Neighbourhood property value and type 2 diabetes mellitus in the Maastricht study: A multilevel study

Abstract

Low individual socioeconomic status (SES) is known to be associated with a higher risk of type 2 diabetes mellitus (T2DM), but the extent to which the local context in which people live may influence T2DM rates remains unclear. This study examines whether living in a low property value neighbourhood is associated with higher rates of T2DM independently of individual SES. Research design and methodsUsing cross-sectional data from the Maastricht Study (2010-2013) and geographical data from Statistics Netherlands, multilevel logistic regression was used to assess the association between neighbourhood property value and T2DM. Individual SES was based on education, occupation and income. Of the 2,056 participants (aged 40-75 years), 494 (24%) were diagnosed with T2DM. ResultsIndividual SES was strongly associated with T2DM, but a significant proportion of the variance in T2DM was found at the neighbourhood level (VPC = 9.2%; 95% CI = 5.0%-16%). Participants living in the poorest neighbourhoods had a 2.38 times higher odds ratio of T2DM compared to those living in the richest areas (95% CI = 1.58-3.58), independently of individual SES.

Neighborhood Greenspace and Socioeconomic Risk are Associated with Diabetes Risk at the Sub-neighborhood Scale: Results from the Prospective Urban and Rural Epidemiology (PURE) Study

“…The index results are concurrent with the literature, in that higher neighborhood SES and local greenspace exhibit a protective effect [ 2 , 5 , 11 , 12 , 14 , 15 ]. In terms of urban/regional planning policy and diabetes prevention, low SES, unhealthy food environments, and lack of infrastructure for physical activity have been underscored as key priorities [ 1 ].…”

“…Previous studies have identified a higher prevalence of diabetes in subpopulations with low socioeconomic status (SES), most commonly measured using composite indices that capture diverse aspects of socioeconomic (dis)advantage [ 2 , 3 ]. When measured at the individual- or household-level, socioeconomic risk factors for diabetes include income [ 4 ], educational attainment [ 5 , 6 ], and occupational status [ 5 ]. Individual SES is not distributed randomly, and low and high SES individuals cluster together, which can be measured using area-based SES measures, for example, using census tracts.…”

“…In public health planning and prevention programmes, area-based SES indices (e.g., the Vancouver Area Neighborhood Deprivation Index) have demonstrated immense value as correlates for a wide range of diseases, syndromes, and health conditions [ 7 ]. Even when controlling for individual- or household-level SES, area-based metrics often remain significant predictors, suggesting a social-environmental/neighborhood-scale compositional component to the effects of SES on health [ 5 , 8 , 9 ].…”

Risk of progression from pre‐diabetes to type 2 diabetes in a large UK adult cohort

“…Unemployment might lead to chronic stress, anxiety, unhealthy food choices and hence an increased risk of type 2 diabetes 26,27 . Poorer neighbourhoods might have less availability of healthy food options and physical activity amenities, hence an increased risk for obesity and type 2 diabetes 28 …”

Neighbourhood socioeconomic disadvantage and body size in Australia’s capital cities: The contribution of obesogenic environments

“…Neighbourhood inequities in anthropometric factors such as overweight and obesity likely contribute to associations between neighbourhood disadvantage, CVD and T2D. Overweight and obesity are strongly associated with these (and other) chronic degenerative conditions [4][5][6][7], and studies conducted in Australia [8,9], North America [10,11], and elsewhere [12,13] indicate that residents of disadvantaged neighbourhoods, particularly women, are more likely to be overweight or obese.…”