Type 2 Diabetes Rates and Environmental and Socioeconomic Characteristics Among Philadelphia Commercial and Medicare Payer Populations: Analysis and Policy Considerations

Type 2 diabetes is a leading health issue for the population of Philadelphia. In 2012, adult diabetes prevalence in Philadelphia was 16%, which was a 50% increase from 2004 (Public Health Management Corporation Household Health Survey, 2012) and higher than the national average of 9.3% (Centers for Disease Control and Prevention, 2014). Traditionally, public health organizations use self-reported survey data to identify population-based associations between risk factors and health outcomes. Finding these relationships helps inform policies and interventions to address chronic health conditions, including Type 2 diabetes and related risk factors such as obesity. Because payer claims are based on actual individual diagnoses, these data serve as a rich source for finding associations between Type 2 diabetes rates and neighborhood-based risk factors. The objective of this study was to identify opportunities to positively impact population health in Philadelphia by analyzing rates of Type 2 diabetes prevalence in the 2010 and 2012 Independence Blue Cross commercial and Medicare populations relative to environmental and socioeconomic characteristics such as food site density, recreational facility density, unemployment rate, poverty rate, and crime rate. Multivariate regression analysis was used to identify the associations between Type 2 diabetes rates and all independent variables at the census tract level. Mapping software was used to illustrate all bivariate relationships. Associations were found between Type 2 diabetes prevalence and age, poverty, unemployment and crime rates. These results can be used to identify and monitor census tracts with high Type 2 diabetes prevalence and related environmental and socioeconomic risk factors, and to inform healthcare stakeholder policies and interventions for the work place and in the community to improve Type 2 diabetes prevention and management for the Philadelphia population. Presentation: 23 minute