Evidence mapPaperPMID 39842541Full record

ArticleThe American journal of medicine2025

Rurality and Neighborhood Socioeconomic Status are Associated With Overall and Cause-Specific Mortality and Hepatic Decompensation in Type 2 Diabetes.

Vincent L Chen, Nicholas R Tedesco, Jingyi Hu, Venkata S J Jasty, Ponni V Perumalswami

Abstract read
In one paragraph

Article in The American journal of medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Vincent L ChenDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor. Electronic address: vichen@med.umich.edu.
Nicholas R TedescoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor.
Jingyi HuDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor.
Venkata S J JastyDepartment of Internal Medicine, University of Michigan, Ann Arbor.
Ponni V PerumalswamiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor; Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Mich; Gastroenterology Section, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Mich.

Funding

Pilot and Feasibility ProgramP30DK092926 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$779k
Predictive models for incident cirrhosis in non-alcoholic fatty liver disease using genetic and electronic medical record-based risk factorsK08DK132312 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$165k
NIDDK NIH HHS K08 DK132312NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

introductionSocial determinants of health are key factors driving disease progression. In type 2 diabetes there is limited literature on how distal or intermediate factors (eg, those at the neighborhood level) influence cause-specific mortality or liver disease outcomes.

methodsThis was a single-center retrospective study of patients with type 2 diabetes seen at an integrated healthcare system in the United States. The primary outcomes were overall mortality; death due to cardiovascular disease, cancer, or liver disease; or hepatic decompensation. The primary predictors were neighborhood-level (intermediate) factors measuring neighborhood poverty (Area Deprivation Index [ADI], affluence score, disadvantage score) and rurality (Rural-Urban Commuting Area scores). Associations were modeled using Cox proportional hazards or Fine-Grey competing risk models.

results28,424 participants were included. Higher neighborhood poverty associated with increased overall mortality, with hazard ratio (HR) 1.11 (95% confidence interval 1.10-1.12, P < .001) per 10 points of ADI and HR 1.32 (95% CI 1.26-1.37, P < .001) for 10 points of disadvantage. Conversely, higher neighborhood affluence associated with lower overall mortality with HR 0.87 (95% CI 0.86-0.89, P < .001) per 10 points of affluence. Living in a rural region associated with increased overall mortality: HR 1.08 (95% CI 1.01-1.15, P = .031). Associations were consistent across cause-specific mortality, though effect sizes were larger for liver-related mortality than for other causes. Living in a more rural neighborhood was associated with increased risk of hepatic decompensation.

conclusionsIntermediate neighborhood-level socioeconomic status was associated with overall and cause-specific mortality in type 2 diabetes, with larger effects on liver-related mortality than other causes.

Indexed as

Diabetes Mellitus, Type 2Liver DiseasesNeighborhood CharacteristicsResidence CharacteristicsRural PopulationSocial ClassAgedCause of DeathFemaleHumansMaleMiddle AgedRetrospective StudiesSocial Determinants of HealthUnited StatesDisparitiesLiver related eventsSurvival analysis

Identifiers

PMID39842541
PMCPMC12369890

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.