How your home address can predict your risk of Type 2 diabetes

Where you live may matter more than you think when it comes to your health. A new study has found that people living in neighborhoods with a high climate vulnerability index face a significantly higher risk of developing type 2 diabetes—even after accounting for personal health and lifestyle factors.

The study, one of the largest to date, used the Climate Vulnerability Index (CVI)—a score that captures how vulnerable a neighborhood is to climate stressors such as extreme heat, storms and pollution, as well as socioeconomic stressors like poverty, housing quality, infrastructure and access to care.

The work is published in the journal JAMA Network Open.

The paper, titled “Climate Vulnerability Index and Incident Type 2 Diabetes in a Large Integrated Health Care System,” was co-led by Dr. Jad Ardakani, clinical research fellow at the Houston Methodist Research Institute and Dr. Sadeer Al-Kindi, Houston Methodist medical director of environmental health and prevention.

The researchers conducted a retrospective cohort study using data from the Houston Methodist Cardiovascular Disease Learning Health System (CVD-LHS) Registry. The analysis included more than 1 million adults aged 18 and older who had at least one outpatient visit (but without prior type 2 diabetes diagnosis). A follow-up encounter was undertaken between June 2016 and August 2023, with up to seven years of follow-up.

“Integrating climate vulnerability into clinical data gives us a clearer view of the totality of environmental and social exposures shaping health,” Al-Kindi said. “This work reveals risks that traditional factors overlook and helps us identify vulnerable communities earlier, so we can deliver truly targeted, preventive care.”

Over a seven-year period, adults in the most climate-vulnerable neighborhoods had a 23% higher risk of developing type 2 diabetes compared with those in the least vulnerable areas.

“Where you live matters for your diabetes risk,” Ardakani said. “Climate stressors and socioeconomic conditions can shape health in powerful ways. Recognizing this helps us better target prevention for the communities that need it most.”

Even after the data analysis accounted for age, sex, race and ethnicity, insurance status, obesity, hypertension, cholesterol and baseline HbA1c (blood sugar), the association between climate vulnerability and diabetes risk remained strong.

Senior co-author Dr. Khurram Nasir, the William A. Zoghbi, MD Centennial Chair in Cardiovascular Health, DeBakey Heart & Vascular Center, said that the work reflects a commitment to reimagining population health. He added that understanding how climate and community conditions drive disease helps in building smarter and more equitable health systems.