1409-P: Association between Population Level Social Risk Factors and Prevalence of Diabetes

Abstract

Background: The goal of this study was to evaluate the independent effect of population social risk on the crude prevalence of diabetes. Methods: We combined census tract level data including diabetes prevalence from the CDC PLACES 2019 database and social risk factor data from the Opportunity Insights database. A multiple linear regression model was run with diabetes prevalence as the outcome and incarceration, poverty, housing, education, employment, job environment, economic mobility, and healthcare access as independent correlates, adjusting for US population in 2020 and state fixed effects. Results: The final analytic sample consisted of 11,457 census tracts within 157 counties in 38 states. Mean prevalence of diabetes was 11.8% +/- 4.9%. All indicator variables were significantly associated with crude prevalence of diabetes and explained 89.2% of the variance in diabetes prevalence at the national level. In the fully adjusted model, with every standard deviation (SD) increase in proportion with an annual check-up, crude prevalence increased by 0.7 SD. For every SD increase in proportion uninsured, crude prevalence increased by 0.5 SD. For every SD increase in income below the poverty line, crude prevalence increased by 0.1 SD. For every SD increase in average rent for a two-bedroom apartment, crude prevalence decreased by 0.1 SD. For every SD increase in proportion of residents with a college degree, crude prevalence decreased by 0.1 SD. For every SD increase in proportion incarcerated, crude prevalence increased by 0.05 SD. In addition, in the fully adjusted model, the crude prevalence of diabetes varied significantly across states. Conclusions: Population level social risk factors were significantly associated with changes in prevalence of diabetes at the national level. The strongest drivers of this relationship were healthcare access, insurance, income, housing, education, and incarceration. Disclosure L.E.Egede: None. R.J.Walker: None. S.Linde: None. Funding National Institutes of Health (R01DK118038, R01DK120861, R01MD013826)