Diabetes prevalence is associated with different community factors in the diabetes belt versus the rest of the United States.
Diabetes prevalence is associated with different community factors in the diabetes belt versus the rest of the United States.
复制标题
糖尿病患病率与糖尿病带与美国其他地区的不同社区因素有关。
DOI：
10.1002/oby.21725
复制
发表时间：
2017-02
期刊：
影响因子：
--
通讯作者：
Martin CK
中科院分区：
文献类型：
--
作者：
Myers CA;Slack T;Broyles ST;Heymsfield SB;Church TS;Martin CK
本研究调查了糖尿病带与美国其他地区之间与糖尿病患病率相关的社区特征的差异。除了来自美国人口普查局、美国农业部和美国卫生与公众服务部的数据外，我们还使用了美国疾病控制与预防中心的县级成人糖尿病患病率估计值（即，2009 年诊断为糖尿病的人 [≥20 岁] 的百分比），以进行空间格局分析确定与糖尿病带的糖尿病患病率相关的县级因素与糖尿病带以外的美国其他县的县级因素表明，糖尿病患病率与持续贫困和更高比例的失业劳动力之间存在更强的正相关性。对于糖尿病带的县，糖尿病患病率与自然设施（例如温带气候和地形特征）呈更强的正相关，与健身/娱乐设施密度呈更强的负相关。糖尿病带和美国其他地区之间糖尿病患病率的社区水平相关性有所不同。事实证明，经济困难在糖尿病带以外的地区更为相关，而娱乐环境的影响在该地区的县中更为明显。预防和治疗目标在地理上是独特的，公共卫生工作在制定政策时应承认这些差异。
This study investigated differences in community characteristics associated with diabetes prevalence between the Diabetes Belt and the rest of the contiguous U.S. We used county-level adult diabetes prevalence estimates (i.e., percent of people [≥20 years] with diagnosed diabetes, 2009) from the Centers for Disease Control and Prevention, in addition to data from the U.S. Census Bureau, U.S. Department of Agriculture, and U.S. Department of Health and Human Services, to carry out a spatial regime analysis to identify county-level factors correlated with diabetes prevalence in the Diabetes Belt versus the remainder of the U.S. Counties outside of the Diabetes Belt demonstrated stronger positive associations between diabetes prevalence and persistent poverty and greater percentages of unemployed labor forces. For counties in the Diabetes Belt, diabetes prevalence showed a stronger positive association with natural amenities (e.g., temperate climate and topographic features) and a stronger negative association with fitness/recreation facility density. Community-level correlates of diabetes prevalence differed between the Diabetes Belt and elsewhere in the U.S. Economic hardship was shown to be more relevant outside the Diabetes Belt, while recreational context effects were more pronounced among counties within the region. Prevention and treatment targets are geographically unique and public health efforts should acknowledge these differences in crafting policy.