Perceived neighborhood social cohesion and type 2 diabetes mellitus by age, sex/gender, and race/ethnicity in the United States

• Published in: Preventive medicine Vol. 170; p. 107477
• Main Authors: Williams, Patrice C., Alhasan, Dana M., Gaston, Symielle A., Henderson, Kionna L., Braxton Jackson, W., Jackson, Chandra L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2023
• Subjects: Adolescent; Adult; Community support; Diabetes Mellitus, Type 2 - epidemiology; Ethnicity; Female; Hispanic or Latino; Humans; Interpersonal Relations; Male; Middle Aged; Minoritized groups; Residence Characteristics; Social Cohesion; Social support; Type 2 diabetes mellitus; United States - epidemiology; Young Adult; United States; Minoritized groups; Residence characteristics; Community support; Type 2 diabetes mellitus; Social support
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2023.107477

In prior research, perceived low neighborhood social cohesion (nSC) has been associated with prevalence of type 2 diabetes mellitus (T2DM); however, few studies have investigated the nSC-T2DM relationship among a large, racially/ethnically diverse, and nationally representative sample of the U.S. population. We used National Health Interview Survey (2013–2018) data to determine overall, age-, sex/gender-, and racial/ethnic-specific associations between nSC and T2DM among 170,432 adults. Self-reported nSC was categorized as low, medium, and high. T2DM was determined by participants being told they had diabetes by a health professional. We used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CI) while adjusting for confounders. Mean age was 47.4 ± 0.1 years, 52% were women, and 69% self-identified as Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of T2DM (PR = 1.22 [95% CI: 1.16–1.27]), after adjustment. A higher prevalence of T2DM was observed among participants 31–49 years old who perceived low vs. high nSC (PR = 1.36 [95% CI: 1.20–1.54]) and among participants ≥50 years old (PR = 1.18 [95% CI: 1.13–1.24]). Hispanic/Latinx women 18–30 years old in neighborhoods with low vs. high social cohesion had a higher prevalence of T2DM (PR = 3.70 [95% CI: 1.40–9.80]), whereas NH-Black women 18–30 years old in neighborhoods with medium vs. high social cohesion had a lower prevalence of T2DM (PR = 0.35 [95% CI: 0.14–0.89]). Our findings support the literature by demonstrating an association between neighborhood environment and T2DM as well as extend it by identifying determinants for intervention for T2DM.
•We examined neighborhood social cohesion and diabetes using cross-sectional NHIS data.•Participants reported perceived neighborhood social cohesion (nSC) and diabetes.•Lower perceived nSC is associated with a higher prevalence of type 2 diabetes.•Age, sex/gender, and race/ethnicity modified the relationship.•An intersectional approach reveals environmental influences on health disparities.