title: Neighborhood walkability, deprivation and incidence of type 2 diabetes: a population-based study on 512,061 Swedish adults.
abstract: Neighborhood walkability has been associated with increased physical activity, but only a few studies have explored the association between walkability and health outcomes related to physical activity, such as type 2 diabetes. The aim of this study was to investigate the association between objectively assessed neighborhood walkability and the 4-year incidence of type 2 diabetes in a sample of 512,061 Swedish adults aged 18 years and older. Neighborhoods were defined by 408 administratively defined geographical areas in the city of Stockholm. We found a negative association between walkability and type 2 diabetes (OR=1.33, 95% CI=1.13-1.55) that remained significant after adjusting for neighborhood deprivation. This association, however, no longer remained statistically significant after adjusting for individual socio-demographic factors. These results were also confirmed using a co-sibling design. Future studies are encouraged to further explore the potential effect of a broader array of the neighborhood built environment on health outcomes related to physical activity.
authors.affiliation: Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden. Electronic address: Kristina.Sundquist@med.lu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden. Electronic address: kosteruffe@hotmail.com.
authors.forename: Ulf
authors.initials: U
authors.lastname: Eriksson
authors.affiliation: Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, PO Box 980212, Richmond, 23238 VA, USA. Electronic address: bmezuk@vcu.edu.
authors.forename: Briana
authors.initials: B
authors.lastname: Mezuk
authors.affiliation: Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden. Electronic address: Henrik.Ohlsson@med.lu.se.
authors.forename: Henrik
authors.initials: H
authors.lastname: Ohlsson
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004779:Environment Design; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016138:Walking
keywords: Diabetes mellitus; Epidemiology; Geographic information systems; Neighborhood deprivation; Walkability