Diabetes Risk Increased in Poor Neighborhoods

Longjian Liu, MD, PhD, MSc(LSHTM), FAHA Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics Senior Investigator, Center for Health Equality Drexel University School of Public Health, and Adjunct Associate Professor of Medicine, Drexel U. College of Medicine MedicalResearch.com Interview with:
Longjian Liu, MD, PhD, MSc(LSHTM), FAHA
Interim Chair, Department of Environmental and Occupational Health Associate Professor, Department of Epidemiology and Biostatistics, Senior Investigator, Center for Health Equality
Drexel University School of Public Health, and
Adjunct Associate Professor of Medicine, Drexel U. College of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Liu: The prevalence of diabetes is increasing rapidly in the United States and worldwide. In 2010, 25.8 million Americans, or 8.3% of the population had diabetes in the United States. In 2012, these figures were 29.1 million, or 9.3% in the nation. Philadelphia, the largest city in PA, ranks as the 5th largest city in the nation. However, the city also had the highest prevalence of diabetes according to the national surveys in 2009. We face a great challenge to stop the epidemic of diabetes locally and nationally. It is well-known personal risk factors at individual level, including lifestyles, play a role in the prevention and control of diabetes. However very limited studies addressed the importance that physical and socioeconomic environmental factors at community level may also play a pivotal role in the prevention and control of the disease. This study aimed to quantitatively examine (1) the trend of diabetes from 2002 to 2010 in the city of Philadelphia, and (2) the impact of physical and socioeconomic environmental factors at community level (assessed using zip-codes based neighborhoods) on the risk of the prevalence of diabetes.

The main findings support our hypotheses that

  • (1) the prevalence of diabetes significantly increased from 2002 to 2012.
  • (2) residents who lived in neighborhoods with physical and socioeconomic disadvantage had an increased risk of the prevalence of diabetes.

Medical Research: What should clinicians and patients take away from your report?

Dr. Liu: Early diagnosis of diabetes is the key to control the disease. However, more than one third of patients with diabetes are undiagnosed. If a physician understands that environmental factors, not only personal factors, play a role in the risk of diabetes, they may identify patients with high risk of diabetes at early stage when they provide healthcare service for population who live in certain disadvantaged areas.

Patients: Findings of the study support previous studies that risk factors at individual level, including overweight, obesity and physical inactivity, remain the key risk factors of the development of diabetes. Patients should adhere to healthy lifestyles in order to prevent and control of the disease. Meanwhile, residents and local health policymakers should be aware of the importance of improving physical and socioeconomic environment status at community level that may offers an additional positive impact on the control of diabetes.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Liu: On the basis of the findings from the study we are setting up a project, entitled, Health Outcomes, Prevention and Evaluation (HOPE) Study with focusing on studies of diabetes and cardiovascular disparity in the city of Philadelphia.

Citation:

Longjian Liu, Ana E. Núñez. Multilevel and Urban Health Modeling of Risk Factors for Diabetes Mellitus: A New Insight into Public Health and Preventive Medicine. Advances in Preventive Medicine, 2014; 2014: 1 DOI: 10.1155/2014/246049