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Erschienen in: European Journal of Epidemiology 5/2012

01.05.2012 | DIABETES MELLITUS

Socioeconomic position and the incidence of type 2 diabetes: the ELSA study

verfasst von: Panayotes Demakakos, Michael Marmot, Andrew Steptoe

Erschienen in: European Journal of Epidemiology | Ausgabe 5/2012

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Abstract

We examined the associations between childhood and adult socioeconomic position (SEP) and incident diabetes in 7,432 individuals aged 50 or older from the English Longitudinal Study of Ageing (ELSA). We identified 174 and 189 cases of incident diabetes, in men and women, respectively, over 5.3 years of follow-up. Cox models were estimated. In women, childhood SEP, education, occupational class, income, wealth, and subjective social status (SSS) were related to incident diabetes. Occupational class, income, and SSS did not remain significantly related to incident diabetes after adjustment for individual sets of covariates (i.e. unhealthy behaviours, obesity, or psychosocial factors). Wealth (HR: 1.65, 95 % CI: 1.05, 2.60, poorest vs. wealthiest tertile) remained significantly related to incident diabetes after adjustment for all covariates, but education (HR: 1.46, 95 % CI: 0.92, 2.33, lowest vs. highest category) and childhood SEP (HR: 1.47, 95 % CI: 0.98, 2.19, lowest vs. highest category) did not. In men, only wealth and SSS were related to incident diabetes. SSS remained significantly related to incident diabetes after adjustment for all covariates (HR: 2.46, 95 % CI: 1.32, 4.68, lowest vs. highest category), but wealth did not (HR: 1.42, 95 % CI: 0.94, 2.15, poorest vs. wealthiest tertile). Additional adjustment for wealth did not greatly affect the association between incident diabetes and SSS in men. Incident diabetes in older women is associated with SEP from all life stages, while in older men only with current SEP. Psychosocial factors (in women), unhealthy behaviours, and obesity partly mediate these associations.
Literatur
1.
Zurück zum Zitat Robbins JM, Vaccarino V, Zhang H, Kasl SV. Socioeconomic status and diagnosed diabetes incidence. Diabetes Res Clin Pract. 2005;68:230–6.PubMedCrossRef Robbins JM, Vaccarino V, Zhang H, Kasl SV. Socioeconomic status and diagnosed diabetes incidence. Diabetes Res Clin Pract. 2005;68:230–6.PubMedCrossRef
2.
Zurück zum Zitat Maty SC, Everson-Rose SA, Haan MN, Raghunathan TE, Kaplan GA. Education, income, occupation, and the 34-year incidence (1965–99) of type 2 diabetes in the Alameda County Study. Int J Epidemiol. 2005;34:1274–81.PubMedCrossRef Maty SC, Everson-Rose SA, Haan MN, Raghunathan TE, Kaplan GA. Education, income, occupation, and the 34-year incidence (1965–99) of type 2 diabetes in the Alameda County Study. Int J Epidemiol. 2005;34:1274–81.PubMedCrossRef
3.
Zurück zum Zitat Maty SC, Lynch JW, Raghunathan TE, Kaplan GA. Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. Am J Public Health. 2008;98:1486–94.PubMedCrossRef Maty SC, Lynch JW, Raghunathan TE, Kaplan GA. Childhood socioeconomic position, gender, adult body mass index, and incidence of type 2 diabetes mellitus over 34 years in the Alameda County Study. Am J Public Health. 2008;98:1486–94.PubMedCrossRef
4.
Zurück zum Zitat Ross NA, Gilmour H, Dasgupta K. 14-Year diabetes incidence: the role of socio-economic status. Health Rep. 2010;21:19–28.PubMed Ross NA, Gilmour H, Dasgupta K. 14-Year diabetes incidence: the role of socio-economic status. Health Rep. 2010;21:19–28.PubMed
5.
Zurück zum Zitat Tamayo T, Christian H, Rathmann W. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health. 2010;10:525.PubMedCrossRef Tamayo T, Christian H, Rathmann W. Impact of early psychosocial factors (childhood socioeconomic factors and adversities) on future risk of type 2 diabetes, metabolic disturbances and obesity: a systematic review. BMC Public Health. 2010;10:525.PubMedCrossRef
6.
