Children's risk for diabetes is influenced by where they live

For a long time, type 2 diabetes was something adults had to worry about. Kids weren’t really part of that picture. But that has changed – and fast.

Today, among young people diagnosed with diabetes, about one in four to nearly half have type 2 rather than type 1. In the mid-1990s, that number was only about one or two out of every hundred.

The average age of diagnosis is now close to 13. That aligns closely with increasing child obesity rates.

But there is more involved than weight, genes, or what children eat. A new study implicates another compelling factor that influences diabetes risk: where a child lives.

Diabetes risk factors in children

Researchers at Florida Atlantic University’s Charles E. Schmidt College of Medicine looked at an age group that most relevant studies have not investigated – children under five years old.

The team used national health survey data from 2016 to 2020, analyzing information on over 174,000 children, including about 50,000 kids under the age of six.

The researchers didn’t stop at food and exercise. They looked at everything from neighborhood safety to how often families needed help buying food.

The goal was to figure out how a child’s early environment might quietly influence their risk of developing type 2 diabetes.

The results of the study showed that while the number of diabetes cases in kids under five stayed low, patterns were showing up that couldn’t be ignored.

Children’s location and diabetes risk

Some things that stood out were a bit surprising. For example, living near a library was linked with higher rates of type 2 diabetes in kids, both in 2016 and 2020.

The association is likely due to the fact that libraries are often located in urban neighborhoods with fewer parks or green spaces.

“Research has shown that neighborhood environments – such as the presence of sidewalks, parks or other green spaces – can directly influence a child’s ability to engage in physical activity, and in turn, affect their risk of developing chronic diseases like type 2 diabetes,” said Dr. Lea Sacca, senior author of the study.

Other trends showed that more caregivers were reporting litter, vandalism, and general signs of neighborhood wear and tear between 2016 and 2020. These problems showed up not just in older kids’ neighborhoods, but also in areas with toddlers and preschoolers.

Certain connections emerged in specific years. In 2016, families who reported strong neighborly support showed a link to diabetes risk. In 2019, it was walkability – the ease of walking around the neighborhood – that stood out.

The role of food assistance programs

The research group also examined the contribution that food assistance programs could make. In 2017, having access to free or discounted meals was linked to neighborhood and residential settings.

During 2019-2020, increasing numbers of families enrolled in programs such as SNAP (food stamps), school meal programs, and cash aid.

“While this finding could suggest improved access to food, previous research shows that relying on food assistance doesn’t always equate to better nutrition,” said Dr. Sacca.

“For instance, children in food-insecure households tend to have poorer blood sugar control and higher hospitalization rates. Some research even suggests that participants in programs like SNAP may have worse diet quality than non-participants from similarly low-income households.”

Food assistance programs are still helpful – but the results of the study raise questions about the kind of food kids actually end up eating. Many affordable foods are high in sugar, fat, and empty calories, which all add up when it comes to diabetes risk.

Obesity tops the list

Childhood weight is a major risk factor that remains front and center. Kids with a heavier weight are four times more likely to develop type 2 diabetes by the time they’re 25 compared to kids at a healthy weight.

One major target for prevention? Sugary drinks. Nearly 70% of children aged two to five drink sugar-sweetened beverages every day. School rules like banning soda machines have helped, but overall consumption is still high.

“The rise in early-onset type 2 diabetes is a growing public health concern,” said Dr. Sacca. “Addressing it requires a comprehensive strategy.”

“That includes improving access to nutritious foods, creating healthier neighborhood environments, and investing in policies that promote long-term wellness from the very start of life.”

Some school programs have shown that changing kids’ diets and increasing physical activity is possible with the right tools and support. But for these changes to stick, the fixes need to start early – and extend beyond the classroom.

The full study was published in the journal Pediatric Research.

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