Persistent residential segregation contributes to worse diabetes health in Black youths
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NEW ORLEANS — A new study identified a link between persistent racial residential segregation and worse diabetes health in Black adolescents with type 1 diabetes.
These findings highlight the impact of residential location for young people with diabetes, Deborah A. Ellis, PhD, professor of family medicine and public health sciences at Wayne State University, Detroit, said at the American Diabetes Association Scientific Sessions.
Ellis and colleagues evaluated the association between racial residential segregation and diabetes management and glycemic control among Black adolescents with type 1 diabetes. The study included 144 Black adolescents (mean age, 13.3 years; 57% girls) from seven pediatric diabetes clinics in Chicago and Detroit. The adolescents’ mean HbA1c was 11.5% and mean household annual income was $34,000.
The researchers evaluated diabetes management by self-reports using the Diabetes Management Scale. To determine racial residential segregation, the researchers geocoded family addresses to determine the U.S. Census group block where they resided. The mean location quotient indicated that most adolescents’ residences were in highly segregated neighborhoods, according to the researchers. They also assessed neighborhood adversity, based on a nine-domain factor score that included variables such as the percent of people living in poverty, percent of households with no vehicle and percent of vacant housing units.
“In the world of adult diabetes, there has been a lot of focus on social determinants of health, but in pediatrics, there has been less,” Ellis told Healio. Moreover, research on the effects of neighborhoods on the health of Black youth with type 1 diabetes are limited.
The researchers’ aim was to determine whether racial residential segregation explained diabetes outcomes beyond the effects of adversity associated with living in low-income neighborhoods.
The main outcomes measured were HbA1c and diabetes management.
The results suggested that racial residential segregation was predictive of the diabetes health of Black youths with type 1 diabetes, even after controlling for effects of household income and neighborhood adversity.
“It is interesting that racial residential segregation was even more explanatory than the adversity characteristics of the neighborhood,” Ellis told Healio.
In bivariate correlations, the researchers found an association between racial residential segregation and HbA1c (P = .001), but not with diabetes management, Ellis told Healio. Black youths with type 1 diabetes who resided in more racially segregated neighborhoods had higher HbA1c, according to the findings. Only age (P = .003), insulin delivery method (P = .01) and racial residential segregation (P = .04) had significant effects on HbA1c in the final model, Ellis said.
“Data like this can help [health care providers] be more sensitive to what Black youth with type 1 diabetes are facing in their daily lives and reinforce the need for equitable access to healthy environments,” Ellis said. “It’s important that we are asking young patients with diabetes about factors in their life beyond just, ‘What are you doing to take care of your diabetes?’”
The researchers noted that advocacy and policy efforts are needed to address inequities and improve diabetes population health overall.
Reference:
- Studies uncover stark impact social determinants of health have on youth and adult populations with diabetes. Published June 4, 2022. Accessed June 4, 2022.
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Ellis DA, et al. 569-P. Presented at: American Diabetes Association Scientific Sessions; June 3-7, 2022; New Orleans (hybrid meeting).
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