185 - Associations Between Type 1 Diabetes Distress and ZIP Code of Home Residence

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 185
Publication Number: 185.213

Priya R. Kareti, Columbia University Mailman School of Public Health, New York, NY, United States; Ileana Vargas-Rodriguez, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Kenneth Fernandez, William Paterson University, glen rock, NJ, United States; Virginia L. Rahming, NYP Columbia University Medical Center, Guttenberg, NJ, United States; Cristina R.. Fernandez, Columbia University Irving Medical Center, New York, NY, United States

Presenting Author(s)

Priya R. Kareti (she/her/hers)

MPH Candidate
Columbia University Mailman School of Public Health
New York, New York, United States

Background: According to the American Diabetes Association (ADA), type 1 diabetes (T1D) affects over 1.9 million Americans, with 244,000 being adolescents and children. Socio-structural determinants of health greatly impact T1D management and health outcomes. Youth with T1D may experience an emotional response to the challenges or burden of having diabetes, which is referred to as diabetes distress (DD). Little is understood on how the social and physical environment where youth with T1D live relates to diabetes morbidity and DD experiences.

Objective: To assess the relationship between area of residence and DD among youth with T1D.

Design/Methods: A cross-sectional study was conducted using convenience sampling of youth with T1D ages 2-24 years who received specialty care at a pediatric diabetes center in New York City between 2019-2022. The primary predictor, ZIP code of home residence, was reported via survey. The primary outcome, diabetes distress in youth, was self-reported using the validated 2-item brief Diabetes Distress Screen (DDS-2) and the 17-item Diabetes Distress Screening Scale (DDS-17). Sociodemographic information was self-reported and extracted from the electronic medical record. Tests of association between predictor and outcome and predictor and covariates were performed using IBM SPSS Statistics for MacOS, version 28 (IBM Corp., Armonk, NY, USA), with significance at p< .05.

Results:

There were n=220 youth with T1D in the study sample; 50% were male, 39.5% were Hispanic, and mean age at T1D diagnosis was 6.5 (± 3.9) years old. Neighborhood and borough of residence were significantly associated with DDS-17 Interpersonal Distress Subscale (χ²(10, N=54)=19.52, p=.034; χ²(10, N=172)=18.90, p=.042, respectively). Area of residence was not significantly associated with the other three DDS-17 subscales (Emotional Distress p=.11; Regimen Distress p=.09; Physician-Related Distress p=.06). Household income (χ²(2, N=198)=10.66, p=.005) and parent education (χ²(2, N=200)=7.27, p=.026) were covariates that significantly correlated with DDS-2 scores.

Conclusion(s): Our study found that there is a significant correlation between home residence ZIP code and interpersonal distress that others lacked understanding and support for their diabetes, expressed by youth with type 1 diabetes. Further expansion of this study includes estimating adjusted associations between residence area and DD and using geographic informational systems (GIS) to identify relationships between home residence ZIP code, DDS-17 scores, neighborhood walkability scores, and built environment resources affecting youth with T1D.