Table 3.
Mediation effect of neighborhood food environment in the association between the neighborhood social and economic environments and the risk of T2D
| Relative fast-food restaurants | Relative supermarkets | |||||
|---|---|---|---|---|---|---|
| Total effect (95% CI) | Average direct effect (95% CI) | Average indirect effect (95% CI) | Total effect (95% CI) | Average direct effect (95% CI) | Average indirect effect (95% CI) | |
| Higher-density urban | ||||||
| VADR (risk difference, %)* | ||||||
| Q2 | 0.1495 (0.0998–0.2344) | 0.1488 (0.0992–0.2335) | 0.0007 (0.0003–0.001) | 0.1506 (0.0854–0.2235) | 0.1506 (0.0854–0.2235) | 0 (−0.0001 to 0.0001) |
| Q3 | 0.1895 (0.0978–0.2704) | 0.1916 (0.1002 to 0.2722) | −0.0021 (−0.003 to −0.0009) | 0.1812 (0.079–0.2596) | 0.1805 (0.0777–0.2594) | 0.0007 (−0.0001 to 0.0016) |
| Q4 | 0.1587 (0.0848–0.2444) | 0.1625 (0.089–0.2475) | −0.0038 (−0.0055 to −0.0021) | 0.1849 (0.1095–0.268) | 0.1852 (0.1097–0.2685) | −0.0003 (−0.0007 to 0.0001) |
| REGARDS (risk difference, %)† | ||||||
| Q2 | 4.0619 (−1.7143 to 9.0608) | 4.0613 (−1.6172 to 9.0909) | 0.0006 (−0.2214 to 0.2386) | 4.1648 (−1.4812 to 9.1464) | 4.1729 (−1.4911 to 9.1770) | −0.0081 (−0.1931 to 0.1641) |
| Q3 | 5.6835 (−0.5649 to 11.2082) | 5.6291 (−0.7326 to 11.2343) | 0.0543 (−0.1782 to 0.3682) | 5.9538 (0.1267–11.4083) | 5.9702 (0.1002–11.4280) | −0.0164 (−0.2448 to 0.1638) |
| Q4 | 2.7952 (−2.8888 to 8.4708) | 2.8476 (−2.8835 to 8.5545) | −0.0524 (−0.3431 to 0.1710) | 3.0214 (−2.8578 to 8.9549) | 3.0134 (−2.8452 to 8.9836) | 0.0080 (−0.1267 to 0.1897) |
| G/JHU (odds ratio)‡ | ||||||
| Q2 | 1.1901 (0.9271–1.5457) | 1.1059 (0.8717–1.4184) | 1.0761 (0.9752–1.1885) | 1.1899 (0.9267–1.5457) | 1.194 (0.9315–1.5582) | 0.9966 (0.9685–1.0191) |
| Q3 | 1.111 (0.8827–1.4054) | 1.0456 (0.8428–1.3048) | 1.0626 (0.9602–1.1747) | 1.1123 (0.8837–1.4073) | 1.1169 (0.8896–1.4205) | 0.9959 (0.9687–1.0160) |
| Q4 | 0.7745 (0.5496–1.1034) | 0.7698 (0.5707–1.0538) | 1.0061 (0.8961–1.1254) | 0.7776 (0.5532–1.1068) | 0.7845 (0.5622–1.1209) | 0.9912 (0.9447–1.0285) |
| Lower-density urban | ||||||
| VADR (risk difference, %)* | ||||||
| Q2 | 0.1203 (0.0989–0.1412) | 0.1169 (0.0951–0.1377) | 0.0034 (0.0025–0.0043) | 0.1309 (0.1123–0.1493) | 0.1308 (0.1122–0.149) | 0.0001 (−0.0003 to 0.0004) |
| Q3 | 0.1766 (0.1368–0.2181) | 0.1704 (0.1307–0.2114) | 0.0061 (0.0043–0.0077) | 0.1842 (0.156–0.2049) | 0.1843 (0.1559–0.2053) | 0 (−0.0007 to 0.0008) |
| Q4 | 0.1153 (0.0822–0.1727) | 0.1116 (0.0783–0.1689) | 0.0037 (0.0031–0.0045) | 0.1111 (0.0833–0.1428) | 0.1111 (0.0832–0.1423) | 0 (−0.0006 to 0.0006) |
