Date of Conferral

2019

Degree

Ph.D.

School

Public Health

Advisor

Raymond W. Thron

Abstract

Type 2 diabetes has reached epidemic proportions in adults and youths. Persistent organic pollutants and endocrine-disrupting chemicals (EDCs), such as pesticides, dioxins, and organochlorines, are omnipresent and persist in the environment with potential for human exposure via contaminated air, waterways, soil, and human food supply. EDCs have been correlated with diabetes incidence and risks. Residential proximity to hazardous waste sites (HWS) has been correlated with increased hospital admission rates for diabetes. The study used a sample population (N = 1,724), ages ≥ 12 years from the 2005-2012 Continuous NHANES and HWS data from the National Priorities List of Superfund Sites. The ecosocial theory of disease distribution, and geocoordinates provided theoretical support. Mann-Whitney U test and binary logistic regression analysis were used to investigate the relationship between residence ≤ 1 mile compared with residence >1 mile from a HWS in NHANES surveyed counties of NJ, PA, NY, and CA on the outcome abnormal A1c ≥ 5.7% while controlling the effect of the moderators: abnormal body mass index (BMI), age, sex, and race/ethnicity on the relationship. Participants with a BMI ≥ 28.95 kg/m2 were 1.8 times and persons ≥ 58 years of age were 2.1 times more likely to have an A1c ≥ 5.7%. Also, non-Hispanic Whites residing >1 mile of a HWS had 82.1 % reduced risk of abnormal A1c compared with the same group residing ≤ 1 mile of a HWS. The results forge opportunities for future studies to consider border distance between residence and HWS. In addition, the results may promote positive social change through diabetes risks education, environmental health education, and practices and raise dialogue about social justice and the geographic distribution of hazardous waste sites.

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