Abstract
There is a growing diabetes epidemic in the United States and if we are to halt its progress we need to better understand the social determinants of this disease and its control. Social capital, which has been associated with general health and mortality, may be one important mediator of glucose control. In this study we determine if neighborhood social capital is associated with glucose control, independent of individual factors. We performed a cross-sectional study of Black veterans with diabetes living in Philadelphia. We merged individual-level data from surveys and charts with six area-level social capital descriptors. Holding all other variables constant, patients who lived in neighborhoods that scored near the 5th percentile of working together to improve the neighborhood were estimated to have glycosylated hemoglobin (HbA1c) values that were at least one point above a conservative clinical definition of “diabetes control” (HbA1c ≤ 8%). If these same patients were to live in neighborhoods in the 95th percentile, their expected HbA1c would be over ½ a point below the cut-off value 8%. No other measure of social capital was associated with HbA1c. In this study of black veterans with diabetes we observed that living in neighborhoods where people work together is associated with better glucose control.
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References
http://www.cdc.gov/diabetes/statistics/index.htm#prevalence.
Brown, A. F., Ettner, S. L., Piette, J., et al. (2004). Socioeconomic position and health among persons with diabetes mellitus: A conceptual framework and review of the literature. Epidemiologic Reviews, 26, 63–77.
Brancati, F. L., Kao, W. H., Folsom, A. R., Watson, R. L., & Szklo, M. (2000). Incident type 2 diabetes mellitus in African American and white adults: The Atherosclerosis risk in communities study. JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 283(17), 2253–2259.
Harris, M. I., Eastman, R. C., Cowie, C. C., Flegal, K. M., & Eberhardt, M. S. (1999). Racial and ethnic differences in glycemic control of adults with type 2 diabetes. Diabetes Care, 22(3), 403–408.
de Rekeneire, N., Rooks, R. N., Simonsick, E. M., et al. (2003). Health, Aging and Body Composition Study. Racial differences in glycemic control in a well-functioning older diabetic population: Findings from the health, aging and body composition study. Diabetes Care, 26(7), 1986–1992.
Young, B. A., Maynard, C., & Boyko, E. J. (2003). Racial differences in diabetic nephropathy, cardiovascular disease, and mortality in a national population of veterans. Diabetes Care, 26(8), 2392–2399.
Harris, E. L., Sherman, S. H., & Georgopoulos, A. (1999). Black-white differences in risk of developing retinopathy among individuals with type 2 diabetes. Diabetes Care, 22(5), 779–783.
Karter, A. J., Ferrara, A., Liu, J. Y., Moffet, H. H., Ackerson, L. M., & Selby, J. V. (2002). Ethnic disparities in diabetic complications in an insured population. JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 287(19), 2519–2527.
Raphael, D. (2003). Barriers to addressing the societal determinants of health: Public health units and poverty in Ontario, Canada. Health Promotion International, 18(4), 397–405.
Liburd, L. C., Jack, L, Jr, Williams, S., & Tucker, P. (2005). Intervening on the social determinants of cardiovascular disease and diabetes. American Journal of Preventive Medicine, 29(5 Suppl 1), 18–24.
Kawachi, I., & Berkman, L. (2000). Social Cohesion, Social Capital, and Health. In L. Berkman & I. Kawachi (Eds.), Social Epidemiology (pp. 174–190). New York, NY: Oxford University Press.
Putnam, R. D. (1993). Making democracy work: Civic traditions in modern Italy. NJ, Princeton: Princeton University Press.
Kawachi, I., Kennedy, B. P., Lochner, K., & Prothow-Smith, D. (1997). Social capital, income inequality, and mortality. American Journal of Public Health, 87, 1491–1498.
Lochner, K. A., Kawachi, I., Brennan, R. T., & Buka, S. L. (2003). Social capital and neighborhood mortality in Chicago. Social Science & Medicine, 56, 1797–1805.
Wen, M., & Christakis, N. A. (2005). Neighborhood effects on posthospitalization mortality: A population-based cohort study of the elderly in Chicago. Health Services Research, 40(4), 1108–1127.
Kawachi, I., Kennedy, B. P., & Glass, R. (1999). Social capital and self-rated health: A contextual analysis. American Journal of Public Health, 89(8), 1187–1193.
Franzini, L., Caughy, M., Spears, W., & Fernandez Esquer, M. E. (2005). Neighborhood economic conditions, social processes, and self-rated health in low-income neighborhoods in Texas: a multilevel latent variables model. Social Science & Medicine, 61(6), 1135–1150.
Hendryx, M. S., Ahern, M. M., Lovrich, N. P., & McCurdy, A. H. (2002). Access to health care and community social capital. Health Services Research, 37(1), 87–103.
Ahern, M. M., & Hendryx, M. S. (2003). Social capital and trust in providers. Social Science & Medicine, 57(7), 1195–1203.
