Abstract
OBJECTIVESThis study examined the spatiotemporal epidemiological status of diabetes-related death in relation to school district boundaries in the state of Michigan, United States.METHODSA retrospective observational study was conducted using death records spanning the years 2007–2014 in Michigan, with school districts as the geographic unit of analysis. Geocoding was performed for each death record. Cluster analysis used spatial autocorrelation with local Moran’s I, and spatiotemporal analysis used the Space Time Pattern Mining tool in ArcGIS Pro 2.1.RESULTSThe study revealed spatial clusters of high-high locations of diabetes-related mortality rate by school district in Michigan from 2007 to 2014. Spatiotemporal analysis showed grids with intensifying, consecutive, sporadic, and persistent hotspots of diabetes-related death in the Lansing, Royal Oak, Flint City, Berkley, Detroit City, East Lansing, South Lake, and Holt public school districts. These school districts should be prioritized for school-based diabetes prevention programsCONCLUSIONSThe study demonstrated the presence of various hotspots of diabetes-related deaths within the state of Michigan across the 8-year period of analysis. Understanding spatial and temporal hotspots could further improve our ability to evaluate diabetes burden across both time and space.
Highlights
Type 2 diabetes is a preventable chronic disease
The spatial clusters were referred to as highhigh or low-low clusters, where school districts with high diabetes-related mortality rates were surrounded by school districts with similar high rates, and school districts with low rates were surrounded by school districts with rates that were low [38]
As the aim of the study was to provide information for targeting school-based diabetes prevention programs, the results focused on high-high locations
Summary
Type 2 diabetes is a preventable chronic disease. The Healthy People 2020 data indicated that in 2015, only 63.8% of adults aged 18 years or older engaged in lei-. 2021, Korean Society of Epidemiology sure-time physical activity [2]. Physical activity and diet are among the risk factors associated with type 2 diabetes [4,5]. Preventive measures of diabetes should focus on modifying these factors
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