TOPLINE:

A recent study found that while social and behavioral drivers of diabetes were broadly shared between Southern California and the rest of the US, their importance varied by region. In Southern California, physical inactivity, lack of routine checkups, binge drinking, lack of insurance, and food insecurity emerged as top correlates, whereas nationally, obesity, food assistance, older age, and racial or ethnic minority status were key correlates.

METHODOLOGY:

• Diabetes disproportionately affects different racial and ethnic communities across the US and with prevalence rising, more regional and national research is needed on behavioral and socioecological drivers of risk.
• Researchers conducted a cross-sectional study to identify social and behavioral correlates of diabetes in Southern California, which has a large Hispanic population, and to compare these findings with national data.
• They used modeled estimates from 5420 census tracts in Southern California (approximately 18.5 million adults) and from 62,480 census areas nationwide (approximately 253 million adults) using the CDC’s 2024 Population Level Analysis and Community Estimates (PLACES) dataset.
• Among the 52 PLACES variables relevant for estimating diagnosed diabetes prevalence, 24 social and behavioral correlates were tested for their association with the prevalence of diagnosed diabetes.
• The prevalence of diagnosed diabetes represented the percentage of adults ever diagnosed with the condition — excluding gestational diabetes — by healthcare professionals.

TAKEAWAY:

• In Southern California, the mean prevalence of diagnosed diabetes was 11.29% (range, 1.4%-33.6%), whereas at the national level, the mean prevalence was 11.52%.
• In Southern California, five key correlates accounted for 67% of the estimated prevalence of diagnosed diabetes: physical inactivity (31%), lack of routine checkups (14%), binge drinking (11%), lack of insurance (6%), and food insecurity (5%).
• Although some key correlates overlapped between regional and national levels, their estimated contributions differed significantly; obesity, receipt of food stamps, age 65 years or older, and racial or ethnic minority status emerged as key correlates nationally but not in Southern California.

IN PRACTICE:

“These findings suggest potential regional variation in the correlates of diabetes prevalence and underscore the need for further research to understand whether these differences are meaningful, why they exist, and whether they may inform more targeted interventions,” the authors wrote.

SOURCE:

This study was led by Alexandra Descarpentrie, PhD, Department of Pediatrics, The Saban Research Institute, Children’s Hospital Los Angeles, University of Southern California. It was published online on in JAMA Network Open.

LIMITATIONS:

Due to the ecological, cross-sectional design, the identified correlates indicate contextual associations rather than causal links, with potential for reverse causation. The outcome of self-reported diagnosed diabetes was also modeled and without medical confirmation. Using prevalence rather than incidence data prevented establishing temporal relationships between social and behavioral correlates and diabetes cases. The study could not distinguish between type 1 and type 2 diabetes or account for undiagnosed cases.

DISCLOSURES:

This work was supported by The Southern California Center for Latino Health from the National Institute of Minority Health Disparities. Two authors disclosed serving as a scientific advisor or receiving personal fees and grants from various pharma companies and institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.