Racial Residential Segregation and the Health of Black Youth With Type 1 Diabetes.
Racial Residential Segregation and the Health of Black Youth With Type 1 Diabetes.
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DOI：
10.1542/peds.2022-058856
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发表时间：
2023-05-01
期刊：
影响因子：
8
通讯作者：
Worley, Jessica
中科院分区：
文献类型：
--
作者：
Ellis, Deborah A. A.;Cutchin, Malcolm P. P.;Carcone, April Idalski;Evans, Meredyth;Weissberg-Benchell, Jill;Buggs-Saxton, Colleen;Boucher-Berry, Claudia;Miller, Jennifer L. L.;Drossos, Tina;Dekelbab, M. Bassem;Worley, Jessica
患有1型糖尿病（T1D）的黑人青年血糖控制不佳的风险更高。邻里对T1D青年健康影响的研究有限。本研究调查了种族居住隔离对T1D黑人青少年糖尿病健康的影响。从美国2个城市的7个儿童糖尿病诊所共招募了148名参与者。种族居住隔离（RRS）是根据美国人口普查数据在人口普查区块组水平上计算的。糖尿病管理通过自我报告问卷进行测量。血红蛋白A1c（HbA1c）信息是在家庭数据收集过程中从参与者那里收集的。分层线性回归被用来测试RRS的影响，同时控制家庭收入，年轻的年龄，胰岛素输送方法（胰岛素泵与注射器治疗），和邻里逆境。在双变量分析中，HbA1c与RRS显著相关，而年轻人报告的糖尿病管理无关。在分层回归分析中，模型1中家庭收入、年龄和胰岛素给药方式均与HbA1c显著相关，而模型2中仅RRS、年龄和胰岛素给药方式与HbA1c显著相关。模型2解释了HbA1c 25%的方差（P = .001）。RRS与T1D黑人青年样本中的血糖控制相关，即使在控制了不利的邻里条件后，RRS也能解释HbA1c的变化。减少居住隔离的政策，沿着改善对社区一级风险的筛查，有可能改善青年弱势群体的健康。
Black youth with type 1 diabetes (T1D) are at heightened risk for suboptimal glycemic control. Studies of neighborhood effects on the health of youth with T1D are limited. The current study investigated the effects of racial residential segregation on the diabetes health of young Black adolescents with T1D. A total of 148 participants were recruited from 7 pediatric diabetes clinics in 2 US cities. Racial residential segregation (RRS) was calculated at the census block group level based on US Census data. Diabetes management was measured via self-report questionnaire. Hemoglobin A1c (HbA1c) information was gathered from participants during home-based data collection. Hierarchical linear regression was used to test the effects of RRS while controlling for family income, youth age, insulin delivery method (insulin pump versus syringe therapy), and neighborhood adversity. HbA1c was significantly associated with RRS in bivariate analyses, whereas youth-reported diabetes management was not. In hierarchical regression analyses, whereas family income, age, and insulin delivery method were all significantly associated with HbA1c in model 1, only RRS, age, and insulin delivery method were significantly associated with HbA1c in model 2. Model 2 explained 25% of the variance in HbA1c (P = .001). RRS was associated with glycemic control in a sample of Black youth with T1D and accounted for variance in HbA1c even after controlling for adverse neighborhood conditions. Policies to reduce residential segregation, along with improved screening for neighborhood-level risk, hold the potential to improve the health of a vulnerable population of youth.
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影响因子：
3.1
作者：
Green, Kaye-Alese;Bovell-Ammon, Allison;Sandel, Megan
通讯作者：
Sandel, Megan
影响因子：
8
作者：
Kaufman, FR;Halvorson, M;Carpenter, S
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Carpenter, S
影响因子：
4.8
作者：
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Kershaw, Kiarri N.
影响因子：
13.8
作者：
Tung, Elizabeth L.;Hampton, David A.;Peek, Monica E.
通讯作者：
Peek, Monica E.
影响因子：
2.8
作者：
Le-Scherban, Felice;Ballester, Lance;Buehler, James W.
通讯作者：
Buehler, James W.