Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network
Introduction: Geographic disparities in diabetes burden exist throughout the United States (US), with many risk factors for diabetes clustering at a community or neighborhood level. We hypothesized that the likelihood of new onset type 2 diabetes (T2D) would differ by community type in three large s...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | SSM: Population Health |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352827322001409 |
| _version_ | 1811237168081797120 |
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| author | Tara P. McAlexander Gargya Malla Jalal Uddin David C. Lee Brian S. Schwartz Deborah B. Rolka Karen R. Siegel Rania Kanchi Jonathan Pollak Linda Andes April P. Carson Lorna E. Thorpe Leslie A. McClure |
| author_facet | Tara P. McAlexander Gargya Malla Jalal Uddin David C. Lee Brian S. Schwartz Deborah B. Rolka Karen R. Siegel Rania Kanchi Jonathan Pollak Linda Andes April P. Carson Lorna E. Thorpe Leslie A. McClure |
| author_sort | Tara P. McAlexander |
| collection | DOAJ |
| description | Introduction: Geographic disparities in diabetes burden exist throughout the United States (US), with many risk factors for diabetes clustering at a community or neighborhood level. We hypothesized that the likelihood of new onset type 2 diabetes (T2D) would differ by community type in three large study samples covering the US. Research design and methods: We evaluated the likelihood of new onset T2D by a census tract-level measure of community type, a modification of RUCA designations (higher density urban, lower density urban, suburban/small town, and rural) in three longitudinal US study samples (REGARDS [REasons for Geographic and Racial Differences in Stroke] cohort, VADR [Veterans Affairs Diabetes Risk] cohort, Geisinger electronic health records) representing the CDC Diabetes LEAD (Location, Environmental Attributes, and Disparities) Network. Results: In the REGARDS sample, residing in higher density urban community types was associated with the lowest odds of new onset T2D (OR [95% CI]: 0.80 [0.66, 0.97]) compared to rural community types; in the Geisinger sample, residing in higher density urban community types was associated with the highest odds of new onset T2D (OR [95% CI]: 1.20 [1.06, 1.35]) compared to rural community types. In the VADR sample, suburban/small town community types had the lowest hazard ratios of new onset T2D (HR [95% CI]: 0.99 [0.98, 1.00]). However, in a regional stratified analysis of the VADR sample, the likelihood of new onset T2D was consistent with findings in the REGARDS and Geisinger samples, with highest likelihood of T2D in the rural South and in the higher density urban communities of the Northeast and West regions; likelihood of T2D did not differ by community type in the Midwest. Conclusions: The likelihood of new onset T2D by community type varied by region of the US. In the South, the likelihood of new onset T2D was higher among those residing in rural communities. |
| first_indexed | 2024-04-12T12:21:28Z |
| format | Article |
| id | doaj.art-c92cc8c158484251aa2f0b12db6897fb |
| institution | Directory Open Access Journal |
| issn | 2352-8273 |
| language | English |
| last_indexed | 2024-04-12T12:21:28Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | SSM: Population Health |
| spelling | doaj.art-c92cc8c158484251aa2f0b12db6897fb2022-12-22T03:33:18ZengElsevierSSM: Population Health2352-82732022-09-0119101161Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD networkTara P. McAlexander0Gargya Malla1Jalal Uddin2David C. Lee3Brian S. Schwartz4Deborah B. Rolka5Karen R. Siegel6Rania Kanchi7Jonathan Pollak8Linda Andes9April P. Carson10Lorna E. Thorpe11Leslie A. McClure12Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USADepartment of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USADepartment of Epidemiology, The University of Alabama at Birmingham, Birmingham, AL, USADepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USA; Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USADepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USADivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USADivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USADepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USADepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USADivision of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USADepartment of Medicine, University of Mississippi Medical Center, Jackson, MS, 39213, USADepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USADepartment of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA; Corresponding author.Introduction: Geographic disparities in diabetes burden exist throughout the United States (US), with many risk factors for diabetes clustering at a community or neighborhood level. We hypothesized that the likelihood of new onset type 2 diabetes (T2D) would differ by community type in three large study samples covering the US. Research design and methods: We evaluated the likelihood of new onset T2D by a census tract-level measure of community type, a modification of RUCA designations (higher density urban, lower density urban, suburban/small town, and rural) in three longitudinal US study samples (REGARDS [REasons for Geographic and Racial Differences in Stroke] cohort, VADR [Veterans Affairs Diabetes Risk] cohort, Geisinger electronic health records) representing the CDC Diabetes LEAD (Location, Environmental Attributes, and Disparities) Network. Results: In the REGARDS sample, residing in higher density urban community types was associated with the lowest odds of new onset T2D (OR [95% CI]: 0.80 [0.66, 0.97]) compared to rural community types; in the Geisinger sample, residing in higher density urban community types was associated with the highest odds of new onset T2D (OR [95% CI]: 1.20 [1.06, 1.35]) compared to rural community types. In the VADR sample, suburban/small town community types had the lowest hazard ratios of new onset T2D (HR [95% CI]: 0.99 [0.98, 1.00]). However, in a regional stratified analysis of the VADR sample, the likelihood of new onset T2D was consistent with findings in the REGARDS and Geisinger samples, with highest likelihood of T2D in the rural South and in the higher density urban communities of the Northeast and West regions; likelihood of T2D did not differ by community type in the Midwest. Conclusions: The likelihood of new onset T2D by community type varied by region of the US. In the South, the likelihood of new onset T2D was higher among those residing in rural communities.http://www.sciencedirect.com/science/article/pii/S2352827322001409DiabetesCommunity typeUrbanRuralGeographic disparities |
| spellingShingle | Tara P. McAlexander Gargya Malla Jalal Uddin David C. Lee Brian S. Schwartz Deborah B. Rolka Karen R. Siegel Rania Kanchi Jonathan Pollak Linda Andes April P. Carson Lorna E. Thorpe Leslie A. McClure Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network SSM: Population Health Diabetes Community type Urban Rural Geographic disparities |
| title | Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network |
| title_full | Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network |
| title_fullStr | Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network |
| title_full_unstemmed | Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network |
| title_short | Urban and rural differences in new onset type 2 diabetes: Comparisons across national and regional samples in the diabetes LEAD network |
| title_sort | urban and rural differences in new onset type 2 diabetes comparisons across national and regional samples in the diabetes lead network |
| topic | Diabetes Community type Urban Rural Geographic disparities |
| url | http://www.sciencedirect.com/science/article/pii/S2352827322001409 |
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