Exploring Differences in the Rate of Type 2 Diabetes Among American Cities: How Urbanization Continues to Challenge the Traditional Epidemiological View

Abstract

As the world’s largest urban regions continue to expand, a concomitant rise in non-communicable diseases, particularly type 2 diabetes, poses an increasingly ominous challenge to experts in the field of public health. Given that the majority of the world’s population (54%) resides in urban areas, a figure likely to reach two-thirds by 2050, this issue presents serious implications for medical practitioners as well as policymakers seeking to manage long-term healthcare costs while sustaining historic increases in life expectancy. To explore how these trends are continuing to affect the United States, a multiple regression analysis was conducted using data provided by the Centers for Disease Control and Prevention (CDC) through their initiative, 500 Cities: Local Data for Better Health. The regression models revealed that larger cities reported significantly higher rates of type 2 diabetes even after controlling for variables that have been perennially linked to disease onset (e.g., levels of obesity, sedentary behavior). Implications are discussed, most notably the argument for moving beyond the ‘food desert’ paradigm when identifying and explaining which characteristics of larger cities place their residents at increased risk. This approach could help reveal opportunities for intervention that may not have garnered sufficient attention in the extant literature.

Prevalence, spatial pattern, and predictors of cardiovascular and chronic diseases: A cross-sectional study

“…Epidemiological studies have reported the link between urbanization and CVD risk factors such as diabetes and hypertension (Young 2019;Tai et al 2020;Chen et al 2020;Pinchoff et al 2020;Boakye et al 2021;Ostchega et al 2022). Urbanization directly impacts the food environment, choices, and behaviors, with a greater likelihood of adopting Western-style diets and sedentary lifestyles contributing to the prevalence and disparities of cardiometabolic risks.…”