Neighborhood Deprivation and Change in BMI Among AdultsWith Type 2 Diabetes The Diabetes Study of Northern California (DISTANCE)

OBJECTIVEdTo compare associations between neighborhood deprivation and measures of BMI change among adults with type 2 diabetes. RESEARCH DESIGN AND METHODSdUsing data from the Kaiser Permanente Di-abetes Study of Northern California (DISTANCE) survey, we estimated the association between neighborhood deprivation and two measures of BMI change over 3 years: 1) a continuous measure and 2) a categorical measure of clinically substantive BMI loss or gain ($7 % of baseline BMI) versus stable BMI. The sample included 13,609 adults. RESULTSdOn average, there was little change in BMI (20.12, SD 3.07); 17.0 and 16.1 % had clinically substantive BMI loss or gain, respectively, at follow-up. There was a positive association between neighborhood deprivation and BMI change for adults in the most versus least-deprived quartile of neighborhood deprivation (b = 0.22, P = 0.02) in adjusted models. In addition, relative to the least-deprived quartile (Q1), adults in more-deprived quartiles of neighborhood deprivation were more likely to experience either substantive BMI loss (Q2 relative risk ratio 1.19, 95%CI 1.00–1.41; Q3 1.20, 1.02–1.42; Q4 1.30, 1.08–1.55) or gain (Q2 1.25, 1.04–1.49; Q3 1.24, 1.04–1.49; Q4 1.45, 1.20–1.75)