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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Bibliographic Details
Published in:Diabetes care Vol. 36; no. 2; pp. 302 - 308
Main Authors: Booth, Gillian L., Creatore, Maria I., Moineddin, Rahim, Gozdyra, Peter, Weyman, Jonathan T., Matheson, Flora I., Glazier, Richard H.
Format: Journal Article
Language:English
Published: Alexandria, VA American Diabetes Association 01.02.2013
Subjects:
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
Online Access:Get full text
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Summary: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.
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ISSN:0149-5992
1935-5548
1935-5548
DOI:10.2337/dc12-0777