Zurück zum Zitat Kumari M, Head J, Marmot M. Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Arch Intern Med. 2004;27(164):1873–80.CrossRef Kumari M, Head J, Marmot M. Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. Arch Intern Med. 2004;27(164):1873–80.CrossRef
7.
Zurück zum Zitat Williams ED, Tapp RJ, Magliano DJ, Shaw JE, Zimmet PZ, Oldenburg BF. Health behaviours, socioeconomic status and diabetes incidence: the Australian Diabetes Obesity and Lifestyle Study (AusDiab). Diabetologia. 2010;53:2538–45.PubMedCrossRef Williams ED, Tapp RJ, Magliano DJ, Shaw JE, Zimmet PZ, Oldenburg BF. Health behaviours, socioeconomic status and diabetes incidence: the Australian Diabetes Obesity and Lifestyle Study (AusDiab). Diabetologia. 2010;53:2538–45.PubMedCrossRef
8.
Zurück zum Zitat Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol. 2011;40:804–18.PubMedCrossRef Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol. 2011;40:804–18.PubMedCrossRef
9.
Zurück zum Zitat Best LE, Hayward MD, Hidajat MM. Life course pathways to adult-onset diabetes. Soc Biol. 2005;52:94–111.PubMed Best LE, Hayward MD, Hidajat MM. Life course pathways to adult-onset diabetes. Soc Biol. 2005;52:94–111.PubMed
10.
Zurück zum Zitat Tanaka T, Gjonca E, Gulliford MC. Income, wealth and risk of diabetes among older adults: cohort study using the English Longitudinal Study of Ageing. Eur J Public Health. 2011. doi:10.1093/eurpub/ckr050. Tanaka T, Gjonca E, Gulliford MC. Income, wealth and risk of diabetes among older adults: cohort study using the English Longitudinal Study of Ageing. Eur J Public Health. 2011. doi:10.​1093/​eurpub/​ckr050.
11.
Zurück zum Zitat Kowall B, Rathmann W, Strassburger K, Meisinger C, Holle R, Mielck A. Socioeconomic status is not associated with type 2 diabetes incidence in an elderly population in Germany: KORA S4/F4 Cohort Study. J Epidemiol Community Health. 2011;65:606–12.PubMedCrossRef Kowall B, Rathmann W, Strassburger K, Meisinger C, Holle R, Mielck A. Socioeconomic status is not associated with type 2 diabetes incidence in an elderly population in Germany: KORA S4/F4 Cohort Study. J Epidemiol Community Health. 2011;65:606–12.PubMedCrossRef
12.
Zurück zum Zitat Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002;31:285–93.PubMedCrossRef Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. Int J Epidemiol. 2002;31:285–93.PubMedCrossRef
13.
Zurück zum Zitat Oliver ML, Shapiro TM. Black wealth/white wealth. New York: Routledge; 1995. Oliver ML, Shapiro TM. Black wealth/white wealth. New York: Routledge; 1995.
14.
Zurück zum Zitat Robert S, House JS. SES differentials in health by age and alternative indicators of SES. J Aging Health. 1996;8:359–88.PubMedCrossRef Robert S, House JS. SES differentials in health by age and alternative indicators of SES. J Aging Health. 1996;8:359–88.PubMedCrossRef
15.
Zurück zum Zitat Daly MC, Duncan GJ, McDonough P, Williams DR. Optimal indicators of socioeconomic status for health research. Am J Public Health. 2002;92:1151–7.PubMedCrossRef Daly MC, Duncan GJ, McDonough P, Williams DR. Optimal indicators of socioeconomic status for health research. Am J Public Health. 2002;92:1151–7.PubMedCrossRef
16.
Zurück zum Zitat Hurd MD. The economic status of the elderly. Science. 1989;12(244):659–64.CrossRef Hurd MD. The economic status of the elderly. Science. 1989;12(244):659–64.CrossRef
17.
Zurück zum Zitat Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M, et al. Socioeconomic status in health research: one size does not fit all. JAMA. 2005;14(294):2879–88.CrossRef Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M, et al. Socioeconomic status in health research: one size does not fit all. JAMA. 2005;14(294):2879–88.CrossRef
18.
