Living in Resource-Rich Neighborhoods May Lower Diabetes Risk

Neighborhoods with greater resources for healthy diets and physical activity may be associated with lower risk for type 2 diabetes.

Researchers from the University of Michigan studied patients aged 45 to 84 years to determine whether there was a link between type 2 diabetes and long-term exposure to neighborhoods with healthy food, physical activity resources, social cohesion, and safety over a 10-year period.

The patients involved in the study underwent 5 clinical follow-up examinations between July 17, 2000, and February 4, 2012. The researchers collected information on healthy food availability, physical activity resources, and social environment relative to the participants’ addresses.

Data on the patients’ age, sex, income, education level, race/ethnicity, and alcohol and cigarette use were also collected.

“We found that simply having more supermarkets or fruit and vegetable markets in the neighborhood did not necessarily translate to a lower risk for developing diabetes,” researcher Paul J. Christine, MPH, told Pharmacy Times.

However, some models did show that greater cumulative exposure to indicators of neighborhood healthy food was associated with a lower risk for developing diabetes. Dr. Christine stressed that the results varied based on the measurement tools the research team employed.

“We were somewhat surprised to find that residing in a neighborhood rated as more safe and socially cohesive was not associated with a lower risk for developing diabetes,” Dr. Christine said.

However, the researchers did find that those who lived in neighborhoods with greater availability of recreational resources, including pleasant places to walk, had a lower risk of developing diabetes over the study period.

About 12% of the 5124 patients surveyed developed type 2 diabetes over the median follow-up period of 9 years.

Prevalence of diabetes was most likely to be found in individuals who were black or Hispanic, had lower income, had fewer years of education, less healthy diets, lower levels of moderate or vigorous physical activity, a higher body mass index, or a family history of type 2 diabetes.

“A good first step for pharmacists is to recognize that the effectiveness of the anti-hyperglycemic pharmacotherapy they administer may be influenced by the neighborhood environments in which their patients live,” Dr. Christine said. “Furthermore, pharmacists interested in diabetes prevention may wish to partner with public health agencies, city planners, and community organizations to ensure that modifying neighborhood environments is part of the diabetes prevention discussion.”

In an accompanying editorial, Nancy E. Adler, PhD, and Aric A. Prather, PhD, from the Center for Health and Community at the University of California, San Francisco said by addressing environmental causes of type 2 diabetes, strain can be alleviated from traditional medical treatments alone.

“Addressing environmental causes recasts diet and exercise as behaviors that are not only a function of individual choice and will power but that are strongly shaped by the resources and obstacles encountered in the environments in which behaviors are enacted,” Drs. Adler and Prather wrote. “The neighborhood effects measured by Dr. Christine and colleagues documented that individuals residing in neighborhoods marked by limited resources for healthy eating and physical activity are at higher risk for being diagnosed with type 2 diabetes.”

The study findings were published in JAMA Internal Medicine.