TITLE:
Black-White residential segregation and diabetes status: Results from the Behavioral Risk Factor Surveillance System
AUTHORS:
Antwan Jones, Diana S. Grigsby-Toussaint, Jessica Kubo
KEYWORDS:
Diabetes; Multilevel Modeling; Residential Segregation; Socioeconomic Status; Spatial Analysis
JOURNAL NAME:
Open Journal of Preventive Medicine,
Vol.3 No.2,
April
29,
2013
ABSTRACT: Racial residential
segregation in the United States is
generally associated differences in health outcomes among Blacks and Whites due
to differential exposures to physical, social and economic resources. While
several studies have explored the association between segregation and several
chronic conditions in the US, few have specifically examined diabetes using a nationally representative population-based sample. The current study relies on 2005 data from both the Behavioral Risk Factor
Surveillance Survey (BRFSS) and the American Community Survey (ACS) to explore
the association between segregation, socioeconomic status and diabetes. Using multilevel
mixed-effects logistic regression, we present models that account for clustering
of individuals within metropolitan areas and are adjusted for objective
environmental measures (including segregation) and potential individual-level
confounders (including education, employment, and income) among a sample of
121,321 adults who were at least 18 years old. After controlling for individual-level
factors, Blacks residing in highly segregated areas have the same odds of being
diagnosed with diabetes as Whites. Whites are more likely to be diagnosed with
diabetes in areas where there are higher percentages of Blacks than in areas
with low Black representation. Moreover, in this national sample, there is no
statistical association between Blacks residing in highly segregated
neighborhoods and diabetes risk. However, the increased prevalence of diabetes among Whites living in Black metropolitan
areas suggests that future studies are
needed to explore the linkages between levels of segregation and
diabetes risk.