In response to an alarming increase in the prevalence of diabetes in Philadelphia, ranking the highest among the country’s biggest cities, a group of public health researchers from Drexel University conducted a study that sought to understand how physical and social environments impact the risk for developing the disease. The study is currently available in the November issue of the journal Advances in Preventive Medicine. Statistics show that 1 out of every 5 Americans will have diabetes by 2050. Studying disease risk factors and learning how to positively modify them is essential to fostering preventive health.
“Too often, we focus exclusively on the individual in solving the problem. Here we found that we also need to focus on the healthiness of the community if we want to improve overall health and ultimately decrease health care costs” said co-author Dr. Ana E. Nuñez, a professor and associate dean for urban health equity, education and research in Drexel’s College of Medicine.
The researchers studied these factors according to each neighborhood in Philadelphia. They discovered prevalence in residents age 18 and older increased notably between the years 2002 and 2010, and that living in an underprivileged neighborhood can greatly increase an individual’s risk for diabetes, representing roughly 12% of the difference in risk compared to other groups examined in the study. Additionally, lead author Longjian Liu, MD, PhD, who is also an associate professor and interim chair of the Department of Environmental and Occupational Health in Drexel’s School of Public Health, said that one of the important things to consider about noting environmental risk factors in Philadelphia is that people living in one area tend to have contrasting socioeconomic standing.
Dr. Liu explained that although studying the individual biologic factors behind diabetes is important to understanding the disease and learning how best to treat it, a more significant difference can be made in preventing the disease by focusing on modifiable risk factors on a larger community level.
Dr. Liu and his co-author, Dr. Nuñez, developed a scoring system called people’s physical and social environment (PSE) based on participants’ answers to a set of questions. Participants were asked about the availability of healthy food, their use of nearby recreational facilities that promote physical activity, the general helping attitude in their community, and several questions meant to assess poverty level. Over 17,000 people from 46 Philadelphia zip codes answered the survey, which also included questions on the person’s weight, physical activity, nutrition, age, sex, ethnicity, and smoking status.
The results of the surveys revealed the PSEs varied significantly per zip code, with the worse scores indicating a higher risk for diabetes for people living in that area. When the PSEs were adjusted for the respondents’ sex and age, the researchers predict a 12% drop in diabetes rates upon improvement of environmental factors. These considered, excess weight and ethnicity remain the leading factors that drive diabetes.