Association of neighbourhood unemployment rate with incident Type 2 diabetes mellitus in five German regions. Issue 8 (30th December 2014)

• Record Type: Journal Article
• Authors: Müller, G.; Wellmann, J.; Hartwig, S.; Greiser, K. H.; Moebus, S.; Jöckel, K.‐H.; Schipf, S.; Völzke, H.; Maier, W.; Meisinger, C.; Tamayo, T.; Rathmann, W.; Berger, K.; the DIAB‐CORE Consortium
• Is Part Of: Diabetic medicine. Volume 32:Issue 8(2015:Aug.)
• Page Start: 1017
• Page End: 1022
• Publication Date: 2014-12-30
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12652
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12652-abs-0001"> <title>Abstract</title> <sec id="dme12652-sec-0001" sec-type="section"> <title>Aim</title> <p>To analyse the association of neighbourhood unemployment with incident self‐reported physician‐diagnosed Type 2 diabetes in a population aged 45–74 years from five German regions.</p> </sec> <sec id="dme12652-sec-0002" sec-type="section"> <title>Methods</title> <p>Study participants were linked via their addresses at baseline to particular neighbourhoods. Individual‐level data from five population‐based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self‐reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval‐censoring and clustering.</p> </sec> <sec id="dme12652-sec-0003" sec-type="section"> <title>Results</title> <p>We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person‐years (95% CI 11.4–13.8). The risk of Type 2 diabetes mellitus was higher in men [hazard ratio 1.79 (95% CI 1.47–2.18)] than in women and higher in people with a low education level [hazard ratio 1.55 (95% CI 1.18–2.02)] than in those with a high education level. Independently of individual‐level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment [quintile 5; hazard ratio 1.72 (95% CI 1.23–2.42)] than in neighbourhoods with low unemployment (quintile 1).</p> </sec> <sec id="dme12652-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high‐risk populations.</p> </sec> </abstract>