Abstract P151: Neighborhood-Level Socioeconomic Deprivation Is Associated with Diabetes Mellitus in a Multi-Ethnic Population: The Dallas Heart Study

Abstract

Background: Although neighborhood-level socioeconomic deprivation has been associated with obesity, its relationship with diabetes, a cardio-metabolic risk factor and determinant of cardiovascular health, is poorly understood. Methods and Results: We examined the relationship between neighborhood-level socioeconomic deprivation and prevalent diabetes in the Dallas Heart Study (DHS), a multi-ethnic, population-based sample of Dallas County residents aged 18-65 (N=1621). Participants underwent detailed examination between 2000-2002. Geo-coded home addresses defined neighborhood block groups; a neighborhood-level deprivation index (NDI) for Dallas County was created using factor analysis based on 21 Census block-group characteristics (higher scores=greater neighborhood-level deprivation). Diabetes was defined by self-report, use of anti-hyperglycemic medication, or fasting glucose≥126 mg/dl. Logistic regression modeling was used to determine odds of prevalent diabetes for those in highest vs. lowest NDI tertile. In DHS, diabetes prevalence was 5%, 13%, and 16% across NDI tertiles (p<0.001). In modeling diabetes, we found a significant interaction between race and NDI (p=0.03); therefore, models were race-stratified. White, Hispanic, and black DHS participants in neighborhoods in the highest NDI tertile were up to seven times more likely to have diabetes than those living in the lowest tertile (Table). In whites and Hispanics, higher deprivation remained associated with a greater likelihood of diabetes after adjustment for age, sex, smoking, and education and was only attenuated after adjusting for income. In contrast, adjustment for confounders attenuated the relationship between NDI and diabetes among blacks. Conclusions: Residing in socioeconomically deprived neighborhoods is associated with prevalent diabetes among whites and Hispanics in DHS. These data suggest racial/ethnic disparities in cardio-metabolic risk within areas of higher socioeconomic deprivation in Dallas County.