Health selection into neighborhoods among patients enrolled in a clinical trial

Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whe...

Full description

Bibliographic Details
Main Authors: Coleman, Ruth L. (Author), Razak, Fahad (Author), Holman, Rury R. (Author), Arcaya, Mariana Clair (Contributor), Alvarez, Mariajose (Contributor)
Other Authors: Massachusetts Institute of Technology. Department of Urban Studies and Planning (Contributor)
Format: Article
Language:English
Published: Elsevier BV, 2019-02-04T19:48:16Z.
Subjects:
Online Access:Get fulltext
Description
Summary:Health selection into neighborhoods may contribute to geographic health disparities. We demonstrate the potential for clinical trial data to help clarify the causal role of health on locational attainment. We used data from the 20-year United Kingdom Prospective Diabetes Study (UKPDS) to explore whether random assignment to intensive blood-glucose control therapy, which improved long-term health outcomes after median 10 years follow-up, subsequently affected what neighborhoods patients lived in. We extracted postcode-level deprivation indices for the 2710 surviving participants of UKPDS living in England at study end in 1996/1997. We observed small neighborhood advantages in the intensive versus conventional therapy group, although these differences were not statistically significant. This analysis failed to show conclusive evidence of health selection into neighborhoods, but data suggest the hypothesis may be worthy of exploration in other clinical trials or in a meta-analysis. Keywords: Neighborhoods, Self-selection, Health, Equity, Socioeconomic status