New Link Between Neighborhood Food Environment and the Likelihood of Chronic Diseases

Living in neighborhoods with higher availability of fast-food outlets across all regions of the United States is associated with a higher risk of developing type 2 diabetes, according to a new study published in JAMA Network Open.

Previous studies have suggested a link between a neighborhood’s built environment and the likelihood that its residents will develop chronic diseases such as heart disease, type 2 diabetes (T2D), and certain types of cancers.

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‘The availability of more supermarkets could be protective against developing Type 2 diabetes, particularly in suburban and rural neighborhoods.’

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The new study used data from the U.S. Veterans Health Administration (the largest single-payer healthcare system in the country) that captures more than 9 million veterans seen at more than 1,200 health facilities around the country.

Using this data, researchers then constructed a national study population of more than 4 million veterans without diabetes from the VA electronic health records (EHR) between 2008 and 2016.

Each veteran’s health status was followed through 2018 or until the individual either developed diabetes, died, or had no appointments for more than two years.

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The proportion of fast-food restaurants and the proportion of food outlets that were supermarkets were tabulated within a one-mile walk in high-density urban neighborhoods, a two-mile drive in low-density urban neighborhoods, a six-mile drive in suburban communities, and a 10-mile drive in rural communities.

During the following period, 13.2 percent of the study population were newly diagnosed with T2D. Males developed T2D more frequently than females (13.6 versus 8.2 percent).

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Non-Hispanic Black adults had the highest incidence (16.9 percent), compared to non-Hispanic whites (12.9 percent), non-White Asian and Hispanics (12.8 percent), Native Hawaiian and Pacific Islanders (15 percent), and Native American and Alaskan Indians (14.2 percent).

When stratifying by community types, 14.3 percent of veterans living in high-density urban communities developed T2D, while the lowest incidence was among those living in suburban and small-town communities (12.6 percent).

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These findings concluded that the effect of the food environment on T2D incidence varied by how urban the community was, but did not vary further by region of the country.

“The more we learn about the relationship between the food environment and chronic diseases like type 2 diabetes, the more policymakers can act by improving the mix of healthy food options sold in restaurants and food outlets, or by creating better zoning laws that promote optimal food options for residents,” said Lorna Thorpe, Ph.D., MPH, professor in the Department of Population Health at NYU Langone and senior author of the study.

One limitation of the study is that the study may not be fully generalizable to non-veteran populations, as U.S. veterans tend to be predominantly male and have substantially greater health burdens and financial instability than the civilian population.

The next phase of the research will be to better understand the impacts of the built environment on diabetes risk by subgroups.

They also plan to examine whether or not the relationships between fast-food restaurants, supermarkets, and community types vary by gender, race/ethnicity, and socioeconomic status.

Source-Medindia