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The Effect of Surrounding Greenness on Type 2 Diabetes Mellitus: A Nationwide Population-Based Cohort in Taiwan

Author

Listed:
  • Hui-Ju Tsai

    (Institute of Population Health Sciences, National Health Research Institutes, Maioli 35053, Taiwan)

  • Chia-Ying Li

    (Department of Environmental and Occupational Health, National Cheng Kung University, Tainan 70101, Taiwan)

  • Wen-Chi Pan

    (Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei 112304, Taiwan)

  • Tsung-Chieh Yao

    (Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333323, Taiwan
    Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333323, Taiwan
    Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung 20401, Taiwan)

  • Huey-Jen Su

    (Department of Environmental and Occupational Health, National Cheng Kung University, Tainan 70101, Taiwan)

  • Chih-Da Wu

    (Department of Geomatics, National Cheng Kung University, Tainan 70101, Taiwan
    National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan)

  • Yinq-Rong Chern

    (Department of Geomatics, National Cheng Kung University, Tainan 70101, Taiwan)

  • John D. Spengler

    (Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA)

Abstract

This study determines whether surrounding greenness is associated with the incidence of type 2 diabetes Mellitus (T2DM) in Taiwan. A retrospective cohort study determines the relationship between surrounding greenness and the incidence of T2DM during the study period of 2001–2012 using data from the National Health Insurance Research Database. The satellite-derived normalized difference vegetation index (NDVI) from the global MODIS database in the NASA Earth Observing System is used to assess greenness. Cox proportional hazard models are used to determine the relationship between exposure to surrounding greenness and the incidence of T2DM, with adjustment for potential confounders. A total of 429,504 subjects, including 40,479 subjects who developed T2DM, were identified during the study period. There is an inverse relationship between exposure to surrounding greenness and the incidence of T2DM after adjustment for individual-level covariates, comorbidities, and the region-level covariates (adjusted HR = 0.81, 95% CI: 0.79–0.82). For the general population of Taiwan, greater exposure to surrounding greenness is associated with a lower incidence of T2DM.

Suggested Citation

  • Hui-Ju Tsai & Chia-Ying Li & Wen-Chi Pan & Tsung-Chieh Yao & Huey-Jen Su & Chih-Da Wu & Yinq-Rong Chern & John D. Spengler, 2020. "The Effect of Surrounding Greenness on Type 2 Diabetes Mellitus: A Nationwide Population-Based Cohort in Taiwan," IJERPH, MDPI, vol. 18(1), pages 1-11, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2020:i:1:p:267-:d:473390
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    References listed on IDEAS

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    1. Liang-Ting Tsai & Feng-En Lo & Chih-Chien Yang & Wen-Min Lo & Joseph Jordan Keller & Chiou-Wei Hwang & Ching-Feng Lin & Shu-Yu Lyu & Donald E. Morisky, 2016. "Influence of Socioeconomic Factors, Gender and Indigenous Status on Smoking in Taiwan," IJERPH, MDPI, vol. 13(11), pages 1-11, October.
    2. Jenny J. Roe & Catharine Ward Thompson & Peter A. Aspinall & Mark J. Brewer & Elizabeth I. Duff & David Miller & Richard Mitchell & Angela Clow, 2013. "Green Space and Stress: Evidence from Cortisol Measures in Deprived Urban Communities," IJERPH, MDPI, vol. 10(9), pages 1-18, September.
    3. Paul Zimmet & K. G. M. M. Alberti & Jonathan Shaw, 2001. "Global and societal implications of the diabetes epidemic," Nature, Nature, vol. 414(6865), pages 782-787, December.
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