Does where you live predict your risk of developing Type 2 diabetes?
In the past, studies have correlated living in high-poverty neighborhoods with a higher risk of developing Type 2 diabetes. However, it’s been difficult to decipher whether it was the economic conditions or the ethnic makeup of that neighborhood that was the engine behind that higher risk rate, as some ethnicities are more genetically prone to diabetes than others.
For better or worse, world events sometimes provide a living laboratory for such questions. A recent study tracked refugees in Sweden who were randomly dispersed by the Swedish government into different neighborhoods to see whether localized poverty, not ethnicity, increases the risk of Type 2 diabetes.
According to a Medscape report, researchers used government data to track 61,386 Swedish refugees who arrived in Sweden between 1987 and 1991. These refugees were randomly settled by the Swedish government into 48,333 neighborhoods with differing levels of poverty, unemployment, public education, and social welfare programs (after being settled, the refugees were, of course, free to move to other neighborhoods in the country). Most refugees were settled into lower-income or moderate-income neighborhoods. The researchers then compared the rate of Type 2 diagnosis for these former refugees between January 1st, 2002 and December 31, 2010 across neighborhoods.
After adjusting for other factors, researchers found that former refugees who were originally settled in areas of high deprivation had a 22 percent higher risk for Type 2 diabetes than those settled in affluent neighborhoods. Those settled in moderate income neighborhoods also had increased risk of 15 percent. And how long you were in that area of high deprivation mattered – increased exposure to a high-deprivation neighborhood over the course of five years was associated with a 9 percent increase in diabetes risk. That means that even living for a short while in an area of high poverty increased Type 2 risk.
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The refugees’ ethnic makeup appeared to have no effect on Type 2 risk, but those who came from poor countries had a higher risk for Type 2 than those who came from more well-off countries. This seems to provide strong evidence that exposure to poverty, even at an early age, drives Type 2 risk much more than ethnicity.
The study was led by researchers with the University of California School of Medicine and Stanford University School of Medicine. The researchers conclude that more diabetes resources, education, and attention should be allocated to parents in high-deprivation areas. In addition, physicians should work with local social workers and community organizers to seek the best way to provide care in communities with high poverty rates.
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