Neighborhood Physical Disinvestment and Incident Diabetes between visits 1 and 2 of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Neighborhood-scale environmental factors, including disinvestment in infrastructure, may impact cardiometabolic disease risk. To our knowledge, no prior studies have investigated the association between neighborhood disinvestment and incident diabetes. We used a virtual street audit of Google Street View Imagery to generate a neighborhood disinvestment score for participants' residential addresses in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). An item response theory model was fit to indicators (litter, graffiti, under-maintained buildings, bars on windows, and abandoned buildings) to form a scale measuring a latent level of disinvestment. Ordinary kriging was used to estimate levels for each residential address within the HCHS/SOL census tracts via spatial interpolation. HCHS/SOL is a longitudinal cohort study of self-identified Hispanic/Latino adults in the Bronx, Chicago, Miami, and San Diego. Using covariate-adjusted and survey-weighted Poisson regression models with data from 9120 participants free of diabetes at baseline (2008-2011), we investigated the association between neighborhood disinvestment and incident diabetes at visit 2 (2014-2017). A sensitivity analysis included only those who did not move during the follow-up period. A one-standard deviation increase in neighborhood disinvestment score was associated with a 13% (95% CI, 1-23%) lower risk of incident diabetes when adjusting for age, sex, education, income, study center/heritage, years in the US, family history, and a neighborhood socioeconomic index. Our sensitivity analysis yielded qualitatively similar results with lower precision. Overall, our analysis does not support the hypothesis that neighborhood physical disinvestment is associated with incident type 2 diabetes in this Hispanic/Latino population.