Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study
Background Area-level credit scores (the mean of credit scores for persons in a community) may be a unique indicator of community-level socioeconomic conditions associated with health outcomes. We analysed community credit scores (CCS) in association with new onset type 2 diabetes (T2D) across a geo...
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BMJ Publishing Group
2024-04-01
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| Series: | BMJ Public Health |
| Online Access: | https://bmjpublichealth.bmj.com/content/2/1/e000744.full |
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| author | Jonathan Pollak Melissa N Poulsen Karen Bandeen-Roche Katherine Moon Joseph DeWalle Annemarie G Hirsch Brian S Schwartz Lorraine Dean Meghann Reeder |
| author_facet | Jonathan Pollak Melissa N Poulsen Karen Bandeen-Roche Katherine Moon Joseph DeWalle Annemarie G Hirsch Brian S Schwartz Lorraine Dean Meghann Reeder |
| author_sort | Jonathan Pollak |
| collection | DOAJ |
| description | Background Area-level credit scores (the mean of credit scores for persons in a community) may be a unique indicator of community-level socioeconomic conditions associated with health outcomes. We analysed community credit scores (CCS) in association with new onset type 2 diabetes (T2D) across a geographically heterogeneous region of Pennsylvania and evaluated whether associations were independent of community socioeconomic deprivation (CSD), which is known to be related to T2D risk.Methods In a nested case–control study, we used medical records to identify 15 888 T2D cases from diabetes diagnoses, medication orders and laboratory test results and 79 435 diabetes-free controls frequency matched on age, sex and encounter year. CCS was derived from Equifax VantageScore V.1.0 data and categorised as ‘good’, ‘high fair’, ‘low fair’ and ‘poor’. Individuals were geocoded and assigned the CCS of their residential community. Logistic regression models adjusted for confounding variables and stratified by community type (townships (rural/suburban), boroughs (small towns) and city census tracts). Independent associations of CSD were assessed through models stratified by high/low CSD and high/low CCS.Results Compared with individuals in communities with ‘high fair’ CCS, those with ‘good’ CCS had lower T2D odds (42%, 24% and 12% lower odds in cities, boroughs and townships, respectively). Stratified models assessing independent effects of CCS and CSD showed mainly consistent associations, indicating each community-level measure was independently associated with T2D.Conclusion CCS may capture novel, health-salient aspects of community socioeconomic conditions, though questions remain regarding the mechanisms by which it influences T2D and how these differ from CSD. |
| format | Article |
| id | doaj-art-fbbf548c89444a45ba564a50e1c4c14a |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Public Health |
| spelling | doaj-art-fbbf548c89444a45ba564a50e1c4c14a2025-01-28T23:25:10ZengBMJ Publishing GroupBMJ Public Health2753-42942024-04-012110.1136/bmjph-2023-000744Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control studyJonathan Pollak0Melissa N Poulsen1Karen Bandeen-Roche2Katherine Moon3Joseph DeWalle4Annemarie G Hirsch5Brian S Schwartz6Lorraine Dean7Meghann Reeder8Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania, USADepartment of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania, USADepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania, USADepartment of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Population Health Sciences, Geisinger, Danville, Pennsylvania, USABackground Area-level credit scores (the mean of credit scores for persons in a community) may be a unique indicator of community-level socioeconomic conditions associated with health outcomes. We analysed community credit scores (CCS) in association with new onset type 2 diabetes (T2D) across a geographically heterogeneous region of Pennsylvania and evaluated whether associations were independent of community socioeconomic deprivation (CSD), which is known to be related to T2D risk.Methods In a nested case–control study, we used medical records to identify 15 888 T2D cases from diabetes diagnoses, medication orders and laboratory test results and 79 435 diabetes-free controls frequency matched on age, sex and encounter year. CCS was derived from Equifax VantageScore V.1.0 data and categorised as ‘good’, ‘high fair’, ‘low fair’ and ‘poor’. Individuals were geocoded and assigned the CCS of their residential community. Logistic regression models adjusted for confounding variables and stratified by community type (townships (rural/suburban), boroughs (small towns) and city census tracts). Independent associations of CSD were assessed through models stratified by high/low CSD and high/low CCS.Results Compared with individuals in communities with ‘high fair’ CCS, those with ‘good’ CCS had lower T2D odds (42%, 24% and 12% lower odds in cities, boroughs and townships, respectively). Stratified models assessing independent effects of CCS and CSD showed mainly consistent associations, indicating each community-level measure was independently associated with T2D.Conclusion CCS may capture novel, health-salient aspects of community socioeconomic conditions, though questions remain regarding the mechanisms by which it influences T2D and how these differ from CSD.https://bmjpublichealth.bmj.com/content/2/1/e000744.full |
| spellingShingle | Jonathan Pollak Melissa N Poulsen Karen Bandeen-Roche Katherine Moon Joseph DeWalle Annemarie G Hirsch Brian S Schwartz Lorraine Dean Meghann Reeder Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study BMJ Public Health |
| title | Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study |
| title_full | Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study |
| title_fullStr | Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study |
| title_full_unstemmed | Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study |
| title_short | Community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in Pennsylvania: a case–control study |
| title_sort | community credit scores and community socioeconomic deprivation in association with type 2 diabetes across an urban to rural spectrum in pennsylvania a case control study |
| url | https://bmjpublichealth.bmj.com/content/2/1/e000744.full |
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