Neighborhood level risk factors for type 1 diabetes in youth: the SEARCH case-control study

Neighborhood level risk factors for type 1 diabetes in youth: the SEARCH case-control study

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Abstract

Background

European ecologic studies suggest higher socioeconomic status is associated with higher incidence of type 1 diabetes.Using data from a case-control study of diabetes among racially/ethnically diverse youth in the United States (U.S.), we aimed to evaluate the independent impact of neighborhood characteristics on type 1 diabetes risk.

Data were available for 507 youth with type 1 diabetes Gameboy and 208 healthy controls aged 10-22 years recruited in South Carolina and Colorado in 2003-2006.Home addresses were used to identify Census tracts of residence.Neighborhood-level variables were obtained from 2000 U.S.

Census.Multivariate generalized linear mixed models were applied.

Results

Controlling for individual risk factors (age, gender, race/ethnicity, infant feeding, birth weight, maternal age, number of household residents, parental education, income, state), higher neighborhood household income (p = 0.005), proportion of population in managerial jobs (p = 0.

02), with at least high Spacers school education (p = 0.005), working outside the county (p = 0.04) and vehicle ownership (p = 0.03) were each independently associated with increased odds of type 1 diabetes.

Conversely, higher percent minority population (p = 0.0003), income from social security (p = 0.002), proportion of crowded households (0.0497) and poverty (p = 0.

008) were associated with a decreased odds.

Conclusions

Our study suggests that neighborhood characteristics related to greater affluence, occupation, and education are associated with higher type 1 diabetes risk.Further research is needed to understand mechanisms underlying the influence of neighborhood context.

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