Residential self-selection, perceived built environment and type 2 diabetes incidence: A longitudinal analysis of 36,224 middle to older age adults

Much of the existing studies on the built environment and type 2 diabetes are cross-sectional and prone to residential self-selection bias. Using multilevel logistic regression analysis of 36,224 participants from a longitudinal study, we examined whether perceived built environment characteristics are associated with type 2 diabetes. We found that the odds of diabetes incidence varied geographically. Those who reported that there were no local amenities and reported day- and night-time crime rates made walking unsafe in the neighbourhood had higher odds of developing incident type 2 diabetes. These associations persisted after accounting for some predictors of residential self-selection. More longitudinal studies are needed to corroborate the findings. Changing the features of the residential built environment may be an important point of intervention for type 2 diabetes prevention. •Day- and night-time crime was associated with increased odds of developing type 2 diabetes.•Perceived local amenities was related to reduced odds of developing type 2 diabetes.•The odds of developing incident type 2 diabetes varied geographically.•Residential self-selection did not explain the environment-diabetes association suggesting a causal relationship.•Changing the residential built environment features may help prevent type 2 diabetes.