Der Zusammenhang von Deprivation im Wohnumfeld und der Typ-2-Diabetes-Prävalenz: Ergebnisse der Dortmunder Gesundheitsstudie (Do-GS)

Zusammenfassung

Ziel der Studie:

Der Zusammenhang zwischen Deprivation im Wohnumfeld und der Typ-2-Diabetes-Prävalenz wurde unter Verwendung von 2 Ansätzen zur Deprivationsmessung untersucht.

Methodik:

Individualdaten der Dortmunder Gesundheitsstudie (n=1 312) wurden mit administrativen Daten der 62 Bezirke in Dortmund kombiniert. Ein Index aus 8 demografischen und sozio-ökonomischen Kontextvariablen wurde mittels Hauptkomponentenanalyse konstruiert. Logistische Mehr-Ebenen-Regressionsmodelle wurden geschätzt und für Alter, Geschlecht, soziale Schicht und Erwerbsstatus kontrolliert.

Ergebnisse:

Die Studienpopulation wies eine Typ-2-Diabetes-Prävalenz von 7,2% auf. Die Hauptkomponentenanalyse lieferte eine 2-Faktorenlösung, von der der sozio-ökonomische Deprivationsfaktor in die multivariable Analyse ­genommen wurde. Individuen, die in Wohnumfeldern mit einem sehr hohen Niveau an Arbeitslosigkeit oder sozio-ökonomischer Deprivation lebten, hatten, unabhängig von individuellen Merkmalen, eine höhere Chance eines Typ-2-Diabetes [OR: 4,44 (95% KI: 1,29–15,33), bzw. OR: 2,79 (95% KI: 1,10–7,07)].

Schlussfolgerung:

Über individuelle Merkmale hinaus trägt das nähere Wohnumfeld zu einer erhöhten Chance einen Typ-2-Diabetes zu haben bei. Die Arbeitslosenrate im Wohnumfeld fungiert als ein starker Prädiktor der Chance eines Typ-2-Diabetes.

Abstract

Objective:

The association between depriva­tion in the residential environment and the prevalence of type 2 diabetes has been evaluated by applying two approaches to measure neighbourhood deprivation.

Methods:

Individual data were extracted from the Dortmund Health Study (n=1 312) and combined with administrative data on 62 neighbourhoods in the city of Dortmund. Deprivation indices were constructed by applying principal component analysis with a set of 8 demographic and socio-economic context variables on the low city level. 2-level cross-sectional logistic regression analyses were conducted, adjusted for age, sex, social class and employment status.

Results:

The study population had a type 2 diabetes prevalence of 7.2%. The principal component analysis provided a 2-factor solution of which one factor was given in the multivariable analysis. Individuals, residing in neighbourhoods with a very high level of unemployment rate or socio-economic deprivation, showed a higher chance to have type 2 diabetes [OR: 4.44 (95% CI: 1.29–15.33) or, respectively, OR: 2.79 (95% CI: 1.10–7.07)], independent of individual characteristics.

Conclusion:

Beyond individual characteristics, the residential environment contributes to the chance of type 2 diabetes. The unemployment rate operated as a strong predictor of the chance of type 2 diabetes.

Schlüsselwörter

Deprivation im Wohnumfeld - Diabetes Typ 2 - Mehr-Ebenen-Analyse - sozio-ökonomischer Status - Arbeitslosenrate

Key words

residential deprivation - type 2 diabetes - multilevel analysis - socioeconomic status - unemployment rate

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