Table 5.
Adjusted hazard ratios* for type 2 diabetes mellitus (T2DM) incidence corresponding to a difference between the 90th and 10th percentiles in neighborhood environments, 2000–2013.
| †Survey-based social environments | ||||||
|---|---|---|---|---|---|---|
| Social cohesion | Violence | Problems | ||||
| Model No. | HR(95% CI) | P value | HR(95% CI) | P value | HR(95% CI) | P value |
| Model 1 | 0.74(0.60,0.91) | 0.004 | 1.16(0.95,1.43) | 0.15 | 1.24(1.00,1.54) | 0.051 |
| Model 2 | 0.76(0.61,0.95) | 0.016 | 1.13(0.91,1.40) | 0.284 | 1.20(0.95,1.52) | 0.126 |
| Model 3 | 0.76(0.60,0.95) | 0.016 | 1.13(0.91,1.40) | 0.284 | 1.20(0.95,1.52) | 0.127 |
| Model 4 | 0.76(0.61,0.96) | 0.019 | 1.11(0.90,1.38) | 0.329 | 1.19(0.94,1.50) | 0.149 |
| Model 5 | 0.78(0.62,0.99) | 0.044 | 1.07(0.87,1.32) | 0.515 | 1.15(0.92,1.44) | 0.219 |
| ‡GIS-based physical environments | ||||||
| Favorable food stores | Unfavorable food stores | Physical activity resources | ||||
| Model No. | HR(95% CI) | P value | HR(95% CI) | P value | HR(95% CI) | P value |
| Model 1 | 1.22(0.98,1.52) | 0.080 | 1.37(1.15,1.64) | <0.001 | 1.10(0.98,1.25) | 0.118 |
| Model 2 | 1.21(0.98,1.51) | 0.084 | 1.36(1.13,1.63) | 0.001 | 1.10(0.97,1.25) | 0.135 |
| Model 3 | 1.22(0.98,1.52) | 0.081 | 1.37(1.13,1.65) | 0.001 | 1.10(0.97,1.25) | 0.132 |
| Model 4 | 1.21(0.97,1.52) | 0.089 | 1.36(1.13,1.63) | 0.001 | 1.09(0.97,1.24) | 0.163 |
| Model 5 | 1.23(0.98,1.55) | 0.076 | 1.34(1.12,1.60) | 0.001 | 1.11(0.97,1.26) | 0.135 |
Abbreviations: BMI: body mass index, CI: confidence interval, HR: hazard ratio, GIS: geographic information systems, JHS: Jackson Heart Study.
Adjusted HRs for baseline characteristics and were estimated using Cox hazard regression with sandwich estimator accounting for nesting of participants within census-tract level, and time to event was approximated by using midpoints between clinic visits.
Survey-based neighborhood environments were collected from JHS participants and aggregated to census tracts using empirical Bayes estimation. Item responses had a possible range of 1 to 4; higher scores indicate better neighborhood social cohesion, and higher neighborhood violence and problems.
GIS-based densities of favorable and unfavorable food stores and physical activity resources were derived using standard industrial classification codes from commercial listings of establishments obtained from National Establishment Time-Series database from Walls & Associates. The densities were calculated for a 1-mile buffer around each of JHS participant’s residential address.
Model 1: Age, sex, and family history of diabetes
Model 2: Model 1 + income, and educational level
Model 3: Model 2 + alcohol intake, and smoking status
Model 4: Model 3 + physical activity level, and diet
Model 5: Model 4 + BMI