1-5Case Western Reserve University; Cleveland, OH
1,2University Hospitals Cleveland Medical Center; Cleveland, OH
Background/Purpose: Social and environmental determinants of health (SEDOH) are known to impact cardiometabolic health, including blood pressure and other cardiovascular health (CVH) factors in the general population. In previous studies, higher socioeconomic deprivation was associated with lower CVH in adolescents and adults living with type 1 diabetes (T1D). However, the contribution of environmental risk in the CVH of individuals with T1D is not well established.
Methods: Logistic regression was used to examine the odds of elevated blood pressure (BP) (ie, systolic BP > 130 mmHg or diastolic BP > 80 mmHg) for each environmental risk factor among 5597 individuals with T1D across 2761 zip code tabulation areas. Covariates controlled for included social deprivation index, age, sex, race, education, income, body mass index, low-density lipoprotein, A1C, and T1D duration.
Results: A majority of the study sample identified as non-Hispanic White (87.7%), with a mean age of 36.7 years (SD = 16.3) and mean A1C of 8% (SD = 1.31). A little under one-third (30.9%) of the sample had elevated BP. Individuals in zip codes with no to sparse healthy vegetation (ie, normalized difference vegetation index < 0.5) had 20% higher odds of elevated BP than those in zip codes with dense vegetation. Individuals in zip codes with air pollution (ie, PM2.5 > 10 μg/m3) had 32% lower odds of elevated BP than those in zip codes without air pollution. The association between light pollution (ie, approximate total sky brightness > 0.188 mcd/m2) and elevated BP was not significant.
Conclusions: Examining the role of environmental risk factors in cardiometabolic health among more diverse samples of individuals with T1D would expand upon the current study findings. Future investigators should utilize comprehensive measures of environmental risk factors and measure additional covariates (ie, current medications and other co-morbidities). Diabetes care and education specialists can integrate the American Heart Association’s model of CVH components—Life’s Essential 8™—into their practice to reduce the risk for individuals living with T1D.
Disclosures: The authors received funding from a Legacy Fellowship, awarded by Frances Payne Bolton School of Nursing (Rieke) and the National Institute of Nursing Research (NINR) R00NR018886 (Griggs). Dr. Blanchette receives research funding from The Leona M. and Harry B. Helmsley Charitable Trust.