An Empirical Analysis of the Relationship Between Diabetes and Demographic, Socioeconomic and Built Environment Factors Across Turkish Cities

Abstract

Demographic, socioeconomic, and built environment factors of cities are considered among risk factors for many Noncommunicable Diseases (NCDs). Decreasing NCDs and supporting healthy, high-quality urban environments is one of the United Nations’ Sustainable Development Goals (SDGs). In particular, diabetes is related to quality of life and physical activity, making the disease more responsive to built environment factors. This study examines the geographical distribution of diabetes disease rate and its risk factors across Turkish cities. Principal component analysis and spatial regression models are used for this purpose. It is observed that green areas with high accessibility can increase physical activity and thus have a reducing effect on diabetes prevalence. In addition, in cities with sufficient healthcare services per capita, diabetes prevalence is lower. On the other hand, private vehicle ownership can have an increasing effect on diabetes prevalence, and a high share of the elderly population can be another reason for high diagnosis. According to the study findings, planning settlements with high green areas prioritizing green area development, public transportation and non-motorized vehicles, and accessible healthcare facilities can reduce diabetes risk factors by promoting physical activity and increased mobility along with a positive planning and design approach for public health. Elderly-friendly planning specifications need prioritization for some cities. This study presents evidence for the necessity of urban policies and public health strategies prioritizing health and physical activity in urban built environments.