighborhood environments with BMI, HbA1c, and diabetes across 6 years in Hispanic/Latino adults.


      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.


      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.


      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 access
      One-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 to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. 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. Published 2019. Accessed September 15, 2020.

        • Schneiderman N
        • Llabre M
        • Cowie CC
        • et al.
        Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
        Diabetes Care. 2014; 37: 2233-2239
        • Avilés-Santa ML
        • Pérez CM
        • Schneiderman N
        • et al.
        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: 110-118
        • Isasi CR
        • Ayala GX
        • Sotres-Alvarez D
        • et al.
        Is acculturation related to obesity in Hispanic/Latino adults? Results from the Hispanic Community Health Study/Study of Latinos.
        J Obes. 2015; 2015186276
        • Hill-Briggs F
        • Adler NE
        • Berkowitz SA
        • et al.
        Social determinants of health and diabetes: a scientific review.
        Diabetes Care. 2020; 44: 258-279
        • Bailey ZD
        • Krieger N
        • Agénor M
        • Graves J
        • Linos N
        • Bassett MT.
        Structural racism and health inequities in the USA: evidence and interventions.
        Lancet. 2017; 389: 1453-1463
        • Churchwell K
        • Elkind MSV
        • Benjamin RM
        • et al.
        Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association.
        Circulation. 2020; 142: e454-e468
        • Bullard R
        Growing Smarter: Achieving Livable Communities, Environmental Justice, and Regional Equity.
        MIT Press, Cambridge, MA2007
        • Dendup T
        • Feng X
        • Clingan S
        • Astell-Burt T
        Environmental risk factors for developing type 2 diabetes mellitus: a systematic review.
        Int J Environ Res Public Health. 2018; 15: 78
        • den Braver NR
        • Lakerveld J
        • Rutters F
        • Schoonmade LJ
        • Brug J
        • Beulens JWJ.
        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: 12
        • Chandrabose M
        • Rachele JN
        • Gunn L
        • et al.
        Built environment and cardio-metabolic health: systematic review and meta-analysis of longitudinal studies.
        Obes Rev. 2019; 20: 41-54
        • Malambo P
        • Kengne AP
        • De Villiers A
        • Lambert EV
        • Puoane T.
        Built environment, selected risk factors and major cardiovascular disease outcomes: a systematic review.
        PLoS One. 2016; 11e0166846
        • Diez Roux AV
        • Mair C.
        Neighborhoods and health.
        Ann N Y Acad Sci. 2010; 1186: 125-145
        • Beulens JWJ
        • Pinho MGM
        • Abreu TC
        • et al.
        Environmental risk factors of type 2 diabetes-an exposome approach.
        Diabetologia. 2022; 65: 263-274
        • James P
        • Banay RF
        • Hart JE
        • Laden F.
        A review of the health benefits of greenness.
        Curr Epidemiol Rep. 2015; 2: 131-142
        • Hartig T
        • Mitchell R
        • de Vries S
        • Frumkin H.
        Nature and health.
        Annu Rev Public Health. 2014; 35: 207-228
        • Wong MS
        • Chan KS
        • Jones-Smith JC
        • Colantuoni E
        • Thorpe Jr, RJ
        • Bleich SN.
        The neighborhood environment and obesity: understanding variation by race/ethnicity.
        Prev Med. 2018; 111: 371-377
        • Garcia L
        • Lee A
        • Al Zeki
        • Zeki Al Hazzouri A
        • et al.
        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; 6e010905
        • Garcia L
        • Lee A
        • Zeki Al Hazzouri A
        • Neuhaus J
        • Epstein M
        • Haan M
        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: 77-85
        • McCurley JL
        • Gutierrez AP
        • Bravin JI
        • et al.
        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: 975-987
        • Lavange LM
        • Kalsbeek WD
        • Sorlie PD
        • et al.
        Sample design and cohort selection in the Hispanic Community Health Study/Study of Latinos.
        Ann Epidemiol. 2010; 20: 642-649
        • Gallo LC
        • Carlson JA
        • Sotres-Alvarez D
        • et al.
        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: 57-65
      2. 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.

        • Frank LD
        • Sallis JF
        • Saelens BE
        • et al.
        The development of a walkability index: application to the Neighborhood Quality of Life Study.
        Br J Sports Med. 2010; 44: 924-933
        • Sorlie PD
        • Avilés-Santa LM
        • Wassertheil-Smoller S
        • et al.
        Design and implementation of the Hispanic Community Health Study/Study of Latinos.
        Ann Epidemiol. 2010; 20: 629-641
        • Muthén LK
        • Muthén BO.
        Mplus User’s Guide. 8th. Muthén & Muthén, Los Angeles, CA1998-2012
        • Enders CK.
        Applied Missing Data Analysis.
        Guilford Press, New York, NY2010
        • Khambaty T
        • Schneiderman N
        • Llabre MM
        • et al.
        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: 188-199
        • Daviglus ML
        • Talavera GA
        • Avilés-Santa ML
        • et al.
        Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States.
        JAMA. 2012; 308: 1775-1784
        • Hirsch JA
        • Diez Roux AV
        • Moore KA
        • Evenson KR
        • Rodriguez DA
        Change in walking and body mass index following residential relocation: the Multi-ethnic Study of Atherosclerosis.
        Am J Public Health. 2014; 104: e49-e56
        • Braun LM
        • Rodríguez DA
        • Evenson KR
        • Hirsch JA
        • Moore KA
        Diez Roux AV. Walkability and cardiometabolic risk factors: cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis.
        Health Place. 2016; 39: 9-17
        • Christine PJ
        • Auchincloss AH
        • Bertoni AG
        • et al.
        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: 1311-1320
        • Fazli GS
        • Moineddin R
        • Chu A
        • Bierman AS
        • Booth GL.
        Neighborhood walkability and pre-diabetes incidence in a multiethnic population.
        BMJ Open Diabetes Res Care. 2020; 8e000908
        • Brown SC
        • Lombard J
        • Wang K
        • et al.
        Neighborhood greenness and chronic health conditions in Medicare beneficiaries.
        Am J Prev Med. 2016; 51: 78-89
        • South EC
        • Hohl BC
        • Kondo MC
        • MacDonald JM
        • Branas CC.
        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; 1e180298
        • Garvin EC
        • Cannuscio CC
        • Branas CC.
        Greening vacant lots to reduce violent crime: a randomised controlled trial.
        Inj Prev. 2013; 19: 198-203
        • Kondo MC
        • Andreyeva E
        • South EC
        • MacDonald JM
        • Branas CC.
        Neighborhood interventions to reduce violence.
        Annu Rev Public Health. 2018; 39: 253-271
        • Ross CE
        • Mirowsky J.
        Neighborhood socioeconomic status and health: context or composition?.
        City Commun. 2008; 7: 163-179
        • Oakes JM.
        The (mis)estimation of neighborhood effects: causal inference for a practicable social epidemiology.
        Soc Sci Med. 2004; 58: 1929-1952
      3. National Diabetes Statistics Report.
        Centers for Disease Control and Prevention, January 18, 2022 (HHS. Accessed February 1, 2022)
        • Haire-Joshu D
        • Hill-Briggs F.
        The next generation of diabetes translation: a path to health equity.
        Annu Rev Public Health. 2019; 40: 391-410
        • Siminerio LM
        • Albright A
        • Fradkin J
        • et al.
        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: 209-218