Spatial association of socio-demographic, environmental factors and prevalence of diabetes mellitus in middle-aged and elderly people in Thailand

Abstract

The burden of diabetes mellitus (DM), one of the major noncommunicable diseases (NCDs), has been significantly rising globally. In the Asia-Pacific region, Thailand ranks within the top ten of diabetic patient populations and the disease has increased from 2.3% in 1991 to 8.0% in 2015. This study applied local indicators of spatial association (LISA) and spatial regression to examine the local associations in Thailand with night-time light, spatial density of alcohol/convenience stores, concentration of elderly population and prevalence of DM among middle-aged and elderly people. Univariate LISA identified the statistically significant cluster of DM prevalence in the upper north-eastern region. For multivariate spatial analysis, the obtained R2 values of the spatial lag model (SLM) and spatial error model (SEM) were 0.310 and 0.316, respectively. These two models indicated a statistical significant association of several sociodemographic and environmental characteristics with the DM prevalence: food shops (SLM coefficient = 9.625, p<0.001; SEM coefficient = 9.695, p<0.001), alcohol stores (SLM coefficient = 1.936, p<0.05; SEM coefficient = 1.894, p<0.05), population density of elderly people (SLM coefficient = 0.156, p<0.05; SEM coefficient = 0.188, p<0.05) and night-time light density (SLM coefficient = -0.437, p<0.001; SEM coefficient = -0.437, p<0.001). These findings are useful for policymakers and public health professionals in formulating measures aimed at reducing DM burden in the country.