Mapping the Effects of Pollution on Diabetes in Durham, NC

Abstract BackgroundThough the impact of environmental pollution on chronic disease remains largely unknown, previous case control studies have begun to examine the adverse effects of particulate matter (PM2.5) on prevalence of type 2 diabetes. Based on multivariate regression models in these studies, a 1% increase in diabetes prevalence is seen with a 10 μg/m3 increase in PM2.5 exposure due to impairment of vascular reactivity. Presentation of the hypothesis This study proposes the use of Geographic Information Systems (GIS) to illustrate the correlation of diabetes to the anthropogenic footprint to target healthcare delivery and policy for diabetes-related health mitigation. GIS is used to overlay variables of diabetes prevalence, social determinates of health, and particulate matter concentration as layers on a map allowing targeted prevention programming.Testing of the hypothesisThough PM2.5 can be harmful in many contexts, for adults with diabetes, it becomes adverse as it enters the bloodstream, placing the body under oxidative stress. The window of opportunity for testing the hypothesis is large in that ambient air pollution and patients with diabetes are abundant. Using a longitudinal, matched, family cohort design, we are able to assess the long and short-term exposure of PM2.5 to better understand the nature and timing of the onset of disease. Implications of the hypothesis The hypothesis has the potential to identify high risk patients and could provide the basis for future work to assess risk at the neighborhood level. Based on risk acceptance and aversion, targeted policy interventions within states, counties, and neighborhoods may advance the state of the science for improving health and reducing health risk at a population level.