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Castillo-Reinado, K.* ; Maier, W. ; Holle, R. ; Stahl-Pehe, A.* ; Baechle, C.* ; Kuss, O.* ; Hermann, J.* ; Holl, R.W.* ; Rosenbauer, J.* ; The German Pediatric Surveillance Unit (ESPED*

Associations of area deprivation and urban/rural traits with the incidence of type 1 diabetes: Analysis at the municipality level in North Rhine-Westphalia, Germany.

Diabetic Med. 37, 2089-2097 (2020)
Verlagsversion Postprint Forschungsdaten DOI
Open Access Green
Aim To analyse the associations of area deprivation and urban/rural traits with the incidence of type 1 diabetes in the German federal state of North Rhine-Westphalia.Methods Data of incident type 1 diabetes cases in children and adolescents aged <20 years between 2007 and 2014 were extracted from a population-based diabetes register. Population data, indicators of area deprivation and urban/rural traits at the municipality level (396 entities) were obtained from official statistics. Area deprivation was assessed in five groups based on quintiles of an index of multiple deprivation and its seven deprivation domains. Poisson regression accounting for spatial dependence was applied to investigate associations of area deprivation and urban/rural traits with type 1 diabetes incidence.Results Between 2007 and 2014, 6143 incident cases were reported (99% completeness); the crude incidence was 22.3 cases per 100 000 person-years. The incidence decreased with increasing employment and environmental deprivation (relative risk of the most vs. the least deprived municipalities: 0.905 [95% CI: 0.813, 1.007] and 0.839 [0.752, 0.937], respectively) but was not associated with the composite deprivation index. The incidence was higher in more peripheral, rural, smaller and less densely populated municipalities, and the strongest association was estimated for the location trait (relative risk of peripheral/very peripheral compared with very central location: 1.231 [1.044, 1.452]).Conclusions The results suggest that the type 1 diabetes risk is higher in more remote, more rural, less densely populated and less deprived areas. Urban/rural traits were stronger predictors of type 1 diabetes risk than area deprivation indicators.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Population-density; Childhood; Mellitus; Epidemiology; Disparities; Ireland; Trends; Uk
ISSN (print) / ISBN 0742-3071
e-ISSN 1464-5491
Zeitschrift Diabetic Medicine
Quellenangaben Band: 37, Heft: 12, Seiten: 2089-2097 Artikelnummer: , Supplement: ,
Verlag Wiley
Verlagsort 111 River St, Hoboken 07030-5774, Nj Usa
Begutachtungsstatus Peer reviewed