title: Immigrant enclaves and risk of diabetes: a prospective study.
abstract: BACKGROUND
  The diversity of the Swedish population has increased substantially over the past three decades. The aim of this study was to assess whether living in an ethnic enclave is associated with risk of diabetes mellitus (DM) among first and second-generation immigrants and native Swedes.
  
  
  METHODS
  Cumulative incidence of DM in three urban municipalities was assessed from 2006-2010 by linking records from the national census, multi-generational family register, and prescription drug register. Immigrant enclaves were identified using Moran's Index. Multi-level logistic regression was used to assess the relationship between enclave residence and risk of DM for three groups: Iraqi immigrants, non-Iraqi immigrants, and native Swedes (N = 887,603).
  
  
  RESULTS
  The cumulative incidence of DM was greater in Iraqi enclaves compared to other neighborhoods (4.7% vs. 2.3%). Among Iraqi immigrants, enclave residence was not associated with odds of DM (Odds ratio (OR): 1.03, 95% Confidence Interval (CI): 0.86 - 1.24). Among other immigrants, enclave residence was not associated with DM after accounting for neighborhood deprivation. Among native Swedes, enclave residence was associated with elevated risk of DM even after accounting for neighborhood deprivation and individual-level characteristics (OR: 1.23, 95% CI: 1.11 - 1.36).
  
  
  CONCLUSIONS
  Residential ethnic composition is associated with DM but this relationship differs across ethnic group. Enclave residence is not associated with increased odds of DM for immigrants, regardless of their nation of origin, but it is associated with increased likelihood of DM for native Swedes.
authors.affiliation: Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University School of Medicine, P,O, Box 980212, Richmond, VA 23298, USA. bmezuk@vcu.edu.
authors.forename: Briana
authors.initials: B
authors.lastname: Mezuk
authors.forename: Klas
authors.initials: K
authors.lastname: Cederin
authors.forename: Xinjun
authors.initials: X
authors.lastname: Li
authors.forename: Kristen
authors.initials: K
authors.lastname: Rice
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
mesh_terms: D000328:Adult; D000368:Aged; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007493:Iraq / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D011446:Prospective Studies; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012306:Risk; D013548:Sweden / Q000453:epidemiology