| REGARDS (risk difference, %)† | ||||||
| Q2 | 1.0367 (−2.3973 to 4.2590) | 0.9713 (−2.4721 to 4.1819) | 0.0654 (−0.0527 to 0.2345) | 0.9263 (−2.5576 to 4.1751) | 0.9269 (−2.5662 to 4.1417) | −0.0006 (−0.0692 to 0.0555) |
| Q3 | 4.2572 (0.5388–7.8820) | 4.0912 (0.3541–7.7326) | 0.1660 (−0.1387 to 0.4753) | 4.2955 (0.3851–7.8567) | 4.2933 (0.3758–7.8498) | 0.0021 (−0.0728 to 0.0719) |
| Q4 | 3.6776 (−0.6152 to 7.6582) | 3.5915 (−0.7722 to 7.6100) | 0.0862 (−0.0788 to 0.3208) | 3.8804 (−0.4388 to 8.1474) | 3.8782 (−0.4052 to 8.1741) | 0.0022 (−0.0837 to 0.1042) |
| G/JHU (odds ratio)‡ | ||||||
| Q2 | 1.5484 (1.1575–2.0631) | 1.5112 (1.1393–2.0288) | 1.0246 (0.9397–1.0995) | 1.5482 (1.1579–2.0623) | 1.5375 (1.1432–2.0774) | 1.0069 (0.9462–1.0626) |
| Q3 | 1.6747 (1.2509–2.2326) | 1.5923 (1.2244–2.0849) | 1.0518 (0.9533–1.1476) | 1.6747 (1.2512–2.2325) | 1.6622 (1.2459–2.2318) | 1.0075 (0.9456–1.0625) |
| Q4 | 1.7003 (1.2822–2.2672) | 1.6605 (1.2847–2.2023) | 1.024 (0.9301–1.1048) | 1.7006 (1.2829–2.2676) | 1.6958 (1.2775–2.2736) | 1.0028 (0.9637–1.0393) |
| Suburban/small town | ||||||
| VADR (risk difference, %)* | ||||||
| Q2 | 0.13 (0.0922–0.1694) | 0.1313 (0.0936–0.1707) | −0.0013 (−0.0016 to −0.0009) | 0.1274 (0.0936–0.1624) | 0.1292 (0.0955–0.1639) | −0.0018 (−0.0025 to −0.0013) |
| Q3 | 0.204 (0.166–0.2533) | 0.2048 (0.1669–0.2544) | −0.0008 (−0.0012 to −0.0005) | 0.2149 (0.1811–0.2673) | 0.2183 (0.1841–0.2694) | −0.0034 (−0.005 to −0.002) |
| Q4 | 0.2571 (0.1911–0.3001) | 0.26 (0.1935–0.3029) | −0.0029 (−0.0038 to −0.002) | 0.2581 (0.1974–0.3139) | 0.264 (0.2029–0.3196) | −0.0059 (−0.0087 to −0.0046) |
| REGARDS (risk difference, %)† | ||||||
| Q2 | −0.7554 (−5.6646 to 3.3976) | −0.7417 (−5.6261 to 3.4446) | −0.0138 (−0.2132 to 0.1658) | −0.7999 (−5.8290 to 3.9437) | −0.8269 (−5.7967 to 3.9241) | 0.0270 (−0.1292 to 0.2227) |
| Q3 | 1.6791 (−3.1482 to 5.9948) | 1.7063 (−3.0969 to 6.1044) | −0.0271 (−0.4053 to 0.3239) | 1.6828 (−3.3518 to 6.4491) | 1.8242 (−3.1168 to 6.5940) | −0.1414 (−0.6024 to 0.3008) |
| Q4 | 3.9079 (−1.7098 to 9.3131) | 3.9331 (−1.6844 to 9.4345) | −0.0251 (−0.3906 to 0.2514) | 3.9196 (−1.6493 to 10.1089) | 4.0754 (−1.5386 to 10.2197) | −0.1558 (−0.7832 to 0.3676) |
| G/JHU (odds ratio)‡ | ||||||
| Q2 | 1.0574 (0.8821–1.2704) | 1.0658 (0.8939–1.2740) | 0.9921 (0.9673–1.0173) | 1.0575 (0.8822–1.2706) | 1.0559 (0.8795–1.2646) | 1.0016 (0.9848–1.0235) |
