title: Influence of neighbourhood socioeconomic position on the transition to type II diabetes in older Mexican Americans: the Sacramento Area Longitudinal Study on Aging.
abstract: To examine the influence of neighbourhood socioeconomic position (NSEP) on development of diabetes over time.
  
  
  
  A longitudinal cohort study.
  
  
  
  The data reported were from the Sacramento Area Latino Study on Aging, a longitudinal study of the health of 1789 older Latinos.
  
  
  
  Community-dwelling older Mexican Americans residing in the Sacramento Metropolitan Statistical Area.
  
  
  
  Multistate Markov regression were used to model transitions through four possible states over time: 1=normal; 2=pre-diabetic; 3=diabetic; and 4=death without diabetes.
  
  
  
  At baseline, nearly 50% were non-diabetic, 17.5% were pre-diabetic and nearly 33% were diabetic. At the end of follow-up, there were a total of 824 people with type 2 diabetes. In a fully adjusted MSM regression model, among non-diabetics, higher NSEP was not associated with a transition to pre-diabetes. Among non-diabetics, higher NSEP was associated with an increased risk of diabetes (HR=1.66, 95% CI 1.14 to 2.42) and decreased risk of death without diabetes (HR: 0.56, 95% CI 0.33 to 0.96). Among pre-diabetics, higher NSEP was significantly associated with a transition to non-diabetic status (HR: 1.22, 95% CI 0.99 to 1.50). Adjusting for BMI, age, education, physical activity, smoking, alcohol consumption, medical insurance and nativity did not affect this relationship.
  
  
  
  Our findings show that high NSEP poses higher risk of progression from normal to diabetes compared with a lower risk of death without diabetes. This work presents a possibility that these associations are modified by nativity or culture.
authors: Department of Public Health Sciences, University of California, Davis, California, USA.
authors: Lorena
authors: L
authors: Garcia
authors: Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA.
authors: Anne
authors: A
authors: Lee
authors: Department of Epidemiology & Public health, University of Miami, Miami, Florida, USA.
authors: Adina
authors: A
authors: Zeki Al Hazzouri
authors: Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA.
authors: John M
authors: JM
authors: Neuhaus
authors: Department of Public Health Sciences, University of California, Davis, California, USA.
authors: Sally
authors: 0000-0003-0995-6239
authors: S
authors: Moyce
authors: Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA.
authors: Allison
authors: A
authors: Aiello
authors: Department of Epidemiology & Public health, University of Miami, Miami, Florida, USA.
authors: Tali
authors: T
authors: Elfassy
authors: Department of Epidemiology & Biostatistics, University of California, San Francisco, California, USA.
authors: Mary N
authors: MN
authors: Haan
mesh_terms: D000368:Aged; D000375:Aging; D002140:California / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008390:Markov Chains; D017058:Mexican Americans; D008875:Middle Aged; D008954:Models, Biological; D011236:Prediabetic State / Q000453:epidemiology*; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class
keywords: EPIDEMIOLOGY; PUBLIC HEALTH