Neighborhood predictors of physical activity and health outcomes in African-Americans with type II diabetes

Objective: Neighborhood characteristics have been shown to affect various health outcomes. However, most of this research has focused on white populations. Moreover, most studies are based on self-reported rather than objective neighborhood measures and few studies have explored neighborhood influences on individuals with type II diabetes. The goal of this study is to use objective data to analyze the effects of neighborhood characteristics on moderate/vigorous physical activity (MVPA) and diabetes-related clinical measures in African-Americans with type II diabetes.

Methods: Subjects are enrolled in the LIFE study, a randomized-controlled trial testing a culturally-tailored, self-management intervention for African-Americans with type II diabetes. Participant measures of objectively measured MVPA, BMI, HbA1c, and BP were taken at baseline. Neighborhood variables, based on public data, included hardship, walkability and homicide density and were generated using a 1000m buffer around each participant address. Linear and logistic models were used to determine associations between personalized neighborhood characteristics and health outcomes, controlling for individual characteristics. 

Results: Demographics include mean age=55 years, 30% male, 68.3% income <$20,000, and 12.8% college graduate. Living in an area with greater homicide density predicted higher BMI, higher diastolic BP, and lower odds of at least 20 minutes MVPA per day. Having a higher street intersection density was associated with higher MVPA and higher HbA1c. Walkability was also associated with higher HbA1c. Neighborhood hardship was not associated with any health outcomes.  

Conclusion: Objectively measured homicide density and walkability are associated with health outcomes in African-Americans with Type II diabetes.