title: Association between neighborhood-level deprivation and disability in a community sample of people with diabetes.
abstract: OBJECTIVE
  The objective of the present study was to analyze the association between neighborhood deprivation and self-reported disability in a community sample of people with type 2 diabetes.
  
  
  METHODS
  Random digit dialing was used to select a sample of adults with self-reported diabetes aged 18-80 years in Quebec, Canada. Health status was assessed by the World Health Organization Disability Assessment Schedule II. Material and social deprivation was measured using the Pampalon index, which is based on the Canadian Census. Potential risk factors for disability included sociodemographic characteristics, socioeconomic status, social support, lifestyle-related factors (smoking, physical activity, and BMI), health care-related problems, duration of diabetes, insulin use, and diabetes-specific complications.
  
  
  RESULTS
  There was a strong association between disability and material and social deprivation in our sample (n = 1,439): participants living in advantaged neighborhoods had lower levels of disability than participants living in disadvantaged neighborhoods. The means +/- SD disability scores for men were 7.8 +/- 11.8, 12.0 +/- 11.8, and 18.1 +/- 19.4 for low, medium, and high deprivation areas, respectively (P < 0.001). The disability scores for women were 13.4 +/- 12.4, 14.8 +/- 15.9, and 18.9 +/- 16.2 for low, medium, and high deprivation areas, respectively (P < 0.01). Neighborhood deprivation was associated with disability even after controlling for education, household income, sociodemographic characteristics, race, lifestyle-related behaviors, social support, diabetes-related variables, and health care access problems.
  
  
  CONCLUSIONS
  The inclusion of neighborhood characteristics might be an important step in the identification and interpretation of risk factors for disability in diabetes.
authors.affiliation: Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada. norbert.schmitz@mcgill.ca
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
authors.forename: Danit
authors.initials: D
authors.lastname: Nitka
authors.forename: Genevieve
authors.initials: G
authors.lastname: Gariepy
authors.forename: Ashok
authors.initials: A
authors.lastname: Malla
authors.forename: JianLi
authors.initials: J
authors.lastname: Wang
authors.forename: Richard
authors.initials: R
authors.lastname: Boyer
authors.forename: Lyne
authors.initials: L
authors.lastname: Messier
authors.forename: Irene
authors.initials: I
authors.lastname: Strychar
authors.forename: Alain
authors.initials: A
authors.lastname: Lesage
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D048909:Diabetes Complications / Q000191:economics / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology; D003925:Diabetic Angiopathies; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011203:Poverty; D011792:Quebec / Q000453:epidemiology; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult
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