Analyzing the association of the built and social environment with the prevalence of Type 2 Diabetes (T2D) in Mexico City, Mexico Open Access
Zelaya, Alana M. (Spring 2019)
Abstract
Background: Type 2 Diabetes (T2D) is now the leading cause of death in Mexico, with 76,000 lives lost in 2016 and the prevalence of T2D is expected to continue to increase in the upcoming decade. The rise of megacities and urbanization in Latin America has shaped the urban built environment in a way that unfortunately concentrated risks that impact individuals’ risk of developing T2D. The risk of T2D is affected by the built and social environment as it influences behavior, like physical activity and diet. The purpose of this study was to characterize the built and social environment exposures that relate to diabetes using Geographical Information Systems (GIS): proximity and density of parks, street connectivity, security from crime, population density and neighborhood poverty, and analyze the relationship between these variables and prevalence of diabetes/prediabetes. Methods: A cross-sectional probabilistic population-based survey representative of adults aged 20–69 years (n=1304) living in Mexico City was conducted in 2015 which collected information on diabetes (by self-report and through fasting blood glucose or hemoglobin A1c). Geographical Information Systems (GIS) was used to derive the objectively measured built and social environment characteristics. Logistic regression models were used to explore the association between diabetes/prediabetes and environmental characteristics. Results: The adjusted models for individual (age, sex, educational attainment, marital status, and individual socioeconomic status) and environmental variables, showed that participants living in a 500 meter buffer area with medium number of crimes (between 166 to < 240 crimes) were 2.2 (95% CI :1.24 - 3.78) times more likely to have prediabetes or diabetes compared to those living in an area with a low number of crimes (less than 6 crimes). Discussion: Our results indicate that medium crime density was a positive correlate for prediabetes and diabetes. In Mexico, injuries and interpersonal violence are leading causes of healthy life lost among Mexican men. We recommend development of public policies to curb crime and increase safety in order to promote healthy behaviors and less stress to prevent the development of T2D.
Table of Contents
CHAPTER I. BACKGROUND 1
CHAPTER II. METHODS 9
CHAPTER III. RESULTS 13
CHAPTER IV. DISCUSSION: SUMMARY, PUBLIC HEALTH IMPLICATIONS, AND POSSIBLE FUTURE DIRECTIONS 15
REFERENCES 20
TABLES 23
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