title: The geography of diabetes in London, Canada: the need for local level policy for prevention and management.
abstract: Recent reports aimed at improving diabetes care in socially disadvantaged populations suggest that interventions must be tailored to meet the unique needs of the local community-specifically, the community's geography. We have examined the spatial distribution of diabetes in the context of socioeconomic determinants of health in London (Ontario, Canada) to characterize neighbourhoods in an effort to target these neighbourhoods for local level community-based program planning and intervention. Multivariate spatial-statistical techniques and geographic information systems were used to examine diabetes rates and socioeconomic variables aggregated at the census tract level. Creation of a deprivation index facilitated investigation across multiple determinants of health. Findings from our research identified 'at risk' neighbourhoods in London with socioeconomic disadvantage and high diabetes. Future endeavours must continue to identify local level trends in order to support policy development, resource planning and care for improved health outcomes and improved equity in access to care across geographic regions.
authors.affiliation: Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada. jordan.tompkins@uwo.ca
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tompkins
authors.forename: Isaac N
authors.initials: IN
authors.lastname: Luginaah
authors.forename: Gillian L
authors.initials: GL
authors.lastname: Booth
authors.forename: Stewart B
authors.initials: SB
authors.lastname: Harris
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D040362:Geographic Information Systems; D006291:Health Policy; D006801:Humans; D008297:Male; D009864:Ontario / Q000453:epidemiology; D025341:Principal Component Analysis