The neighborhood has an influence on the risk of diabetes, through access to stores more likely to sell healthier foods and local sports facilities, a 10-year study has found.

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Local leisure facilities had an influence on health behavior.

Published in JAMA Internal Medicine, the research found that people living in neighborhoods marked by “limited resources for healthy eating and physical activity” had higher risk for being diagnosed with type 2 diabetes.

The authors used data from the Multi-Ethnic Study of Atherosclerosis, examining a group of 5,124 individuals free of diabetes at the start and followed up between the years 2000 and 2012.

Information on healthy food and physical activity resources came from:

  • Geographic information system-based measures of access to healthy food stores and access to recreational facilities
  • Survey information about the availability of healthy foods, the walking environment and the social environment for safety and social cohesion.

Researcher Paul Christine of the University of Michigan in Ann Arbor worked with coauthors on the longitudinal prospective study.

Of 5,124 participants, 616, or 12%, developed type 2 diabetes, and these new cases were more likely to be found in black or Hispanic people, those with lower income, fewer years of education, less healthy diets, lower levels of moderate and vigorous physical activity, a higher BMI or a family history of diabetes.

After accounting for a number of patient-related factors, a lower risk for developing type 2 diabetes was associated with greater cumulative exposure to healthy food and – with a bigger effect – resources for physical activity in the neighborhood.

The authors conclude: “Our results suggest that modifying specific features of neighborhood environments, including increasing the availability of healthy foods and physical activity resources, may help to mitigate the risk for type 2 diabetes although additional intervention studies with measures of multiple neighborhood features are needed.

“Such approaches may be especially important for addressing disparities in T2DM given the concentration of low-income and minority populations in neighborhoods with fewer health-promoting resources.”

A commentary article on the study is published in the same issue of the journal. Written by Nancy Adler, PhD, and Aric Prather, PhD, of the University of California, San Francisco, it says:

“Having markets and recreational facilities located nearby may be necessary but not sufficient to enable healthy behaviors.

Building more facilities in neighborhoods that lack them is a component of an overall strategy to address the national rise in obesity, but this strategy needs to be informed by an understanding of when such facilities are actually used and the characteristics of the individuals who use them.”

The commentary also calls for “precision prevention” – collection of more information to inform medicine.

It recommends that personal financial information and residential address be routinely included in patients’ electronic medical records alongside other social and behavioral health determinants.