Zurück zum Zitat Jackman MR, Jackman RW. Interpretation of relation between objective and subjective social status. Am Soc Rev. 1973;38:569–82.CrossRef Jackman MR, Jackman RW. Interpretation of relation between objective and subjective social status. Am Soc Rev. 1973;38:569–82.CrossRef
19.
Zurück zum Zitat Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000;19:586–92.PubMedCrossRef Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000;19:586–92.PubMedCrossRef
20.
Zurück zum Zitat Demakakos P, Nazroo J, Breeze E, Marmot M. Socioeconomic status and health: the role of subjective social status. Soc Sci Med. 2008;67:330–40.PubMedCrossRef Demakakos P, Nazroo J, Breeze E, Marmot M. Socioeconomic status and health: the role of subjective social status. Soc Sci Med. 2008;67:330–40.PubMedCrossRef
21.
Zurück zum Zitat Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care. 2008;31:2383–90.PubMedCrossRef Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and type 2 diabetes over the lifespan: a meta-analysis. Diabetes Care. 2008;31:2383–90.PubMedCrossRef
22.
Zurück zum Zitat Barth J, Schneider S, von Kanel R. Lack of social support in the etiology and the prognosis of coronary heart disease: a systematic review and meta-analysis. Psychosom Med. 2010;72:229–38.PubMedCrossRef Barth J, Schneider S, von Kanel R. Lack of social support in the etiology and the prognosis of coronary heart disease: a systematic review and meta-analysis. Psychosom Med. 2010;72:229–38.PubMedCrossRef
23.
Zurück zum Zitat van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HF, van den Borne BH. Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns. 2005;59:1–12.PubMedCrossRef van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HF, van den Borne BH. Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns. 2005;59:1–12.PubMedCrossRef
24.
Zurück zum Zitat Chandola T, Kuper H, Singh-Manoux A, Bartley M, Marmot M. The effect of control at home on CHD events in the Whitehall II study: gender differences in psychosocial domestic pathways to social inequalities in CHD. Soc Sci Med. 2004;58:1501–9.PubMedCrossRef Chandola T, Kuper H, Singh-Manoux A, Bartley M, Marmot M. The effect of control at home on CHD events in the Whitehall II study: gender differences in psychosocial domestic pathways to social inequalities in CHD. Soc Sci Med. 2004;58:1501–9.PubMedCrossRef
25.
Zurück zum Zitat DeVogli R, Chandola T, Marmot MG. Negative aspects of close relationships and heart disease. Arch Intern Med. 2007;8(167):1951–7.CrossRef DeVogli R, Chandola T, Marmot MG. Negative aspects of close relationships and heart disease. Arch Intern Med. 2007;8(167):1951–7.CrossRef
26.
Zurück zum Zitat Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007;30:744–52.PubMedCrossRef Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of moderate intensity and risk of type 2 diabetes: a systematic review. Diabetes Care. 2007;30:744–52.PubMedCrossRef
27.
Zurück zum Zitat Gill JM, Cooper AR. Physical activity and prevention of type 2 diabetes mellitus. Sports Med. 2008;38:807–24.PubMedCrossRef Gill JM, Cooper AR. Physical activity and prevention of type 2 diabetes mellitus. Sports Med. 2008;38:807–24.PubMedCrossRef
28.
Zurück zum Zitat Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007;12(298):2654–64.CrossRef Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2007;12(298):2654–64.CrossRef
29.
Zurück zum Zitat Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev. 2010;11:202–21.PubMedCrossRef Fogelholm M. Physical activity, fitness and fatness: relations to mortality, morbidity and disease risk factors. A systematic review. Obes Rev. 2010;11:202–21.PubMedCrossRef
30.
Zurück zum Zitat Qiao Q, Nyamdorj R. Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index? Eur J Clin Nutr. 2010;64:30–4.PubMedCrossRef Qiao Q, Nyamdorj R. Is the association of type II diabetes with waist circumference or waist-to-hip ratio stronger than that with body mass index? Eur J Clin Nutr. 2010;64:30–4.PubMedCrossRef
31.
Zurück zum Zitat Lynch JW, Kaplan GA, Salonen JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc Sci Med. 1997;44:809–19.PubMedCrossRef Lynch JW, Kaplan GA, Salonen JT. Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. Soc Sci Med. 1997;44:809–19.PubMedCrossRef
32.
