Diabetes and Obesity Less Common in Better Neighborhoods

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Diabetes and Obesity Less Common in Better NeighborhoodsOf all the factors that affect your health, your neighborhood may be the last thing you’d consider. But a recent study has discovered that the average economic status of a neighborhood’s residents are tied to their risk of obesity and diabetes. The researchers who discovered the association describe it as “modest but potentially important.”

“The effects we see in the study are comparable to what you see from targeted lifestyle interventions or with providing people with medications to prevent the onset of diabetes,” said Jens Ludwig of the University of Chicago, who was lead author on the study. Ludwig commented that the findings of the study demonstrate that an individual’s environment has important implications for his or her health.

Published in the October 20 edition of the New England Journal of Medicine, the findings do not actually show a positive causal relationship between residence and health factors. The study was also limited in that it only measured height, weight, and diabetes status of the participants at the end of the study, not at the beginning.

The study analyzed data from around 4,500 mothers who lived in public housing with high poverty levels, where at least 40 percent of the neighborhood residents lived below the poverty level.

The U.S. government conducted the Moving to Opportunity program from 1994 through 1998; the program gave housing vouchers for neighborhoods with lower than a 10 percent poverty level to 1,788 individuals. Vouchers that were good for any location were given to 1,312 individuals, and all voucher recipients received counseling related to moving. Another 1,398 individuals did not receive any vouchers or counseling.

Over ten years later, the government followed up with the women involved with the study, measuring their height and weight as well as conducting a blood test to determine their blood glucose levels over the three months prior to the follow-up.

For the women classified as obese—those who had a body mass index of 30 or higher—their location of residence made no difference.

Women with more severe obesity—a BMI of 35 or higher—did demonstrate differences according to their place of residence. About 31 percent of the women who received vouchers for low-poverty neighborhoods had a BMI of 35 or higher compared to 36 percent of the women who did not receive vouchers.

Morbid obesity (BMI of 40 or higher) was also more likely in women who did not receive vouchers, at 18 percent, compared to women who did receive vouchers, at 14 percent.

Diabetes was higher in women who did not receive vouchers—20 percent, compared to 16 percent among women who did receive vouchers.

The findings are complicated since only about half of the women who received vouchers for low-poverty areas actually used them. Additionally, most of the women involved in the study moved to less-impoverished neighborhoods regardless of their voucher status.

Despite these limitations, Ludwig believes that the findings demonstrate a real trend. The Department of Housing and Urban Development (HUD) considered 57 additional variables in each of the individuals in the study, finding that individuals in the three groups were very similar at the beginning of the study. It stands to reason, according to Ludwig, that the three groups would be similar in obesity and diabetes status as well.

Ludwig stated that a variety of factors associated with better neighborhoods could be responsible for improved health, including better sidewalks for exercise, better access to supermarkets with healthy food, and less everyday stress.

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