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

作者

  • M. L. Cathorall Southern Illinois University Edwardsville
  • H. Xin Department of Kinesiology and Health Education, Southern Illinois University Edwardsville
  • R. Aronson Department of Public Health, Taylor University
  • A. Peachey Department of Health Studies, James Madison University
  • D. L. Bibeau Department of Public Health Education, University of North Carolina at Greensboro
  • M. Schulz Department of Public Health Education, University of North Carolina at Greensboro
  • G. Dave Department of Internal Medicine, University of North Carolina Chapel Hill

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https://doi.org/10.5195/hcs.2015.184

关键词:

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

摘要

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.

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Dr. Michelle Cathorall works in the Department of Kinesiology and Health Education, Southern Illinois University Edwardsville. She received her DrPH in Community Health from the University of North Carolina at Greenboro in 2013 and joined the Health Education program in fall 2013. Dr. Cathorall is a Master Certified Health Education Specialist, Certified Worksite Wellness Program Manager, and a certified Health and Wellness Coach. She teaches several core courses in the undergraduate Health Education program including Principle and Foundations of Health Education, Introduction to Public Health. Her research also focuses on Death & Dying in Contemporary Society, Worksite Health Promotion, Environmental Health, and Injury and Violence Prevention.

Dr. Cathorall’s current research projects include a study of injuries and the perception of injury risk in contact sports.  She is currently working on two high impact regional studies: 1) the frequency and types of injuries sustained by female roller derby players and 2) the role injury risk perception plays in decision making to play roller derby.  Dr. Cathorall has research expertise in qualitative data collection methodology.  Her future research will focus on applying the findings from the current studies to develop injury prevention programs for athletes.

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Dr. Huaibo Xin joined the Department of Kinesiology and Health Education at SIUE in Fall, 2011. She obtained her bachelor's degree in Clinical Medicine from the Shanghai Medical College, Fudan University, China. She practiced medicine both in psychiatry and internal medicine in China for years. In 2007, she received her master's degree in Public Health (MPH) from the Department of Public Health Education, University of North Carolina at Greensboro. In 2011, she received her doctoral degree in Public Health (DrPH) from the same department. Her dissertation focused on examining individual, family, and community resilience to a natural disaster among Vietnamese refugees in North Carolina by using an ethnographic approach.

Dr. Xin's research interest is working with vulnerable populations on their mental health disparities. For example, she has been conducting studies with multiethnic international refugee groups. The goal is to reduce their vulnerabilities to mental disorders including disaster mental disorders within a social-ecological domain, and increase their access to mental health care. . In addition, she has been actively involved in health-related program evaluation by using community-based participatory research/evaluation methodology. Her research studies have been presented at both national and international conferences. Recently, she is a professional member of the American Public Health Association, American Evaluation Association, Mental Health America, and Association of Refugee Service Professionals.

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Dr. Robert Aranson holds a DrPH, International Health, Social Science and Public Health track from the Johns Hopkins University School of Public Health.

His research focuses on Health Disparities, Social Determinants of Health, Minority Health, Men and Masculinity, International Health, Community Health Education, Community Development, Infant Mortality Prevention, HIV/AIDS Prevention, Ethnographic Research Methods, Qualitative and Quantitative Research and Community-Based Participatory Research.

Racial reconciliation and addressing institutional racism are central to Dr. Aranson's work, including work in infant mortality prevention, diabetes and cardiovascular disease prevention, and HIV/AIDS prevention.

 

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Dr. Andrew Peachey obtained his DrPH in Community Health Education from the University of North Carolina at Greensboro, an M.A., Applied Geography, from the University of North Carolina at Greensboro and B.S. in Biology and Geology from Guilford College

His research interests include the relationship between the built environment and health

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Dr. Daniel L. Bibeau holds an undergraduate degree in zoology from Texas A&M University, followed by a Masters degree in health education from A&M in 1976. He received his doctorate in health education from Penn State University in 1984 where his mentors were Drs. Jim Eddy, Dick St. Pierre, and Bob Shute in health education and Drs. John Swisher and Joey Herr (Counseling) and a host of quantitative methodologists from Rural Sociology, Statistics, and Educational Psychology. He has been at UNCG since August 1984.

Dr. Bibeau's scholarly interests focus on understanding and reducing or controlling chronic disease risks among adults using a socio-ecological approach to health education and health coaching. Within the area of chronic disease risk reduction he concentrates on reaching adult populations through health care, public health, worksite, and higher education organizations.

 

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Dr. Marks Schulz holds a Ph.D. from the University of North Carolina in Epidemiology, 2002, and an M.P.H. from the University of North Carolina at Chapel Hill focusing on Air, Radiation and Industrial Hygiene. His B.S. is from the University of Wisconsin-Parkside, in Industrial and Environmental Hygiene. Dr. Schulz also holds a B.A in Economics from the University of Wisconsin-Madison, Madison, Wisconsin.

Dr. Schulz's research interest interests are the determinants of physical activity particularly bicycling in populations and prevention of bicycling injuries. The bicycle-related research is a newer, developing research area. His earlier research was in occupational and environmental health and dates back to his work in the 1980s and 1990s with non-profit organizations advocating for improved workplace health conditions in Wisconsin and North Carolina. Dr. Schulz's publications and presentations include work documenting predictors of bicycle helmet use, occupational health issues of Latino farmworkers, racial and ethnic disparities in work-related cancers and risk assessment research comparing cancer risks estimated from epidemiologic studies with risks estimated from animal bioassays. 

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Dr. Gaurav Dave is the Administrative Director of the Community Academic Resources for Engaged Scholarship (CARES) at the UNC Translational and Clinical Sciences Institute (TraCS) and researcher in the UNC Center for Health Equity Research. His primary research interests include methods and evaluation research to address disparities associated with cardiovascular disease, hypertension and sickle cell disease outcomes.

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已出版

2015-12-17

期

卷 8 编号 2 (2015): Horizons of Health

栏目

Invited Articles

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