Diabetes and the socioeconomic and built environment: geovisualization of disease prevalence and potential contextual associations using ring maps

Abstract

BackgroundEfforts to stem the diabetes epidemic in the United States and other countries must take into account a complex array of individual, social, economic, and built environmental factors. Increasingly, scientists use information visualization tools to "make sense" of large multivariate data sets. Recently, ring map visualization has been explored as a means of depicting spatially referenced, multivariate data in a single information graphic. A ring map shows multiple attribute data sets as separate rings of information surrounding a base map of a particular geographic region of interest. In this study, ring maps were used to evaluate diabetes prevalence among adult South Carolina Medicaid recipients. In particular, county-level ring maps were used to evaluate disparities in diabetes prevalence among adult African Americans and Whites and to explore potential county-level associations between diabetes prevalence among adult African Americans and five measures of the socioeconomic and built environment—persistent poverty, unemployment, rurality, number of fast food restaurants per capita, and number of convenience stores per capita. Although Medicaid pays for the health care of approximately 15 percent of all diabetics, few studies have examined diabetes in adult Medicaid recipients at the county level. The present study thus addresses a critical information gap, while illustrating the utility of ring maps in multivariate investigations of population health and environmental context.ResultsRing maps showed substantial racial disparity in diabetes prevalence among adult Medicaid recipients and suggested an association between adult African American diabetes prevalence and rurality. Rurality was significantly positively associated with diabetes prevalence among adult African American Medicaid recipients in a multivariate statistical model.ConclusionsEfforts to reduce diabetes among adult African American Medicaid recipients must extend to rural African Americans. Ring maps can be used to integrate diverse data sets, explore attribute associations, and achieve insights critical to the promotion of population health.

Feasibility study of geospatial mapping of chronic disease risk to inform public health commissioning

“…The ‘ring map’ is a relatively new technique, which allows factors of interest (such as putative environmental determinants) to be displayed circumferentially around a map 41. To produce these, we aggregated data to the level of middle super output area (n=31) and presented as quintiles of risk.…”

Racial/Ethnic Variability in Diabetes Mellitus among United States Residents Is Unexplained by Lifestyle, Sociodemographics and Prognostic Factors

“…However, diabetes mellitus prevalence was not higher among Hispanics compared to Caucasians in both our crude and adjusted models. Whereas family income predicts diabetes mellitus prevalence among African Americans, similar claims could not be made of the Hispanics relative to Caucasians [7,[21][22][23][24][25][26][27][28].…”

Matching the Genotype in Resolution: Innovative Ways of Phenotype Capture

“…Indeed, there is a wealth of studies on walkability and healthy food resources, most often in relation to obesity, with many, but not all, finding an inverse association (see Papas et al, 64 Booth et al, 65 and Feng et al 66 for reviews), and others found that inequalities in these features may explain inequalities in obesity. 67 Research into obesity-related outcomes including diabetes and cardiovascular disease have been speculated, 18,68 but the empiric literature has yielded mixed results, 12,21,22,66,[68][69][70][71] which may be owing to incomplete measurement of the built environment.…”