Neighborhood Can Affect Obesity, Diabetes Risk10/19/11
WEDNESDAY, Oct. 19 (HealthDay News) -- Women living in poor
neighborhoods are more likely to be obese and have type 2 diabetes
than those who move into more advantaged areas, new research
In the first randomized trial of its kind, researchers provided
women living in high-poverty areas with vouchers and counseling so
they could move into better neighborhoods. After 10 years of living
in the new areas, those women were 19 percent less likely to be
morbidly obese, and 22 percent less likely to have developed type 2
diabetes compared to the control group that stayed in high-poverty
"Investments outside the health care system can be really important complements to spending within the health care system," noted study author Jens Ludwig, the McCormick Foundation Professor of Social Service Administration, Law and Public Policy at the University of Chicago.
"The effects in our paper seem to be roughly comparable to the best practice lifestyle and medication interventions. That's pretty striking," he said. "The initial aim of the study was to help families be safer, but it turns out there's an effect on these really important health outcomes that's in the ballpark of lifestyle and medical interventions."
Results of the study are published in the Oct. 20 issue of the
New England Journal of Medicine.
From 1994 through 1998, the study authors recruited 4,498 women
with children living in public housing in high-poverty areas. The
study was called Moving to Opportunity, and its aim was to see if
moving the women and their children from high-poverty areas to
lower-poverty areas could improve their lives. The study volunteers
came from five U.S. cities: Baltimore, Boston, Chicago, Los Angeles
and New York.
The women were assigned to one of three groups based on the
results of a random lottery: one group received housing vouchers
that were only redeemable if they moved to an area with less than
10 percent of people living in poverty, and they received
counseling on moving; another group received housing vouchers with
no restrictions; and the final group received no intervention.
In 2008 through 2010, the researchers collected follow-up
information, including measurements of height, weight and blood
samples to test for diabetes.
During the follow-up period, 17 percent of the women in the
control group were morbidly obese, which means a body mass index of
40 or above. Among the women who moved to lower-poverty areas, that
rate was 14.4 percent, which is 19 percent lower than the control
group, according to the study. Women who received traditional
housing vouchers had a morbid obesity rate of 15.4 percent.
The rate of diabetes was 16.3 percent in the women who moved to
lower-poverty areas, 20.6 percent in the traditional housing
voucher group and 20 percent in the control group.
Ludwig said this study wasn't designed to identify the specific
factors that might have contributed to the drop in obesity and
diabetes rates after moving to lower-poverty areas, but that there
are four major factors that likely contributed. One is access to
better foods. In higher-poverty areas, there are often no grocery
stores, only small corner stores. Another is the ability to
exercise in safer neighborhoods. Access to better health care may
also play a role, said Ludwig. And, reduced psychological stress
because of moving to a safer neighborhood may also help, he
"This was a good study looking at a very complicated problem. And, they showed that the neighborhood may be a very important component in controlling obesity and diabetes," said Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City.
And, he added, the change wasn't an expensive one to
Ludwig said that counseling was really the only additional cost
of the study, as the women were already living in public housing.
And, he noted, it's estimated that caring for one person with
diabetes costs about $5,000 per year, so the savings from such a
program could end up being quite significant.
Learn more about preventing diabetes from the
U.S. Centers for Disease Control and
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