People living in hilly residential areas in metropolitan Perth have less diabetes: Spurious association or important environmental determinant?

Villanueva, K, Knuiman, M, Koohsari, M, Hickey, S, Foster, S, Badland, H, Nathan, A, Bull, F and Giles-Corti, B 2013, 'People living in hilly residential areas in metropolitan Perth have less diabetes: Spurious association or important environmental determinant?', International Journal of Health Geographics, vol. 12, 59, pp. 1-11.


Document type: Journal Article
Collection: Journal Articles

Title People living in hilly residential areas in metropolitan Perth have less diabetes: Spurious association or important environmental determinant?
Author(s) Villanueva, K
Knuiman, M
Koohsari, M
Hickey, S
Foster, S
Badland, H
Nathan, A
Bull, F
Giles-Corti, B
Year 2013
Journal name International Journal of Health Geographics
Volume number 12
Article Number 59
Start page 1
End page 11
Total pages 11
Publisher BioMed Central
Abstract Background: Variations in 'slope' (how steep or flat the ground is) may be good for health. As walking up hills is a physiologically vigorous physical activity and can contribute to weight control, greater neighbourhood slopes may provide a protective barrier to weight gain, and help prevent Type 2 diabetes onset. We explored whether living in 'hilly' neighbourhoods was associated with diabetes prevalence among the Australian adult population. Methods: Participants (>=25 years; n = 11,406) who completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) were asked whether or not they had medically-diagnosed diabetes. Geographic Information Systems (GIS) software was used to calculate a neighbourhood mean slope score, and other built environment measures at 1600 m around each participant's home. Logistic regression models were used to predict the odds of self-reported diabetes after progressive adjustment for individual measures (i.e., age, sex), socioeconomic status (i.e., education, income), built environment, destinations, nutrition, and amount of walking. Results: After full adjustment, the odds of self-reported diabetes was 0.72 (95% CI 0.55-0.95) and 0.52 (95% CI 0.39-0.69) for adults living in neighbourhoods with moderate and higher levels of slope, respectively, compared with adults living in neighbourhoods with the lowest levels of slope. The odds of having diabetes was 13% lower (odds ratio 0.87; 95% CI 0.80-0.94) for each increase of one percent in mean slope. Conclusions: Living in a hilly neighbourhood may be protective of diabetes onset or this finding is spurious. Nevertheless, the results are promising and have implications for future research and the practice of flattening land in new housing developments.
Subject Epidemiology
Urban and Regional Planning not elsewhere classified
Keyword(s) Adults
Built environment
Diabetes
Hilly
Neighbourhood
Slope
Terrain
Walking
DOI - identifier 10.1186/1476-072X-12-59
Copyright notice © 2013 Villanueva et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
ISSN 1476-072X
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