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Entrepreneurial Environment and the Prevalence of Diabetes in U.S. Counities

DOI: 10.5402/2012/359473

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Abstract:

Objective. To examine whether the presence of an entrepreneurial culture in a community is associated with county-level diabetes prevalence in the U.S. after accounting for high level of spatial clustering of prevalence rates observed in prior research. Methods. We perform a county-level spatial regression analysis of CDC diabetes prevalence rates. We measure entrepreneurial culture as the number of businesses with 0 to 4 employees per 1,000 residents. Results. The level of entrepreneurial culture in a community is associated with lower rates of diabetes. Our findings show that the key measure of entrepreneurial culture has expected effects on county diabetes rates. However, we show that failure to control for spatial error dependence in previous research leads to an overestimation of the effects of entrepreneurial culture on diabetes prevalence. Conclusion. Policies aimed at curbing diabetes prevalence should utilize the business community as a key agent of social change. Researchers should also utilize spatial regression techniques when analyzing county-level diabetes prevalence rates, because of high level of spatial clustering of rates. 1. Introduction An emerging line of research on county-level variation in morbidity and mortality points to the importance of structural aspects of the county that are features of the social and cultural environment of the community.Facilitated by the development of county-level estimates of diabetes prevalence by the Centers for Disease Control [1], health researchers studying the health of U.S. communities have been provided the capacity to understand county-level variation in diabetes prevalence.The study of diabetes prevalence for U.S. counties is valuable to public policy practitioners because many federal programs are administered at the county level. Recent research on the role of the cultural environment in diabetes prevalence by Blanchard et al. [2] suggests that a community’s level of entrepreneurial culture is a key explanatory factor for variation in diabetes prevalence.An important aspect of the entrepreneurial culture is the capacity for a community to solve local problems without external assistance. The presence of an entrepreneurial culture implies that a community possesses a higher level of collective efficacy, or the capacity and willingness of community members to take responsibility for solving local problems [3–5]. Because business owners are both economically and socially tied to the community, local entrepreneurs have an economic interest in maintaining the quality of life for local residents

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