Chicago Neighborhood Context and Racial/Ethnic Disparities in Maternal Diabetes.

Area of Science:

• Public Health
• Epidemiology
• Social Determinants of Health

Background:

• Maternal diabetes, encompassing gestational diabetes (GDM) and preexisting diabetes, poses significant health risks.
• Understanding disparities in diabetes rates across racial, ethnic, and socioeconomic groups is crucial for targeted interventions.

Purpose of the Study:

• To investigate the association between maternal race/ethnicity, neighborhood economic hardship, and the prevalence of gestational and preexisting diabetes.
• To identify specific disparities in diabetes risk among diverse maternal populations in Chicago.

Main Methods:

• Secondary analysis of live births in Chicago (2010-2017) for mothers aged 15-50.
• Stratification of neighborhoods by Economic Hardship Index tertiles and analysis using generalized logit mixed models.
• Inclusion of Non-Hispanic White, Non-Hispanic Black, Mexican, Non-Hispanic Asian, and Other Hispanic mothers.

Main Results:

• Gestational diabetes affected 4.75% of mothers, with highest frequencies in Asian (8.3%) and Mexican (6.8%) mothers.
• Asian and Mexican mothers in medium hardship neighborhoods showed significantly higher odds of GDM.
• Preexisting diabetes occurred in 0.9% of mothers, highest in Mexican (1.26%) and Black (1.06%) mothers. Asian mothers in medium hardship neighborhoods had the greatest odds of preexisting diabetes.

Conclusions:

• Maternal diabetes rates, both gestational and preexisting, do not consistently increase with neighborhood hardship levels for racial and ethnic minority mothers.
• Diabetes prevalence was often elevated in low and medium hardship neighborhoods, challenging a simple linear relationship with socioeconomic status.