People living in hilly residential areas in metropolitan Perth have less diabetes : spurious association or important environmental determinant?

Villanueva, Karen, Knuiman, Matthew, Koohsari, Mohammad, Hickey, Sharyn, Foster, Sarah, Badland, Hannah, Nathan, Andrea, Bull, Fiona, & Giles-Corti, Billie (2013) People living in hilly residential areas in metropolitan Perth have less diabetes : spurious association or important environmental determinant? International Journal of Health Geographics, 12(59).

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Abstract

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 ([greater than or equal to]25years; 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 1600m 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.

Impact and interest:

3 citations in Scopus
3 citations in Web of Science®
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ID Code: 67182
Item Type: Journal Article
Refereed: Yes
Keywords: Adults, Built environment, Diabetes, Hilly, Neighbourhood, Slope, Terrain, Walking
DOI: 10.1186/1476-072X-12-59
ISSN: 1476-072X
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Preventive Medicine (111716)
Australian and New Zealand Standard Research Classification > STUDIES IN HUMAN SOCIETY (160000) > HUMAN GEOGRAPHY (160400) > Human Geography not elsewhere classified (160499)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2013 Villanueva et al.; licensee BioMed Central Ltd.
Copyright Statement: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Deposited On: 12 Feb 2014 02:10
Last Modified: 13 Feb 2014 08:29

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