Risk of developing diabetes higher in neighbourhoods that aren’t walk-friendly: study

Whether your neighbourhood is conducive to walking could determine your risk for developing diabetes, according to a new study by researchers at the Institute for Clinical Evaluative Sciences and St. Michael’s Hospital.

Researchers found this risk was particularly high for new immigrants living in low-income neighbourhoods. A new immigrant living in a less walkable neighbourhood — fewer destinations within a 10-minute walk, low population density and poorly connected streets — was about 50 per cent more likely to develop diabetes when compared to long-term residents living in the most walkable areas, regardless of neighbourhood income.

“Although diabetes can be prevented through physical activity, healthy eating and weight loss, we found the environment in which one lives is also an important indicator for determining risk,” said Dr. Gillian Booth, an endocrinologist and researcher at St. Michael’s and lead author of the study, which appears online in the journal Diabetes Care.

"For new immigrants, environment is an especially important factor as past research has shown an accelerated risk of obesity-related conditions including diabetes within the first 10 years of arrival to Canada," said Booth, who is also an adjunct scientist at ICES.

While diabetes is on the rise in Canada, the same trends are occurring globally, even in less industrialized countries. This is due in part to the move from rural to urban living in developing countries — often associated with increased exposure to unhealthy foods, fewer opportunities for physical activity and a heightened risk of becoming obese and developing diabetes.

The study looked at data for the population of Toronto aged 30-64 — more than one million people — and identified those who didn’t have diabetes. It then followed them for five years to see if their risk of developing diabetes increased based on where they lived.

To determine which neighbourhoods were more conducive to walking, researchers developed an index based on factors such as population density, street connectivity and the availability of walkable destinations including retail stores and service within a 10-minute walk. According to Booth, neighbourhoods that were the least walkable were often newly developed areas — characterized by urban sprawl — in part because of the reliance suburban design places on the use of cars.

“Previous studies have looked at how walkable neighbourhoods affect health behaviour, but this is the first to look at the risk of developing a disease,” said Booth. "The results emphasize the importance of neighbourhood design in influencing the health of urban populations."

Authors: Booth G., Creatore M., Moineddin R., Gozdyra P., Weyman J., Matheson F., Glazier R.

This study" Unwalkable neighborhoods, poverty, and the risk of diabetes among recent immigrants to Canada compared with long-term residents," was published today in Diabetes Care.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future healthcare professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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