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Climate Vulnerability Index and Incident Type 2 Diabetes in a Large Integrated Health Care System.

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Area of Science:

  • Environmental Health
  • Epidemiology
  • Metabolic Disease Research

Background:

  • Place-based Climate Vulnerability Index (CVI) may influence metabolic risk via environmental and socioeconomic factors.
  • The association between CVI and incident type 2 diabetes (T2D) requires further characterization.

Purpose of the Study:

  • To investigate if residing in communities with higher CVI is associated with an increased risk of incident T2D.

Main Methods:

  • A retrospective cohort study utilizing data from the Houston Methodist Learning Health System Registry (June 2016–August 2023).
  • Included over 1 million adults without T2D at baseline, analyzing US census tract-level CVI categorized into quartiles.
  • Incident T2D was identified via ICD codes, prescriptions, or HbA1c levels; adjusted hazard ratios (HRs) were calculated.

Main Results:

  • Among 1,003,526 participants, 40,152 developed T2D.
  • Diabetes incidence was higher in the highest CVI quartile (Q4) compared to the lowest (Q1) (2.66 vs. 1.48 cases per 100 person-years).
  • Residence in Q4 CVI areas was associated with a 23% increased risk of T2D (HR, 1.23; 95% CI, 1.11-1.36) compared to Q1.

Conclusions:

  • Higher community CVI is independently associated with an increased risk of incident T2D.
  • Integrating geocoded CVI with electronic health records can aid in targeted prevention and population health planning.