Social and Behavioral Factors Associated With Diabetes in Southern California vs the US
Authors' conclusion
In this cross-sectional study, key correlates of diagnosed diabetes in Southern California included physical inactivity, access to health care, and food insecurity, while nationally, obesity, food stamp participation, older age (≥65 years), and racial or ethnic minority status were also key. These findings point to possible regional differences in the factors linked to diabetes prevalence and highlight the need for further research to determine their significance and potential for guiding targeted interventions.
Study context
- Population
- Census tracts in Southern California and nationwide (CDC 2024 Population Level Analysis and Community Estimates (PLACES) modeled estimates); 24 social and behavioral correlates testedcensus tracts
- Participants
- 5,420 vs 62,480
- Exposure
- Social and behavioral correlates of diagnosed diabetes in Southern California vs nationally
- Southern Californian = 5,420
- Nationaln = 62,480reference
- Outcome
- Diagnosed diabetes prevalence (% of adults ever diagnosed by a health care professional, excluding GDM) and its association with 24 indicators
Methodological detailscensus tract–level modeled estimates, CDC 2024 PLACES dataset, gradient-boosted regression tree (explainable machine learning)
- Census tract–level modeled estimates
- CDC 2024 PLACES dataset
- Gradient-boosted regression tree (explainable machine learning)
Main finding
As reported in the abstract
Key correlates of diagnosed diabetes prevalence in Southern California (contribution to model estimate)
- 5 key correlates, total contribution
- 67%
- Physical inactivity
- 31%
- Routine check-ups
- 14%
- Binge drinking
- 11%
- Lack of insurance
- 6%
- Food insecurity
- 5%
Observational data: associations, not effects.
Further findings
| Outcome | Southern California | National |
|---|---|---|
| Diagnosed diabetes prevalenceMean | 11.29% (SE 0.06) | 11.52% (SE 0.02) |
| Range | 1.4% (0.05) to 33.6% (1.37) | — not stated in the abstract |
— not stated in the abstract
Original publication
Social and Behavioral Factors Associated With Diabetes in Southern California vs the US. JAMA Netw Open. Published 1 October 2025. doi:10.
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