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Association between environmental quality and diabetes in the USA
Jyotsna S Jagai1, Alison K Krajewski2, Sabina Shaikh3
1School of Public Health, Division of Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.
Journal of Diabetes Investigation
|October 4, 2019
Summary
Poor environmental quality, not just lifestyle, may influence diabetes rates. Comprehensive diabetes prevention should include improving environmental quality, especially in less urbanized areas.
Area of Science:
- Environmental health
- Epidemiology
- Public health
Background:
- Caloric excess and physical inactivity do not fully explain rising diabetes prevalence.
- Individual environmental pollutants can disrupt glucose homeostasis.
- The impact of cumulative environmental exposures on diabetes risk remains unclear.
Purpose of the Study:
- To investigate the association between cumulative environmental exposures and diabetes prevalence.
- To assess the impact of the Environmental Quality Index on diabetes rates across different rural-urban strata.
Main Methods:
- Developed a county-level Environmental Quality Index (EQI) from five domains.
- Linked EQI to county-level diabetes prevalence rates.
- Used mixed-effects linear regression to estimate prevalence differences (PD) and 95% confidence intervals (CI), stratified by rural-urbanicity.
Main Results:
- Counties with the poorest environmental quality showed lower total diabetes prevalence rates compared to those with the best quality.
- Better overall environmental quality correlated with lower diabetes prevalence in less urbanized strata.
- Good sociodemographic environments were linked to lower diabetes prevalence (PD 2.77 per 100,000).
Conclusions:
- Environmental exposures are significant contributors to diabetes pathogenesis.
- Improving environmental quality is crucial for comprehensive diabetes prevention strategies.
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