The Geography of Diabetes by Census Tract in a Large Sample of Insured Adults in King County, Washington, 2005–2006

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Drewnowski, Adam ; Rehm, Colin D. ; Moudon, Anne V. ; Arterburn, David
• Description:
  Introduction ; Identifying areas of high diabetes prevalence can have an impact on public health prevention and intervention programs. Local health practitioners and public health agencies lack small-area data on obesity and diabetes. ; Methods ; Clinical data from the Group Health Cooperative health care system were used to estimate diabetes prevalence among 59,767 adults by census tract. Area-based measures of socioeconomic status and the Modified Retail Food Environment Index were obtained at the census-tract level in King County, Washington. Spatial analyses and regression models were used to assess the relationship between census tract–level diabetes and area-based socioeconomic status and food environment variables. The mediating effect of obesity on the geographic distribution of diabetes was also examined. ; Results ; In this population of insured adults, diabetes was concentrated in south and southeast King County, with smoothed diabetes prevalence ranging from 6.9% to 21.2%. In spatial regression models, home value and college education were more strongly associated with diabetes than was household income. For each 50% increase in median home value, diabetes prevalence was 1.2 percentage points lower. The Modified Retail Food Environment Index was not related to diabetes at the census-tract level. The observed associations between area-based socioeconomic status and diabetes were largely mediated by obesity (home value, 58%; education, 47%). ; Conclusion ; The observed geographic disparities in diabetes among insured adults by census tract point to the importance of area socioeconomic status. Small-area studies can help health professionals design community-based programs for diabetes prevention and control.
• Subjects:
  • Adult
  • Aged
  • Bayes Theorem
  • Censuses
  • Cluster Analysis
  • Diabetes Mellitus, Type 1
  • Diabetes Mellitus, Type 2
  • Electronic Health Records
  • Female
  • Food Supply
  More +
• Source:
  Prev Chronic Dis. 11.
• DOI:
  http://dx.doi.org/10.5888/pcd11.140135
• ISSN:
  1545-1151
• Document Type:
  Journal Article
• Place as Subject:
  Washington
• Volume:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/24740/cdc_24740_DS1.pdf
• File Type:
  [PDF - 1.04 MB]
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:b3245b74e912fb0cd19c9f1ac35e6b34357ca09e872c22f9a62f53f9ff5dad4b3f13321326ed99463dbfd072cf857bf05e722a7760d979f43909ce15929015df