Lee, S. Y., Chen, W. L., & Weiner, B. J. (2004). Communities and hospitals: Social capital, community accountability, and service provision in US community hospitals. Health Services Research, 39(5), 1487–1508.
Galea, S., Karpati, A., & Kennedy, B. (2002). Social capital and violence in the United States, 1974–1993. Social Science & Medicine, 55(8), 1373–1383.
Cattell, V. (2001). Poor people, poor places, and poor health: The mediating role of social networks and social capital. Social Science & Medicine, 52(10), 1501–1516.
Fitzgerald, J. T., Davis, W. K., Connell, C. M., Hess, G. E., Funnell, M. M., & Hiss, R. G. (1996). Development and validation of the diabetes care profile. Evaluation & The Health Professions, 19, 209–231.
Cunningham, P. J., & Kemper, P. (1998). Ability to obtain medical care for the uninsured: How much does it vary across communities? JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 280(10), 921–927.
Long, J. A., Polsky, D., & Metlay, J. P. (2005). Changes in veterans’ use of outpatient care from 1992 to 2000. American Journal of Public Health, 95(12), 2246–2251.
Moore, S., Shiell, A., Hawe, P., & Haines, V. A. (2005). The privileging of communitarian ideas: Citation practices and the translation of social capital into public health research. American Journal of Public Health, 95(8), 1330–1337.
Theall K. P., Scribner R., Lynch S., Simonsen N., Schonlau M., Carlin B., Cohen D. (2008) Impact of small group size on neighborhood influences in multilevel models. MPRA Online at http://mpra.ub.uni-muenchen.de/11648/ MPRA Paper No. 11648, posted 18. November 2008/22:00.
Lochner, K., Kawachi, I., & Kennedy, B. P. (1999). Social capital: A guide to its measurement. Health Place, 5(4), 259–270.
Drukker, M., Buka, S. L., Kaplan, C., McKenzie, K., & Van Os, J. (2005). Social capital and young adolescents’ perceived health in different sociocultural settings. Soc Sci & Med, 61(1), 185–198.
Altschuler, A., Somkin, C. P., & Adler, N. E. (2004). ) Local services and amenities, neighborhood social capital, and health. Social Science & Medicine, 59(6), 1219–1229.
Baum, F. E., & Ziersch, A. M. (2003). Social capital. Journal of Epidemiology and Community Health, 57(5), 320–323.
Hawe, P., & Shiell, A. (2000). Social capital and health promotion: A review. Social Science & Medicine, 51(6), 871–885.
Pearce, N., & Davey Smith, G. (2003). Is social capital the key to inequalities in health? American Journal of Public Health, 93(1), 122–129.
Subramanian, S. V., Chen, J. T., Rehkopf, D. H., Waterman, P. D., & Krieger, N. (2005). Racial disparities in context: A multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts. American Journal of Public Health, 95(2), 260–265.
Singh, G. K., Miller, B. A., Hankey, B. F., & Edwards, B. K. (2004). Persistent area socioeconomic disparities in US incidence of cervical cancer, mortality, stage, and survival, 1975–2000. Cancer, 101(5), 1051–1057.
Krieger, N., Chen, J. T., Waterman, P. D., Rehkopf, D. H., & Subramanian, S. V. (2003). Race/ethnicity, gender, and monitoring socioeconomic gradients in health: A comparison of area-based socioeconomic measures–the public health disparities geocoding project. American Journal of Public Health, 93(10), 1655–1671.
Horowitz, C. R., Colson, K. A., Hebert, P. L., & Lancaster, K. (2004). Barriers to buying healthy foods for people with diabetes: Evidence of environmental disparities. American Journal of Public Health, 94(9), 1549–1554.
Morland, K., Wing, S., Diez, Roux A, & Poole, C. (2002). Neighborhood characteristics associated with the location of food stores and food service places. American Journal of Preventive Medicine, 22, 23–29.
Zenk, S. N., Schulz, A. J., Israel, B. A., James, S. A., Bao, S., & Wilson, M. L. (2005). Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit. American Journal of Public Health, 95(4), 660–667.
Eyler, A. A., Matson-Koffman, D., Young, D. R., et al. (2003). Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: The Women’s Cardiovascular Health Network Project–summary and conclusions. American Journal of Preventive Medicine, 25(3 Suppl 1), 93–103.
Pilkington, P. (2002). Social capital and health: measuring and understanding social capital at a local level could help to tackle health inequalities more effectively. Journal of Public Health Medicine, 24(3), 156–159.
Edmondson, R. (2003). Social capital: A strategy for enhancing health? Social Science & Medicine, 57(9), 1723–1730.
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Support for Dr. Long was provided by a VA HSR&D RCD 00-023.
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Long, J.A., Field, S., Armstrong, K. et al. Social Capital and Glucose Control. J Community Health 35, 519–526 (2010). https://doi.org/10.1007/s10900-010-9222-0
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DOI: https://doi.org/10.1007/s10900-010-9222-0