title: Neighborhood social and physical environments and type 2 diabetes mellitus in African Americans: The Jackson Heart Study.
abstract: Using data from Jackson Heart Study, we investigated the associations of neighborhood social and physical environments with prevalence and incidence of type 2 diabetes mellitus (T2DM) in African Americans (AA). Among non-diabetic participants at baseline (n=3670), 521 (14.2%) developed T2DM during a median follow-up of 7.3 years. Measures of neighborhood social environments, and food and physical activity resources were derived using survey-and GIS-based methods. Prevalence ratios (PR) and Hazard ratios (HR) were estimated using generalized estimating equations and Cox proportional hazards models. Higher neighborhood social cohesion was associated with a 22% lower incidence of T2DM while higher density of unfavorable food stores was associated with a 34% higher incidence of T2DM after adjusting for individual-level risk factors (HR=0.78 [95% CI:0.62, 0.99] and HR=1.34 [1.12, 1.60], respectively). In addition, neighborhood problems was also associated with prevalence of T2DM (PR=1.12 [1.03, 1.21]) independent of individual-level risk factors. Our findings suggest that efforts to strengthen community ties or to attract healthy food retail outlets might be important strategies to consider for prevention of T2DM in AA.
authors.affiliation: National Human Genome Research Institute, Genomics of Metabolic, Cardiovascular and Inflammatory Branch, Cardiovascular Section, Social Epidemiology Research Unit, 10 Center Drive, Room 7N316, MSC 1644, Bethesda. Electronic address: samson.gebreab@nih.gov.
authors.forename: Samson Y
authors.initials: SY
authors.lastname: Gebreab
authors.affiliation: School of Public Health Initiative, Jackson State University, Jackson, MS, USA.
authors.forename: DeMarc A
authors.initials: DA
authors.lastname: Hickson
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Sims
authors.affiliation: School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Sharon B
authors.initials: SB
authors.lastname: Wyatt
authors.affiliation: National Human Genome Research Institute, Genomics of Metabolic, Cardiovascular and Inflammatory Branch, Cardiovascular Section, Social Epidemiology Research Unit, 10 Center Drive, Room 7N320, MSC 1644, Bethesda, MD, USA.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Davis
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Correa
authors.affiliation: Center for Integrative Approaches to Health Disparities, Philadelphia, PA, USA; School of Public Health, Drexel University, Philadelphia, PA, USA.
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology; D000072001:Diet, Healthy; D004779:Environment Design; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology / Q000208:ethnology
keywords: African Americans; Food stores; Longitudinal analysis; Neighborhood measures; Physical activity resources; Prevention; Social environments; Type 2 diabetes mellitus