Association between environmental quality and diabetes in the USA
Abstract Aims/Introduction Caloric excess and physical inactivity fail to fully account for the rise of diabetes prevalence. Individual environmental pollutants can disrupt glucose homeostasis and promote metabolic dysfunction. However, the impact of cumulative exposures on diabetes risk is unknown....
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2020-03-01
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| Series: | Journal of Diabetes Investigation |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jdi.13152 |
| _version_ | 1830440113690116096 |
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| author | Jyotsna S Jagai Alison K Krajewski Sabina Shaikh Danelle T Lobdell Robert M Sargis |
| author_facet | Jyotsna S Jagai Alison K Krajewski Sabina Shaikh Danelle T Lobdell Robert M Sargis |
| author_sort | Jyotsna S Jagai |
| collection | DOAJ |
| description | Abstract Aims/Introduction Caloric excess and physical inactivity fail to fully account for the rise of diabetes prevalence. Individual environmental pollutants can disrupt glucose homeostasis and promote metabolic dysfunction. However, the impact of cumulative exposures on diabetes risk is unknown. Materials and Methods The Environmental Quality Index, a county‐level index composed of five domains, was developed to capture the multifactorial ambient environmental exposures. The Environmental Quality Index was linked to county‐level annual age‐adjusted population‐based estimates of diabetes prevalence rates. Prevalence differences (PD, annual difference per 100,000 persons) and 95% confidence intervals (CI) were estimated using random intercept mixed effects linear regression models. Associations were assessed for overall environmental quality and domain‐specific indices, and all analyses were stratified by four rural‐urban strata. Results Comparing counties in the highest quintile/poorest environmental quality to those in the lowest quintile/best environmental quality, counties with poor environmental quality demonstrated lower total diabetes prevalence rates. Associations varied by rural–urban strata; overall better environmental quality was associated with lower total diabetes prevalence rates in the less urbanized and thinly populated strata. When considering all counties, good sociodemographic environments were associated with lower total diabetes prevalence rates (prevalence difference 2.77, 95% confidence interval 2.71–2.83), suggesting that counties with poor sociodemographic environments have an annual prevalence rate 2.77 per 100,000 persons higher than counties with good sociodemographic environments. Conclusions Increasing attention has focused on environmental exposures as contributors to diabetes pathogenesis, and the present findings suggest that comprehensive approaches to diabetes prevention must include interventions to improve environmental quality. |
| first_indexed | 2024-12-21T04:57:14Z |
| format | Article |
| id | doaj.art-eb746079c5e14b4f828614f0ec5138a2 |
| institution | Directory Open Access Journal |
| issn | 2040-1116 2040-1124 |
| language | English |
| last_indexed | 2024-12-21T04:57:14Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj.art-eb746079c5e14b4f828614f0ec5138a22022-12-21T19:15:20ZengWileyJournal of Diabetes Investigation2040-11162040-11242020-03-0111231532410.1111/jdi.13152Association between environmental quality and diabetes in the USAJyotsna S Jagai0Alison K Krajewski1Sabina Shaikh2Danelle T Lobdell3Robert M Sargis4School of Public Health Division of Environmental and Occupational Health Sciences University of Illinois at Chicago Chicago Illinois USAOak Ridge Institute for Science and Education National Health and Environmental Effects Research Laboratory Environmental Public Health Division U.S. Environmental Protection Agency Chapel Hill North Carolina USAProgram on Global Environment and Public Policy Studies University of Chicago Chicago Illinois USANational Health and Environmental Effects Research Laboratory Environmental Public Health Division U.S. Environmental Protection Agency Chapel Hill North Carolina USADepartment of Medicine Division of Endocrinology, Diabetes, and Metabolism University of Illinois at Chicago Chicago Illinois USAAbstract Aims/Introduction Caloric excess and physical inactivity fail to fully account for the rise of diabetes prevalence. Individual environmental pollutants can disrupt glucose homeostasis and promote metabolic dysfunction. However, the impact of cumulative exposures on diabetes risk is unknown. Materials and Methods The Environmental Quality Index, a county‐level index composed of five domains, was developed to capture the multifactorial ambient environmental exposures. The Environmental Quality Index was linked to county‐level annual age‐adjusted population‐based estimates of diabetes prevalence rates. Prevalence differences (PD, annual difference per 100,000 persons) and 95% confidence intervals (CI) were estimated using random intercept mixed effects linear regression models. Associations were assessed for overall environmental quality and domain‐specific indices, and all analyses were stratified by four rural‐urban strata. Results Comparing counties in the highest quintile/poorest environmental quality to those in the lowest quintile/best environmental quality, counties with poor environmental quality demonstrated lower total diabetes prevalence rates. Associations varied by rural–urban strata; overall better environmental quality was associated with lower total diabetes prevalence rates in the less urbanized and thinly populated strata. When considering all counties, good sociodemographic environments were associated with lower total diabetes prevalence rates (prevalence difference 2.77, 95% confidence interval 2.71–2.83), suggesting that counties with poor sociodemographic environments have an annual prevalence rate 2.77 per 100,000 persons higher than counties with good sociodemographic environments. Conclusions Increasing attention has focused on environmental exposures as contributors to diabetes pathogenesis, and the present findings suggest that comprehensive approaches to diabetes prevention must include interventions to improve environmental quality.https://doi.org/10.1111/jdi.13152AirCumulative environmental exposuresSociodemographic |
| spellingShingle | Jyotsna S Jagai Alison K Krajewski Sabina Shaikh Danelle T Lobdell Robert M Sargis Association between environmental quality and diabetes in the USA Journal of Diabetes Investigation Air Cumulative environmental exposures Sociodemographic |
| title | Association between environmental quality and diabetes in the USA |
| title_full | Association between environmental quality and diabetes in the USA |
| title_fullStr | Association between environmental quality and diabetes in the USA |
| title_full_unstemmed | Association between environmental quality and diabetes in the USA |
| title_short | Association between environmental quality and diabetes in the USA |
| title_sort | association between environmental quality and diabetes in the usa |
| topic | Air Cumulative environmental exposures Sociodemographic |
| url | https://doi.org/10.1111/jdi.13152 |
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