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Primary Submission Category: Chronic disease
Perceived Neighborhood Walkability and Type 2 Diabetes: Insights from A Cross-Sectional Analysis of the 2024 National Health Interview Survey
Authors: Roman Kassaraba, Muhammad Hudhud, Sana Khan, Kosuke Tamura,
Presenting Author: Roman Kassaraba*
OBJECTIVE: Despite the protective effects of walkable neighborhoods on type 2 diabetes (T2D), fewer studies have examined how perceived neighborhood walkability (PNW) may be associated with T2D among adults. This study aimed to examine the associations of PNW characteristics with T2D prevalence.
METHODS: Cross-sectional household survey data came from the 2024 National Health Interview Survey (n=31,566). Self-reported T2D status was used (yes/no). A composite PNW score was calculated by summing eight different perceived walking environment factors, with responses coded as yes (1) or no (0), and then categorized the total into low (0-2), medium (3-5), and high (6-8) composite groups. A greater score reflected a more favorable PNW. Weighted logistic regression models assessed associations of composite PNW and each perceived walking environment factor with T2D, sequentially adjusted by sociodemographic and health-related factors.
RESULTS: Those reporting medium and high PNW had consistently lower odds of T2D in the unadjusted, age-adjusted, and fully adjusted models (p<.01). In the fully-adjusted model, both medium and high PNW levels (vs low) were associated with lower odds of T2D (pOR=0.77, 95% CI=0.67, 0.89; pOR=0.64, 95% CI=0.56, 0.74, respectively). Furthermore, seven walkability measures were separately associated with T2D status in the fully-adjusted models. Favorable PNW characteristics, such as presence of transit stops and traffic safety while walking, were associated with lower odds of T2D (pOR=0.80, 95% CI=0.72, 0.88; pOR=0.80, 95% CI=0.87, 0.97, respectively).
CONCLUSION: Higher levels of walkability were related to lower T2D prevalence. In particular, the presence of transit stops and traffic safety appeared to matter. Future research should investigate how changes in walkable neighborhoods may be longitudinally related to T2D. Furthermore, local efforts to improve specific walkable neighborhood features to reduce diabetes risk are warranted.