Association between neighborhood-level deprivation and disability in a community sample of people with diabetes.
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.
Schmitz
Norbert
N
Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada. norbert.schmitz@mcgill.ca
Nitka
Danit
D
Gariepy
Genevieve
G
Malla
Ashok
A
Wang
JianLi
J
Boyer
Richard
R
Messier
Lyne
L
Strychar
Irene
I
Lesage
Alain
A
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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