The neighborhood a person lives in can contribute to his or her likelihood of developing type 2 diabetes, according to a study co-authored by Northwestern Medicine investigator Mercedes Carnethon, PhD, associate professor in Preventive Medicine-Epidemiology.
The study, published in JAMA Internal Medicine, found that people living in neighborhoods that were rated highly for having healthy foods and safe spaces for physical activity available were less likely to develop diabetes over time.
“It was somewhat surprising that these associations were present only for ratings of perceived access to food and physical activity,” said Carnethon. “There were no associations when we actually counted the number of stores or characterized the physical environment using measures determined from the U.S. Census.”
The investigators hypothesize that this discrepancy may be due to other unmeasured factors that limit access, such as the cost of healthy food options.
“For example, a woman may live with her family less than one mile from a store with a broad selection of fruits and vegetables, but if she can’t afford to buy the items in that store it’s not a healthy food option for her,” said Carnethon.
Without practical access to healthy food and locations for exercise, a person may struggle to follow a physician’s recommendations for preventing diabetes, she explained.
Using data from the Multi-Ethnic Study of Atherosclerosis, investigators for this study looked at information collected over 12 years from more than 5,000 adults who did not have type 2 diabetes at baseline.
“These findings demonstrate how the neighborhood environment can influence health by shaping choices,” Carnethon said. “However, our finding suggests that these resources not only need to be present, they also need to be viewed as accessible by the residents who live in these neighborhoods.”
The research could inform population-level intervention strategies that bring resources to communities with a high diabetes incidence and educate residents about how those resources can lead to better health.
Carnethon plans to continue to examine how availability of health foods is related to health. As part of a long-term study based at Northwestern called the Coronary Artery Risk Development in Young Adults (CARDIA) study, she will investigate associations between healthy food availability and molecular markers that suggest an elevated risk for kidney and heart disease. This project will be part of a new center at Northwestern funded by the American Heart Association.
“We hope that all of this research can be used to justify policies to improve access to healthy fresh foods in communities that are exposed to a high burden of preventable chronic diseases,” Carnethon said.
This study, led by Paul Christine, MPH, from the University of Michigan, was supported by National Heart, Lung, and Blood Institute contracts N01-HC-95159 through N01-HC-95169 and R01 HL071759 and National Center for Research Resources grants UL1-RR-024156 and UL1-RR-025005.