Neighbourhood disadvantage and self-reported type 2 diabetes, heart disease and comorbidity: A cross-sectional multilevel study
Rachele, Jerome Nikolaos, Giles-Corti, Billie and Turrell, Gavin. (2016) Neighbourhood disadvantage and self-reported type 2 diabetes, heart disease and comorbidity: A cross-sectional multilevel study. Annals of Epidemiology. 26(2), pp. 146 - 150. https://doi.org/10.1016/j.annepidem.2015.11.008
|Authors||Rachele, Jerome Nikolaos, Giles-Corti, Billie and Turrell, Gavin|
Purpose: This study examines associations between neighborhood socioeconomic disadvantage and self-reported type 2 diabetes and heart disease, occurring separately and concurrently at a single time point (comorbidity).
Methods: This study included 11,035 residents from 200 neighborhoods in Brisbane, Australia. Respondents self-reported type 2 diabetes and heart disease as long-term health conditions. Neighborhood socioeconomic disadvantage was measured using a census-derived composite index. Individual socioeconomic position was measured using education, occupation, and household income. Data were analyzed using multilevel multinomial mixed-effects logistic regression using Markov chain Monte Carlo simulation.
Results: Compared with the most advantaged neighborhoods, residents of the most-disadvantaged neighborhoods were more likely to report type 2 diabetes (odds ratio [OR] = 2.21, 95% credible interval [CrI] = 1.55–3.15), heart disease (OR = 1.72, 95% CrI = 1.25–2.38), and comorbidity (OR = 4.38, 95% CrI = 2.27–8.66). This relationship attenuated after adjustment for individual-level socioeconomic position, but remained statistically significant for type 2 diabetes (OR = 1.81, 95% CrI = 1.15–2.83) and comorbidity (OR = 3.00, 95% CrI = 1.49–6.13).
Conclusions: Studies of neighborhood disadvantage that fail to include individual-level socioeconomic measures may inflate associations. Establishing why residents of disadvantaged neighborhoods are more likely to experience the co-occurrence of heart disease and type 2 diabetes independent of their individual socioeconomic position warrants further investigation.
|Keywords||type 2 diabetes; heart disease; comorbidity; chronic disease; neighborhood disadvantage; socioeconomic disadvantage; multilevel|
|Journal||Annals of Epidemiology|
|Journal citation||26 (2), pp. 146 - 150|
|Digital Object Identifier (DOI)||https://doi.org/10.1016/j.annepidem.2015.11.008|
|Page range||146 - 150|
|Research Group||Institute for Health and Ageing|
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|Place of publication||United States of America|
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