Zurück zum Zitat Wardle J, Steptoe A. Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health. 2003;57:440–3.PubMedCrossRef Wardle J, Steptoe A. Socioeconomic differences in attitudes and beliefs about healthy lifestyles. J Epidemiol Community Health. 2003;57:440–3.PubMedCrossRef
33.
Zurück zum Zitat Ajrouch KJ, Blandon AY, Antonucci TC. Social networks among men and women: the effects of age and socioeconomic status. J Gerontol B Psychol Sci Soc Sci. 2005;60:S311–7.PubMedCrossRef Ajrouch KJ, Blandon AY, Antonucci TC. Social networks among men and women: the effects of age and socioeconomic status. J Gerontol B Psychol Sci Soc Sci. 2005;60:S311–7.PubMedCrossRef
34.
Zurück zum Zitat Rosengren A, Orth-Gomer K, Wilhelmsen L. Socioeconomic differences in health indices, social networks and mortality among Swedish men. A study of men born in 1933. Scand J Soc Med. 1998;26:272–80.PubMed Rosengren A, Orth-Gomer K, Wilhelmsen L. Socioeconomic differences in health indices, social networks and mortality among Swedish men. A study of men born in 1933. Scand J Soc Med. 1998;26:272–80.PubMed
35.
Zurück zum Zitat Demakakos P, Hamer M, Stamatakis E, Steptoe A. Low-intensity physical activity is associated with reduced risk of incident type 2 diabetes in older adults: evidence from the English Longitudinal Study of Ageing. Diabetologia. 2010;53:1877–85.PubMedCrossRef Demakakos P, Hamer M, Stamatakis E, Steptoe A. Low-intensity physical activity is associated with reduced risk of incident type 2 diabetes in older adults: evidence from the English Longitudinal Study of Ageing. Diabetologia. 2010;53:1877–85.PubMedCrossRef
37.
Zurück zum Zitat Demakakos P, Pierce MB, Hardy R. Depressive symptoms and risk of type 2 diabetes in a national sample of middle-aged and older adults: the English longitudinal study of aging. Diabetes Care. 2010;33:792–7.PubMedCrossRef Demakakos P, Pierce MB, Hardy R. Depressive symptoms and risk of type 2 diabetes in a national sample of middle-aged and older adults: the English longitudinal study of aging. Diabetes Care. 2010;33:792–7.PubMedCrossRef
38.
Zurück zum Zitat Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson JW, Weinehall L. Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract. 2007;76:368–77.PubMedCrossRef Norberg M, Stenlund H, Lindahl B, Andersson C, Eriksson JW, Weinehall L. Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women. Diabetes Res Clin Pract. 2007;76:368–77.PubMedCrossRef
39.
Zurück zum Zitat Lidfeldt J, Li TY, Hu FB, Manson JE, Kawachi I. A prospective study of childhood and adult socioeconomic status and incidence of type 2 diabetes in women. Am J Epidemiol. 2007;15(165):882–9.CrossRef Lidfeldt J, Li TY, Hu FB, Manson JE, Kawachi I. A prospective study of childhood and adult socioeconomic status and incidence of type 2 diabetes in women. Am J Epidemiol. 2007;15(165):882–9.CrossRef
40.
Zurück zum Zitat Krishnan S, Cozier YC, Rosenberg L, Palmer JR. Socioeconomic status and incidence of type 2 diabetes: results from the Black Women’s Health Study. Am J Epidemiol. 2010;1(171):564–70.CrossRef Krishnan S, Cozier YC, Rosenberg L, Palmer JR. Socioeconomic status and incidence of type 2 diabetes: results from the Black Women’s Health Study. Am J Epidemiol. 2010;1(171):564–70.CrossRef
41.
Zurück zum Zitat Smith BT, Lynch JW, Fox CS, Harper S, Abrahamowicz M, Almeida ND, et al. Life-course socioeconomic position and type 2 diabetes mellitus: the Framingham Offspring Study. Am J Epidemiol. 2011;15(173):438–47.CrossRef Smith BT, Lynch JW, Fox CS, Harper S, Abrahamowicz M, Almeida ND, et al. Life-course socioeconomic position and type 2 diabetes mellitus: the Framingham Offspring Study. Am J Epidemiol. 2011;15(173):438–47.CrossRef
42.
