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Neighborhood conditions and celiac disease risk among children in Sweden
Fredinah Namatovu1, Magnus Strömgren2, Anneli Ivarsson3
1Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå; Sweden fredinah.namatovu@epiph.umu.se.
Insights
Neighborhood factors like income and education influence celiac disease (CD) risk. Higher income areas showed increased CD probability, while factors like older age and higher education levels were linked to reduced risk.
Area of Science:
- Epidemiology
- Environmental Health
Background:
- Celiac disease (CD) incidence exhibits geographical variations.
- Understanding neighborhood-level influences on CD risk is crucial for public health interventions.
Purpose of the Study:
- To investigate geographical clustering of celiac disease (CD) at various levels.
- To examine the association between neighborhood demographic and socioeconomic factors and CD risk.
Main Methods:
- Utilized data from 2080 children diagnosed with CD in Sweden (1998-2003).
- Analyzed 8036 small area market statistics (SAMS) areas nested within municipalities and NUTS 2 regions.
- Employed multilevel logistic regression analyses to assess risk factors.
Main Results:
- Geographical variation in CD incidence was highest at the municipality level.
- Increased CD probability was associated with higher average annual work income in SAMS areas (OR 2.24).
- Reduced CD risk was linked to higher average age (OR 0.96), greater university education (OR 0.98), and industrial/commercial activity (OR 0.59).
Conclusions:
- Neighborhood composition significantly influences celiac disease risk.
- This study provides initial insights into factors explaining geographical variations in CD.
Aim:
To investigate celiac disease (CD) clustering at different geographical levels and to examine the association between neighborhood demographic and socioeconomic conditions and the risk of neighborhood CD.
Methods:
We included 2080 children diagnosed with CD between 1998 and 2003, identified from 43 of the 47 reporting hospitals in Sweden. A total of 8036 small area market statistics (SAMS) areas were included; these were nested in 253 municipalities that were further nested into eight 'nomenclature of territorial units for statistics' (NUTS) 2 regions. We performed multilevel logistic regression analyses.
Results:
We found the highest geographical variation in CD incidence at the municipality level, compared to the region level. The probability of having CD increased in the statistical areas of (SAMS) areas with higher average annual work income, with an odds ratio (OR) of 2.24 and 95% CI of 1.76-2.85. Reduced CD risk in neighborhoods was associated with higher average age (OR 0.96; 95% CI 0.95-0.97), higher proportion of residents with a university education (OR 0.98; 95% CI 0.97-0.99), and higher level of industrial and commercial activity (OR 0.59; 95% CI 0.44-0.82). We found no significant association between CD risk and population density, proportion of Nordic to non-Nordic inhabitants, nor share of the population with only a compulsory education.
Conclusions:
Neighborhood composition influences cd risk this is one of the first attempts to identify factors explaining geographical variation in CD.
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