Unwalkable Neighborhoods, Poverty, and the Risk of Diabetes Among Recent Immigrants to Canada Compared With Long-Term Residents

This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects. We conducted a population-based, retros...

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Vydáno v:	Diabetes care Ročník 36; číslo 2; s. 302 - 308
Hlavní autoři:	Booth, Gillian L., Creatore, Maria I., Moineddin, Rahim, Gozdyra, Peter, Weyman, Jonathan T., Matheson, Flora I., Glazier, Richard H.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	Alexandria, VA American Diabetes Association 01.02.2013
Témata:	Adult Biological and medical sciences Canada - epidemiology Cohort Studies Diabetes Diabetes Mellitus - epidemiology Diabetes. Impaired glucose tolerance Emigrants and Immigrants - statistics & numerical data Endocrine pancreas. Apud cells (diseases) Endocrinopathies Environment Design Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Health sciences Humans Immigrants Immigration policy Incidence Male Medical research Medical sciences Metabolic diseases Middle Aged Miscellaneous Neighborhoods Noncitizens Obesity Original Research Population density Population growth Principal components analysis Public health. Hygiene Public health. Hygiene-occupational medicine Residence Characteristics Retrospective Studies Risk factors Urbanization Walking Womens health Canada North America America Ontario Middle East Endocrinopathy Human Social influence Poverty Immigrant Nutrition Diabetes mellitus Metabolic diseases Risk Residential neighborhoods Long term Risk factor Resident (student) Resident Social aspect Endocrinology Comparative study
ISSN:	0149-5992, 1935-5548, 1935-5548
On-line přístup:	Získat plný text
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Shrnutí:	This study was designed to examine whether residents living in neighborhoods that are less conducive to walking or other physical activities are more likely to develop diabetes and, if so, whether recent immigrants are particularly susceptible to such effects. We conducted a population-based, retrospective cohort study to assess the impact of neighborhood walkability on diabetes incidence among recent immigrants (n = 214,882) relative to long-term residents (n = 1,024,380). Adults aged 30-64 years who were free of diabetes and living in Toronto, Canada, on 31 March 2005 were identified from administrative health databases and followed until 31 March 2010 for the development of diabetes, using a validated algorithm. Neighborhood characteristics, including walkability and income, were derived from the Canadian Census and other sources. Neighborhood walkability was a strong predictor of diabetes incidence independent of age and area income, particularly among recent immigrants (lowest [quintile 1 {Q1}] vs. highest [quintile 5 {Q5}] walkability quintile: relative risk [RR] 1.58 [95% CI 1.42-1.75] for men; 1.67 [1.48-1.88] for women) compared with long-term residents (Q1 to Q5) 1.32 [1.26-1.38] for men; 1.24 [1.18-1.31] for women). Coexisting poverty accentuated these effects; diabetes incidence varied threefold between recent immigrants living in low-income/low walkability areas (16.2 per 1,000) and those living in high-income/high walkability areas (5.1 per 1,000). Neighborhood walkability was inversely associated with the development of diabetes in our setting, particularly among recent immigrants living in low-income areas.
Bibliografie:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 14 ObjectType-Article-1 ObjectType-Feature-2 content type line 23
ISSN:	0149-5992 1935-5548 1935-5548
DOI:	10.2337/dc12-0777