The Influence of Neighborhood Poverty on Blood Glucose Levels: Findings from the Community Initiative to Eliminate Stroke (CITIES) program

M. L. Cathorall, H. Xin, R. Aronson, A. Peachey, D. L. Bibeau, M. Schulz, G. Dave

Abstract


Objectives:  To examine the relationship between both individual and neighborhood level characteristics and non-fasting blood glucose levels.

Study design: This study used a cross sectional design using data from the Community Initiative to Eliminate Stroke Program in NC (2004-2008).  A total of 12,809 adults nested within 550 census block groups from two adjacent urban counties were included in the analysis.

Methods:   Participants completed a cardiovascular risk factor assessment with self-reported demographics, stroke-risk behaviors, and biometric measurements.  Neighborhood level characteristics were based upon census data.  Three multilevel models were constructed for data analysis.

Results:  Mean blood glucose level of this sample population was 103.61mg/dL.  The unconditional model 1 suggested a variation in mean blood glucose levels among the neighborhoods (τ00 = 13.39; P < .001).  Both models 2 and 3 suggested that the neighborhood composite deprivation index had a significant prediction on each neighborhood’s mean blood glucose level (¡01= .69; P < 0.001,¡01= .36; P = .004).  Model 3 also suggested that across all the neighborhoods, on average, after controlling for individual level risk factors, deprivation remained a significant predictor of blood glucose levels.

Conclusions:  The findings provide evidence that neighborhood disadvantage is a significant predictor of neighborhood and individual level blood glucose levels.  One approach to diabetes prevention could be for policymakers to address the problems associated with environmental determinants of health.


Keywords


multilevel; deprivation index; prevention; non-fasting blood glucose level; type 2 diabetes

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References


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DOI: http://dx.doi.org/10.5195/hcs.2015.184

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