Residential mobility, neighborhood environment, and diabetes complications among socioeconomically disadvantaged patients in the United States.

Residential mobility can affect health through changes in available resources, social support, or continuity of healthcare. This study sought to understand whether residential mobility and/or change in neighborhood environment among patients with diabetes were associated with diabetes-related complications. This retrospective study used electronic health record data from 19,853 adults aged 18-64 with a diabetes diagnosis seen in 110 safety-net clinics across the United States. Generalized estimating equations logistic regression models estimated whether moving (pre/post) and change in neighborhood environment (improving, worsening, similar) were associated with diagnoses of chronic diabetes-related complications. Post-move versus pre-move was associated with significantly higher probability of diabetes-related chronic complications (predicted probability: 13.16 vs 6.00, respectively), but no association was found by change in neighborhood environment. Those who moved had lower probability of chronic complications than those who did not move which could have been driven by pre-move circumstances among patients who moved. Residential mobility plays an important role in understanding diabetes-related complications while changes in neighborhood environment may be less important among low-income patients served by safety-net clinics. Moving may not be directly responsible for the development of diabetes-related chronic complications, but it may be an indicator for other factors of instability.