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

Hui-Ju Tsai, Chia-Ying Li, Wen-Chi Pan, Tsung-Chieh Yao, Huey-Jen Su, Chih-Da Wu, Yinq-Rong Chern and John D. Spengler
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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
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
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

IJERPH, 2020, vol. 18, issue 1, 1-11

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.

Keywords: surrounding greenness; type 2 diabetes mellitus; normalized difference vegetation index (NDVI); cohort study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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