Neighborhood Can Affect Obesity Diabetes Risk
The New England Journal of Medicine has published a report stating that females living in disadvantaged areas have a higher probability of developing type 2 diabetes or becoming obese than those who live in areas with less poverty. The research was conducted from 1994 until 1998, with a follow up in 2008 to 2010, and involved 4,498 women. All the women came from poor areas and lived in public housing with their children.
The program was named Moving to Opportunity and had the aim of discovering if women and children living in high poverty areas had any discernable benefits if they lived in lower poverty areas. Volunteers from five cities were involved, New York, Los Angeles, Boston, Baltimore and Chicago.
The study divided the volunteers into three groups in a random manner. One group was not given any assistance, the second group received vouchers which could be spent only if the women moved into an area with less than 10% poverty and they were given assistance in the form of counseling regarding moving. The third group received the same vouchers but had no restrictions placed upon them and did not receive counseling.
The research was carried out by a team led by Jens Ludwig, the McCormick Foundation Professor of Social Service Administration, Law and Public Policy at the University of Chicago. Of the study he says, “The effects in our paper seem to be roughly comparable to the best practice lifestyle and medication interventions. That’s pretty striking. The initial aim of the study was to help families be safer, but it turns out there’s an effect on these really important health outcomes that’s in the ballpark of lifestyle and medical interventions”.
He goes on to say that the report indicates that money spent outside the health system can also provide many health benefits within the healthcare system.
Throughout the follow up period between 2008 and 2010 the researchers repeated height and weight measurements and collected blood for diabetes testing. It was found that of the group with no intervention 17% of the women were morbidly obese. This means that their body mass index was 40 or more. The women who moved to the lower poverty areas had a rate of 14.4% who were morbidly obese and those who could move anywhere had a morbid obesity rate of 15.4%.
Women who moved to lower poverty areas had the lowest incidence of diabetes, at 16.3%, whereas those who could live anywhere had a rate of 20.6% and the control group had a 20% incidence of diabetes.
The findings show that after 10 years of living in the new less poor neighborhoods, those women had decreased their chances of becoming morbidly obese by 19%. They were also 22% less likely to have type 2 diabetes when compared with the group that had no intervention and remained in high-poverty areas.
Ludwig points out that the study cannot specify the factors related to the decrease in obesity and diabetes rates in women who moved to less poor areas because it was not designed for that purpose. However he puts forward an idea that there may be four reasons contributing to the effect. He believes that having access to better food contributes to the outcome and notes that in very poor areas there are no food stores, only small corner shops. He also says that the lower poverty areas are safer thus allowing the women to move around more freely and take exercise. These areas also have access to superior health care facilities. And Ludwig also indicates that because someone is in a safer neighborhood then they have less psychological stress which may help.
Dr. Joel Zonszein, is director of the clinical diabetes center at Montefiore Medical Center in New York City and he asserts that the study was well run and investigated a very complex issue. He says of the study, “They showed that the neighborhood may be a very important component in controlling obesity and diabetes”. He also pointed out that this would not be very expensive to put into practice.
He backs his words by explaining that the cost of dealing with one diabetes sufferer for one year is estimated to be about $5,000. As the women already live in public housing then the only extra cost would be the counseling. He believes that there is scope to make considerable savings if such a scheme was realized.