Abstract: Objective To investigate the association between the built environment of a community and the prevalence of type 2 diabetes and hypertension among older residents.
Methods Based on a cross-sectional design, a survey was conducted on elderly residents aged 65-95 who participated in physical examinations in Longgang City from October 2021 to January 2022, with a total of 5349 participants enrolled. Combined with Geographic Information System (GIS) and Amap, built environment indicators including catering, medical facilities, public transit and green spaces within the 500-meter buffer zone were extracted according to participants’ residential addresses. Binary logistic regression models were used to assess the associations between diverse built environment indicators and type 2 diabetes mellitus and hypertension after adjusting for confounding factors including age, waist circumference and family history.
Results A total of 5,349 participants were enrolled, of whom 49.65% were male and 50.35% were female, with a mean age of 73.32 ± 0.09 years. The prevalence rates of type 2 diabetes mellitus (T2DM) and hypertension were 22.86% and 64.12%, respectively. Logistic regression analyses revealed that greenness level was negatively associated with the prevalence of both T2DM and hypertension in the elderly, with OR (95% CI) of 0.222 (0.120-0.413) and 0.213 (0.128-0.354), respectively. A higher number of scenic spots was associated with a lower prevalence of T2DM (OR = 0.932, 95% CI: 0.886-0.980). The number of sports/fitness facilities and parks was negatively associated with the prevalence of hypertension, with OR (95% CI) of 0.934 (0.889-0.981) and 0.889 (0.824-0.980), respectively. Conversely, a greater number of catering outlets was associated with a higher prevalence of hypertension (OR = 1.008, 95% CI: 1.004-1.011).
Conclusion Among the 500-m neighborhood built environment variables, areas with higher levels of greenness, more scenic spots, parks, and sports/fitness facilities were associated with lower prevalence of type 2 diabetes mellitus and/or hypertension in the elderly. Conversely, areas with a greater number of catering outlets were associated with a higher prevalence of hypertension. The statistically significant associations between built environment and the two diseases were more concentrated in the 65-69 age group and among males.