TY - JOUR
T1 - People living in hilly residential areas in metropolitan Perth have less diabetes
T2 - Spurious association or important environmental determinant?
AU - Villanueva, Karen
AU - Knuiman, Matthew
AU - Koohsari, Mohammad Javad
AU - Hickey, Sharyn
AU - Foster, Sarah
AU - Badland, Hannah
AU - Nathan, Andrea
AU - Bull, Fiona
AU - Giles-Corti, Billie
N1 - Funding Information:
The Western Australian Health Promotion Foundation i.e., Healthway, funded this project (#18922). The University of Western Australia Human Research Ethics Committee and The Department of Health of Western Australia (DoHWA) granted ethics approval (#2010/1). The DoHWA and Western Australian Data Linkage Branch are gratefully acknowledged for providing and extracting Health and Wellbeing Surveillance System survey data. The ©Commonwealth of Australia (Geoscience Australia) provided the DEM data. Spatial data based on information provided by and with the permission of the ©Western Australian Land Information Authority (i.e., Landgate) was used. Sensis Pty Ltd provided access to destination data obtained from its Yellow Pages database. Nick Middleton is gratefully acknowledged for his role in developing GIS scripts used for analyses, and processing GIS measures in 2010 and 2011. SF is supported by a Healthway Health Promotion Research Fellowship (#21363); SH by NHMRC Population Health Capacity Building Grant (#458668), and BGC is supported by a NHMRC Principal Research Fellow Award (#1004900).
PY - 2013
Y1 - 2013
N2 - Background: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population. Methods: Participants (≥25 years; n = 11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600 m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking. Results: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope. Conclusions: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.
AB - Background: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population. Methods: Participants (≥25 years; n = 11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600 m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking. Results: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope. Conclusions: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.
KW - Adults
KW - Built environment
KW - Diabetes
KW - Hilly
KW - Neighbourhood
KW - Slope
KW - Terrain
KW - Walking
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U2 - 10.1186/1476-072x-12-59
DO - 10.1186/1476-072x-12-59
M3 - Article
C2 - 24359514
AN - SCOPUS:84890449259
VL - 12
JO - International Journal of Health Geographics
JF - International Journal of Health Geographics
SN - 1476-072X
IS - 1
M1 - 59
ER -