Higher Neighborhood Drivability Is Associated With a Higher Diabetes Risk in Younger Adults: A Population-Based Cohort Study in Toronto, Canada
Main finding · Diabetes onsetResult — go to the resultAdjusted hazard ratio 1.41 95% CI 1.37–1.44Authors' conclusion
High neighborhood drivability is a risk factor for diabetes, particularly in younger adults. This finding has important implications for future urban design policies.
Study context
- Population
- Working-age adults (20–64 years) living in Toronto on 1 April 2011 without diabetes (type 1 or 2); mean age 40.9 ± 12.2 years77,835 developed diabetes
- Participants
- 1,473,994 adults
- Exposure
- Most drivable vs least drivable neighborhoods
- Outcome
- Diabetes onset
- Follow-up
- 7 years
Methodological detailsadministrative health care data, Cox regression adjusted for baseline characteristics and comorbidities
- Administrative health care data
- Cox regression adjusted for baseline characteristics and comorbidities
Main finding
As reported in the abstract
Adjusted hazard ratio
1.41
95% CI 1.37–1.44
Quintile 5vs Least drivable
aHR 1.41 (95% CI 1.37–1.44)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Diabetes onset, adults aged 20-34 yearsStrongest association | 1.57 (1.47–1.68) | P < 0.001 for interaction | |
| Diabetes onset, older adults aged 55-64 yearsSmaller differences | 1.31 (1.26–1.36) | ||
| 0.512Adjusted hazard ratio (log scale) |
Diabetes onset, younger residents of middle-income neighborhoods · 7 years
- Most vs least drivable neighborhoods, middle income, younger residents (associations appeared strongest in middle-income neighborhoods)
- 1.96, 95% CI 1.64-2.33
Diabetes onset, older residents of middle-income neighborhoods · 7 years
- Most vs least drivable neighborhoods, middle income, older residents (associations appeared strongest in middle-income neighborhoods)
- 1.46, 95% CI 1.32-1.62
Original publication
Higher Neighborhood Drivability Is Associated With a Higher Diabetes Risk in Younger Adults: A Population-Based Cohort Study in Toronto, Canada. Diabetes Care. Published 23 March 2023. doi:10.
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