Neighborhood green space and diabetes mellitus in Brazil

Diabetes mellitus is a global public health concern, yet its association with neighborhood green space remains unexplored at a national scale in Brazil. This study analyzed the relationship between green space, measured via the Normalized Difference Vegetation Index (NDVI), and diabetes-related hospitalizations from 2008 to 2018. Using quasi-Poisson regression models, we assessed hospitalization data by sex and age group, incorporating air pollution, weather, and socioeconomic factors as covariates. Results showed regional variations: increased greenness was linked to lower hospitalizations in the North and Midwest, while the Northeast and Southeast exhibited higher hospitalization rates with increased NDVI. The South had mixed results, with positive associations for men and middle-aged individuals. Findings suggest that green spaces may have a protective effect in some regions but require further investigation in others. These results underscore the need for targeted urban planning and public health strategies to optimize green space benefits.