TY - JOUR
T1 - Racial Residential Segregation and the Health of Black Youth with Type 1 Diabetes
AU - Ellis, Deborah A.
AU - Cutchin, Malcolm P.
AU - Carcone, April Idalski
AU - Evans, Meredyth
AU - Weissberg-Benchell, Jill
AU - Buggs-Saxton, Colleen
AU - Boucher-Berry, Claudia
AU - Miller, Jennifer L.
AU - Drossos, Tina
AU - Dekelbab, M. Bassem
AU - Worley, Jessica
N1 - Funding Information:
FUNDING: Funding for the study was provided in part by R01DK110075 from the National Institute of Diabetes and Digestive Kidney Diseases. The NIDDK had no role in the design and conduct of the study.
Publisher Copyright:
© 2023 American Academy of Pediatrics. All rights reserved.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - OBJECTIVES: Black youth with type 1 diabetes (T1D) are at heightened risk for suboptimal glycemic control. Studies of neighborhood effects on the health of youth with T1D are limited. The current study investigated the effects of racial residential segregation on the diabetes health of young Black adolescents with T1D. METHODS: A total of 148 participants were recruited from 7 pediatric diabetes clinics in 2 US cities. Racial residential segregation (RRS) was calculated at the census block group level based on US Census data. Diabetes management was measured via self-report questionnaire. Hemoglobin A1c (HbA1c) information was gathered from participants during home-based data collection. Hierarchical linear regression was used to test the effects of RRS while controlling for family income, youth age, insulin delivery method (insulin pump versus syringe therapy), and neighborhood adversity. RESULTS: HbA1c was significantly associated with RRS in bivariate analyses, whereas youth-reported diabetes management was not. In hierarchical regression analyses, whereas family income, age, and insulin delivery method were all significantly associated with HbA1c in model 1, only RRS, age, and insulin delivery method were significantly associated with HbA1c in model 2. Model 2 explained 25% of the variance in HbA1c (P 5 .001). CONCLUSIONS: RRS was associated with glycemic control in a sample of Black youth with T1D and accounted for variance in HbA1c even after controlling for adverse neighborhood conditions. Policies to reduce residential segregation, along with improved screening for neighborhood-level risk, hold the potential to improve the health of a vulnerable population of youth.
AB - OBJECTIVES: Black youth with type 1 diabetes (T1D) are at heightened risk for suboptimal glycemic control. Studies of neighborhood effects on the health of youth with T1D are limited. The current study investigated the effects of racial residential segregation on the diabetes health of young Black adolescents with T1D. METHODS: A total of 148 participants were recruited from 7 pediatric diabetes clinics in 2 US cities. Racial residential segregation (RRS) was calculated at the census block group level based on US Census data. Diabetes management was measured via self-report questionnaire. Hemoglobin A1c (HbA1c) information was gathered from participants during home-based data collection. Hierarchical linear regression was used to test the effects of RRS while controlling for family income, youth age, insulin delivery method (insulin pump versus syringe therapy), and neighborhood adversity. RESULTS: HbA1c was significantly associated with RRS in bivariate analyses, whereas youth-reported diabetes management was not. In hierarchical regression analyses, whereas family income, age, and insulin delivery method were all significantly associated with HbA1c in model 1, only RRS, age, and insulin delivery method were significantly associated with HbA1c in model 2. Model 2 explained 25% of the variance in HbA1c (P 5 .001). CONCLUSIONS: RRS was associated with glycemic control in a sample of Black youth with T1D and accounted for variance in HbA1c even after controlling for adverse neighborhood conditions. Policies to reduce residential segregation, along with improved screening for neighborhood-level risk, hold the potential to improve the health of a vulnerable population of youth.
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U2 - 10.1542/peds.2022-058856
DO - 10.1542/peds.2022-058856
M3 - Article
C2 - 37096459
AN - SCOPUS:85159246975
SN - 0031-4005
VL - 151
JO - Pediatrics
JF - Pediatrics
IS - 5
M1 - e2022058856
ER -
