Exploring the Association Between Health Disparities and Neighborhood Characteristics: The Case of Diabetes Mortality in DeKalb and Fulton Counties, Georgia

Abstract

Health disparities refer to preventable, unfair and unjust differences in health outcomes and health determinants of different subpopulations often defined by race, ethnicity, gender, socioeconomic status and location of residence. These differences in health outcomes with respect to chronic or non-communicable diseases are on the rise in low- and middle-income countries worldwide but also affect racial and ethnic minorities in the United States. Residents of minority neighborhoods in the United States continue to have lower socioeconomic status, greater risks for diseases, and lower quality of life than the general population. This chapter analyzes diabetes mortality by race and identifies socioeconomic factors of neighborhoods associated with the distribution of diabetes mortality in two United States counties, DeKalb and Fulton Counties in the State of Georgia from 2013–2017. DeKalb County is primarily a suburban county located east of the City of Atlanta, Georgia, however a portion of Fulton County represents Atlanta’s urban core. Fifty-four percent of DeKalb County’s population is comprised of Black residents as is 44% of Fulton County’s population. Diabetes prevalence and mortality data were obtained from the Georgia Division of Public Health, Office of Health Information and Policy. When analyzed spatially by census tracts using ArcGIS, the diabetes mortality rates, in these two neighboring counties, varied significantly along racial and socio-economic lines. Distressed neighborhoods with a high proportion of Black residents and people living below the poverty level were strongly correlated with more deaths from diabetes. These findings can influence government investments and help facilitate an increase in community partners’ focused and collaborative efforts to implement effective, sustainable, and culturally-relevant prevention and treatment programs.