Examining the Association between Neighbourhood Socioeconomic Disadvantage and Type 2 Diabetes Comorbidity in Serious Mental Illness

This study examined the association between neighbourhood socioeconomic disadvantage and serious mental illness (SMI)–type 2 diabetes (T2D) comorbidity in an Australian population using routinely collected clinical data. We hypothesised that neighbourhood socioeconomic disadvantage is positively associated with T2D comorbidity in SMI. The analysis considered 3816 individuals with an SMI living in the Illawarra and Shoalhaven regions of NSW, Australia, between 2010 and 2017. Multilevel logistic regression models accounting for suburb (neighbourhood) level clustering were used to assess the association between neighbourhood disadvantage and SMI -T2D comorbidity. Models were adjusted for age, sex, and country of birth. Compared with the most advantaged neighbourhoods, residents in the most disadvantaged neighbourhoods had 3.2 times greater odds of having SMI–T2D comorbidity even after controlling for confounding factors (OR 3.20, 95% CI 1.42–7.20). The analysis also revealed significant geographic variation in the distribution of SMI -T2D comorbidity in our sample (Median Odds Ratio = 1.35) Neighbourhood socioeconomic disadvantage accounted for approximately 17.3% of this geographic variation. These findings indicate a potentially important role for geographically targeted initiatives designed to enhance prevention and management of SMI–T2D comorbidity in disadvantaged communities.

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Neighborhood Environment and Type 2 Diabetes Comorbidity in Serious Mental Illness

Journal of Primary Care & Community Health ◽

10.1177/2150132720924989 ◽

2020 ◽

Vol 11 ◽

pp. 215013272092498

Author(s):

Ramya Walsan ◽

Xiaoqi Feng ◽

Darren J. Mayne ◽

Nagesh Pai ◽

Andrew Bonney

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Fast Food ◽

Health Care Services ◽

Neighborhood Environment ◽

Future Research ◽

Logistic Regression Models ◽

Neighborhood Level

Aim: The aim of this study was to examine the association between neighborhood characteristics and type 2 diabetes (T2D) comorbidity in serious mental illness (SMI). We investigated associations of neighborhood-level crime, accessibility to health care services, availability of green spaces, neighborhood obesity, and fast food availability with SMI-T2D comorbidity. Method: A series of multilevel logistic regression models accounting for neighborhood-level clustering were used to examine the associations between 5 neighborhood variables and SMI-T2D comorbidity, sequentially adjusting for individual-level variables and neighborhood-level socioeconomic disadvantage. Results: Individuals with SMI residing in areas with higher crime rates per 1000 population had 2.5 times increased odds of reporting T2D comorbidity compared to the individuals with SMI residing in lower crime rate areas after controlling for individual and areal level factors (95% CI 0.91-6.74). There was no evidence of association between SMI-T2D comorbidity and other neighborhood variables investigated. Conclusion: Public health strategies to reduce SMI-T2D comorbidity might benefit by targeting on individuals with SMI living in high-crime neighborhoods. Future research incorporating longitudinal designs and/or mediation analysis are warranted to fully elucidate the mechanisms of association between neighborhoods and SMI-T2D comorbidity.

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A 5-Year Follow-Up of Diabetes Knowledge in Persons With Serious Mental Illness and Type 2 Diabetes

The Journal of Clinical Psychiatry ◽

10.4088/jcp.08l04602 ◽

2009 ◽

Vol 70 (7) ◽

pp. 1057-1058 ◽

Cited By ~ 6

Author(s):

Faith B. Dickerson ◽

Julie Kreyenbuhl ◽

Richard W. Goldberg ◽

LiJuan Fang ◽

Deborah Medoff ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Diabetes Knowledge

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A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

Psychiatry Research ◽

10.1016/j.psychres.2011.03.013 ◽

2011 ◽

Vol 188 (1) ◽

pp. 109-114 ◽

Cited By ~ 16

Author(s):

Julie Kreyenbuhl ◽

Jaclyn Leith ◽

Deborah R. Medoff ◽

LiJuan Fang ◽

Faith B. Dickerson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Diabetes Patients

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Quality of Life in Individuals With Serious Mental Illness and Type 2 Diabetes

Psychosomatics ◽

10.1176/appi.psy.49.2.109 ◽

2008 ◽

Vol 49 (2) ◽

pp. 109-114 ◽

Cited By ~ 24

Author(s):

Faith Dickerson ◽

Clayton H. Brown ◽

LiJuan Fang ◽

Richard W. Goldberg ◽

Julie Kreyenbuhl ◽

...

Keyword(s):

Quality Of Life ◽

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness

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Predictors of mortality in patients with serious mental illness and co-occurring type 2 diabetes

Psychiatry Research ◽

10.1016/j.psychres.2010.01.004 ◽

2010 ◽

Vol 177 (1-2) ◽

pp. 250-254 ◽

Cited By ~ 13

Author(s):

Clayton Brown ◽

Jaclyn Leith ◽

Faith Dickerson ◽

Deborah Medoff ◽

Julie Kreyenbuhl ◽

...

Keyword(s):

Type 2 Diabetes ◽

Mental Illness ◽

Serious Mental Illness ◽

Predictors Of Mortality

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Community socioeconomic disadvantage drives type of 30-day medical-surgical revisits among patients with serious mental illness

BMC Health Services Research ◽

10.1186/s12913-021-06605-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hayley D. Germack ◽

Khadejah Mahmoud ◽

Mandy Cooper ◽

Heather Vincent ◽

Krista Koller ◽

...

Keyword(s):

Emergency Department ◽

New York ◽

Mental Illness ◽

Serious Mental Illness ◽

Emergency Department Visits ◽

Socioeconomic Disadvantage ◽

Post Discharge ◽

Disadvantaged Communities ◽

Discharge Care

Abstract Background Patients with serious mental illness (SMI) are vulnerable to medical-surgical readmissions and emergency department visits. Methods We studied 1,914,619 patients with SMI discharged after medical-surgical admissions in Florida and New York between 2012 and 2015 and their revisits to the hospital within 30 days of discharge. Results Patients with SMI from the most disadvantaged communities had greater adjusted 30-day revisit rates than patients from less disadvantaged communities. Among those that experienced a revisit, patients from the most disadvantaged communities had 7.3 % greater 30-day observation stay revisits. Conclusions These results suggest that additional investments are needed to ensure that patients with SMI from the most disadvantaged communities are receiving appropriate post-discharge care.

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