The Associations Between Neighborhood Safety and Address Stability With HbA1c Levels Among Adults With Diabetes

Area of Science:

• Public Health
• Health Services Research
• Diabetes Management

Background:

• Nonmedical drivers of health (NMDOH), including neighborhood and economic status, significantly impact diabetes management.
• Understanding these social determinants is vital for effective diabetes quality improvement (QI) programs.

Purpose of the Study:

• To identify specific NMDOH associated with patient response to a diabetes intervention.
• To analyze the relationship between neighborhood characteristics and diabetes outcome improvements.

Main Methods:

• Retrospective analysis of 473 adult patients from a diabetes QI program.
• Categorization of patients into responders (HbA1c reduction ≥ 0.5%) and nonresponders (HbA1c reduction < 0.5%).
• Linking electronic medical record data with NMDOH data to examine associations using ANOVA and Fisher's exact tests.

Main Results:

• Fifty-one percent of patients were responders to the diabetes intervention.
• Significant associations were found between intervention response and neighborhood crime rates.
• Address stability, indicated by the frequency of address changes, was also significantly linked to patient response.

Conclusions:

• Neighborhood environment, specifically crime and residential stability, affects patient response to diabetes interventions.
• Future diabetes QI initiatives should integrate social support navigators to address neighborhood stressors and socioeconomic barriers.