The study published Oct. 20 in the New England Journal of Medicine in a special article, "Neighborhoods, Obesity and Diabetes - " A Randomized Social Experiment." rather cleverly used the same kinds of randomization that are employed to pharmaceutical drug trials. The lead author for the collaboration was Jens Ludwig, the McCormick Foundation Professor of Social Service Administration, Law and Public Policy at U Chicago.
In total Ludwig and associates studied nearly 5,000 women and children who from 1994 to 1998 were part of the U.S. Department of Housing and Urban Development program known as Moving to Opportunity. MTO was operated in 5 cities : Baltimore, Boston, Chicago, Los Angeles and New York.
Those that enrolled in the program were randomly offered housing subsidies to move to better, lower-poverty neighborhoods, while others were randomly assigned to the control group that received no special assistance.
10 to 15 years later the researchers followed up on the families to measure height, weight, and also take blood samples to check for diabetes. They found that 15% of women in the control group were morbidly obese (body mass index at or above 40) and 20% had diabetes. In the group that were offered better housing opportunities, the statistics were 20% lower.
Ludwig was happy with the results :
"These findings provide strong evidence that the environments in low-income neighborhoods can contribute to poor health."
His associate research team member Stacy Tessler Lindau, associate professor in obstetrics and gynecology, and an expert in urban health noted :
"Obesity and diabetes are among the biggest health problems facing our country, and they are preventable. But preventing these conditions through interventions that target individual behavioral change has proven very difficult ... This study shows that where a woman lives with her children may, in part, determine whether she develops serious, costly, life-shortening diseases like diabetes and extreme obesity. Giving a low-income woman the opportunity to move with her children to a less impoverished neighborhood appears to lower her risk of diabetes and extreme obesity."
The study's conclusions that disadvantaged community environments are a factor in extreme obesity and diabetes could help explain disparities in obesity and diabetes prevalence across race and ethnic lines in the U.S. They write in their paper :
"The increase in U.S. residential segregation according to income in recent decades suggests that a larger portion of the population is being exposed to distressed neighborhood environments .... Minorities are also more likely than whites to live in distressed areas."
Ludwig concludes :
"These results highlight the great importance of learning more about what specific aspects of the social or physical environment reduce the risk of diabetes and obesity; for example, greater access to grocery stores, more opportunities for physical activity, or feelings of greater safety and reduced psychological stress."
The study was supported by HUD, the National Science Foundation, the National Institute of Child Health and Human Development, The Centers for Disease Control and Prevention, the National Institute of Mental Health, the National Institute on Aging, the Institute of Education Services at the U.S. Department of Education, the John D. and Catherine T. MacArthur Foundation, the Smith Richardson Foundation, the Spencer Foundation, the Annie E. Casey Foundation, the Bill and Melinda Gates Foundation, the Russell Sage Foundation, and the Robert Wood Johnson Foundation.
Written by Rupert Shepherd