Zurück zum Zitat Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, et al. Work stress and low sense of coherence is associated with type 2 diabetes in middle-aged Swedish women. Diabetes Care. 2003;26:719–24.PubMedCrossRef Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, et al. Work stress and low sense of coherence is associated with type 2 diabetes in middle-aged Swedish women. Diabetes Care. 2003;26:719–24.PubMedCrossRef
43.
Zurück zum Zitat Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, et al. Explanations of socioeconomic differences in excess risk of type 2 diabetes in Swedish men and women. Diabetes Care. 2004;27:716–21.PubMedCrossRef Agardh EE, Ahlbom A, Andersson T, Efendic S, Grill V, Hallqvist J, et al. Explanations of socioeconomic differences in excess risk of type 2 diabetes in Swedish men and women. Diabetes Care. 2004;27:716–21.PubMedCrossRef
44.
Zurück zum Zitat Eriksson JG, Forsen TJ, Osmond C, Barker DJ. Pathways of infant and childhood growth that lead to type 2 diabetes. Diabetes Care. 2003;26:3006–10.PubMedCrossRef Eriksson JG, Forsen TJ, Osmond C, Barker DJ. Pathways of infant and childhood growth that lead to type 2 diabetes. Diabetes Care. 2003;26:3006–10.PubMedCrossRef
45.
Zurück zum Zitat Kajantie E, Osmond C, Barker DJ, Eriksson JG. Preterm birth—a risk factor for type 2 diabetes? The Helsinki birth cohort study. Diabetes Care. 2010;33:2623–5.PubMedCrossRef Kajantie E, Osmond C, Barker DJ, Eriksson JG. Preterm birth—a risk factor for type 2 diabetes? The Helsinki birth cohort study. Diabetes Care. 2010;33:2623–5.PubMedCrossRef
46.
Zurück zum Zitat Osmond C, Barker DJ. Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environ Health Perspect. 2000;108(Suppl 3):545–53.PubMed Osmond C, Barker DJ. Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environ Health Perspect. 2000;108(Suppl 3):545–53.PubMed
47.
Zurück zum Zitat Buren J, Eriksson JW. Is insulin resistance caused by defects in insulin’s target cells or by a stressed mind? Diabetes Metab Res Rev. 2005;21:487–94.PubMedCrossRef Buren J, Eriksson JW. Is insulin resistance caused by defects in insulin’s target cells or by a stressed mind? Diabetes Metab Res Rev. 2005;21:487–94.PubMedCrossRef
48.
Zurück zum Zitat Loucks EB, Rehkopf DH, Thurston RC, Kawachi I. Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. Ann Epidemiol. 2007;17:19–26.PubMedCrossRef Loucks EB, Rehkopf DH, Thurston RC, Kawachi I. Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. Ann Epidemiol. 2007;17:19–26.PubMedCrossRef
49.
Zurück zum Zitat Marmot M, Wilkinson RG. Psychosocial and material pathways in the relation between income and health: a response to Lynch et al. BMJ. 2001;19(322):1233–6.CrossRef Marmot M, Wilkinson RG. Psychosocial and material pathways in the relation between income and health: a response to Lynch et al. BMJ. 2001;19(322):1233–6.CrossRef
50.
Zurück zum Zitat Pierce MB, Zaninotto P, Steel N, Mindell J. Undiagnosed diabetes-data from the English Longitudinal Study of Ageing. Diabet Med. 2009;26:679–85.PubMedCrossRef Pierce MB, Zaninotto P, Steel N, Mindell J. Undiagnosed diabetes-data from the English Longitudinal Study of Ageing. Diabet Med. 2009;26:679–85.PubMedCrossRef
Metadaten
Titel
Socioeconomic position and the incidence of type 2 diabetes: the ELSA study
verfasst von
Panayotes Demakakos
Michael Marmot
Andrew Steptoe
Publikationsdatum
01.05.2012
Verlag
Springer Netherlands
Erschienen in
European Journal of Epidemiology / Ausgabe 5/2012
Print ISSN: 0393-2990
Elektronische ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-012-9688-4

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