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- Title
Association of neighbourhood unemployment rate with incident Type 2 diabetes mellitus in five German regions.
- Authors
Müller, G.; Wellmann, J.; Hartwig, S.; Greiser, K. H.; Moebus, S.; Jöckel, K.‐H.; Schipf, S.; Völzke, H.; Maier, W.; Meisinger, C.; Tamayo, T.; Rathmann, W.; Berger, K.
- Abstract
Aim To analyse the association of neighbourhood unemployment with incident self-reported physician-diagnosed Type 2 diabetes in a population aged 45-74 years from five German regions. Methods Study participants were linked via their addresses at baseline to particular neighbourhoods. Individual-level data from five population-based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self-reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval-censoring and clustering. Results We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person-years (95% CI 11.4-13.8). The risk of Type 2 diabetes mellitus was higher in men [hazard ratio 1.79 (95% CI 1.47-2.18)] than in women and higher in people with a low education level [hazard ratio 1.55 (95% CI 1.18-2.02)] than in those with a high education level. Independently of individual-level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment [quintile 5; hazard ratio 1.72 (95% CI 1.23-2.42)] than in neighbourhoods with low unemployment (quintile 1). Conclusions Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high-risk populations.
- Subjects
GERMANY; TYPE 2 diabetes diagnosis; TYPE 2 diabetes risk factors; CONFIDENCE intervals; PATIENT aftercare; INSULIN resistance; TYPE 2 diabetes; UNEMPLOYMENT; DEVELOPED countries; DATA analysis
- Publication
Diabetic Medicine, 2015, Vol 32, Issue 8, p1017
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12652