The association between neighborhood social and economic environment and prevalent diabetes in urban and rural communities: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) study

The association between neighborhood disadvantage and health is well-documented. However, whether these associations may differ across rural and urban areas is unclear. This study examines the association between a multi-item neighborhood social and economic environment (NSEE) measure and diabetes prevalence across urban and rural communities in the US. This study included 27,159 Black and White participants aged ≥45 years at baseline (2003–2007) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Each participant's residential address was geocoded. NSEE was calculated as the sum of z-scores for six US Census tract variables (% of adults with less than high school education; % of adults unemployed; % of households earning