The Influence of Neighborhood Poverty on Blood Glucose Levels: Findings from the Community Initiative to Eliminate Stroke (CITIES) program

Abstract

Objectives:  To examine the relationship between both individual and neighborhood level characteristics and non-fasting blood glucose levels.Study design: This study used a cross sectional design using data from the Community Initiative to Eliminate Stroke Program in NC (2004-2008).  A total of 12,809 adults nested within 550 census block groups from two adjacent urban counties were included in the analysis.Methods:   Participants completed a cardiovascular risk factor assessment with self-reported demographics, stroke-risk behaviors, and biometric measurements.  Neighborhood level characteristics were based upon census data.  Three multilevel models were constructed for data analysis.Results:  Mean blood glucose level of this sample population was 103.61mg/dL.  The unconditional model 1 suggested a variation in mean blood glucose levels among the neighborhoods (τ00 = 13.39; P < .001).  Both models 2 and 3 suggested that the neighborhood composite deprivation index had a significant prediction on each neighborhood’s mean blood glucose level (¡01= .69; P < 0.001,¡01= .36; P = .004).  Model 3 also suggested that across all the neighborhoods, on average, after controlling for individual level risk factors, deprivation remained a significant predictor of blood glucose levels.Conclusions:  The findings provide evidence that neighborhood disadvantage is a significant predictor of neighborhood and individual level blood glucose levels.  One approach to diabetes prevention could be for policymakers to address the problems associated with environmental determinants of health.