| Q3 | 1.1479 (0.9698–1.3498) | 1.1492 (0.9770–1.3429) | 0.9989 (0.9727–1.0257) | 1.1483 (0.9700–1.3506) | 1.1521 (0.9701–1.3514) | 0.9967 (0.9746–1.0255) |
| Q4 | 1.216 (1.0015–1.4611) | 1.2132 (0.9990–1.4556) | 1.0023 (0.9720–1.0353) | 1.217 (1.0020–1.4630) | 1.2248 (1.0068–1.4766) | 0.9937 (0.9638–1.0231) |
| Rural | ||||||
| VADR (risk difference, %)* | ||||||
| Q2 | 0.0627 (0.0323–0.0925) | 0.0672 (0.0366–0.0976) | −0.0045 (−0.0059 to −0.0034) | 0.0686 (0.0176–0.1004) | 0.0717 (0.0206–0.1038) | −0.003 (−0.0039 to −0.0021) |
| Q3 | 0.1229 (0.0685–0.1655) | 0.1319 (0.0797–0.1745) | −0.0089 (−0.0115 to −0.0066) | 0.116 (0.0783–0.159) | 0.1191 (0.0806–0.1628) | −0.0031 (−0.0045 to −0.0019) |
| Q4 | 0.1662 (0.1307–0.2257) | 0.1792 (0.1454–0.24) | −0.0131 (−0.017 to −0.0096) | 0.184 (0.1282–0.2427) | 0.1886 (0.1325–0.2477) | −0.0045 (−0.0059 to −0.0029) |
| REGARDS (risk difference, %)† | ||||||
| Q2 | 5.4849 (0.7844–9.8848) | 5.5412 (0.8414–9.9011) | −0.0563 (−0.2976 to 0.1198) | 5.4866 (1.1072–10.1278) | 5.4172 (1.0430–10.1214) | 0.0694 (−0.0649 to 0.2977) |
| Q3 | 3.7945 (−0.6019–7.9959) | 3.8548 (−0.5369–8.0826) | −0.0604 (−0.2941 to 0.1155) | 3.8329 (−0.9781 to 8.1141) | 3.6756 (−1.1995 to 7.9824) | 0.1573 (−0.1043 to 0.5153) |
| Q4 | 2.8038 (−2.4782–8.1218) | 2.8129 (−2.433–8.1101) | −0.0091 (−0.1954 to 0.1522) | 2.8600 (−2.6076 to 7.9544) | 2.6367 (−2.7676 to 7.8459) | 0.2234 (−0.2248 to 0.8000) |
| G/JHU (odds ratio)‡ | ||||||
| Q2 | 1.0397 (0.9359–1.1534) | 1.0417 (0.9376–1.1576) | 0.998 (0.9880–1.0067) | 1.0396 (0.9359–1.1533) | 1.0403 (0.9367–1.1545) | 0.9994 (0.9927–1.0056) |
| Q3 | 1.1541 (1.0560–1.2603) | 1.1525 (1.0543–1.2606) | 1.0014 (0.9917–1.0098) | 1.1541 (1.0560–1.2603) | 1.1576 (1.0591–1.2628) | 0.9969 (0.9784–1.0171) |
| Q4 | 1.1735 (1.0562–1.3150) | 1.182 (1.0625–1.3270) | 0.9928 (0.9755–1.0098) | 1.1736 (1.0562–1.3151) | 1.1759 (1.0607–1.3155) | 0.998 (0.9850–1.0107) |
Q, quartile.
*
VADR: Model adjusted for baseline age, quadratic age, race/ethnicity, sex, income/disability flag, neighborhood land-use environment, and percentages of Hispanic and Black participants.
†
REGARDS: Model adjusted for age, race, sex, income, current smoking, neighborhood land-use environment, and percentages of Hispanic and Black participants.
‡
G/JHU: Model adjusted for age, sex, race/ethnicity, medical assistance, smoking, neighborhood land-use environment, percentages of Hispanic and Black participants. To address nonlinearity, the higher-density urban model included a quadratic fast-food variable and suburban/small town included quadratic and cubic fast-food variable.