UC Berkeley

Incidence and prevalence of chronic diseases such as diabetes are increasing in the U.S. Effective diabetes management is essential to ensure healthy outcomes and avoid severe diabetes sequelae including blindness, myocardial infarction, and early mortality. Research and interventions on diabetes management have primarily targeted changes in individual level risk factors related to physical activity, diet, and medication adherence. Features of neighborhoods, such as neighborhood safety may also be risk factors for poor diabetic management. Research has associated neighborhoods with diabetes incidence and prevalence but few studies focus diabetic populations. To this end, the overall goal of these analyses is to examine how neighborhood safety is associated with diabetic health.

Methods: Chapter 1 provides an introduction and overview to the diabetes and neighborhood safety literature. Three analyses investigating research aims related to neighborhood safety and diabetic management and health will be conducted over three chapters, as follows: Chapter 2: Perceived Neighborhood Safety and Crime in Relation to Cardiometabolic Risk Factors among type II diabetics, Chapter 3: Examining associations between police recorded crime and stress among type II diabetics, and Chapter 4: Examining associations between police recorded crime and obesity among type II diabetics. Chapter 5 provides a summary of findings, implications, and recommendations.

This study will use data from the Diabetes Study of Northern California (DISTANCE), one of the largest, racially and ethnically diverse U.S. cohorts of diabetics followed in a managed care health system. This cohort was established to study social determinants of diabetes and is ideally suited to explore how neighborhood safety, using measures of perceived and objective crime, influence stress and cardiometabolic risk factors such as glycemic control and body mass index.

Discussion and Significance: Diabetics are at risk for a multitude of diabetic complications and early mortality. Understanding how neighborhood level risk factors affect diabetic health may help alleviate diabetes sequelae. Contextual risk factors such as neighborhood crime and safety may be amenable to policy changes and may lead to additional effective interventions for diabetics.