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. 2011;6(12):e27670.
doi: 10.1371/journal.pone.0027670. Epub 2011 Dec 14.

Socioeconomic status and incident type 2 diabetes mellitus: data from the Women's Health Study

Timothy C Lee  1 , Robert J Glynn, Jessica M Peña, Nina P Paynter, David Conen, Paul M Ridker, Aruna D Pradhan, Julie E Buring, Michelle A Albert
Affiliations

Socioeconomic status and incident type 2 diabetes mellitus: data from the Women's Health Study

Timothy C Lee et al. PLoS One. 2011.

Abstract

Objectives: We prospectively examined whether socioeconomic status (SES) predicts incident type II diabetes (diabetes), a cardiovascular risk equivalent and burgeoning public health epidemic among women.

Methods: Participants include 23,992 women with Hb(A1c) levels <6% and no CVD or diabetes at baseline followed from February 1993 to March 2007. SES was measured by education and income while diabetes was self-reported.

Results: Over 12.3 years of follow-up, 1,262 women developed diabetes. In age and race adjusted models, the relative risk of diabetes decreased with increasing education (<2 years of nursing, 2 to <4 years of nursing, bachelor's degree, master's degree, and doctorate: 1.0, 0.7 [95% Confidence Interval (CI), 0.6-0.8], 0.6 (95% CI, 0.5-0.7), 0.5 (95% CI, 0.4-0.6), 0.4 (95% CI, 0.3-0.5); p(trend)<0.001). Adjustment for traditional and non-traditional cardiovascular risk factors attenuated this relationship (education: p(trend) = 0.96). Similar associations were observed between income categories and diabetes.

Conclusion: Advanced education and increasing income were both inversely associated with incident diabetes even in this relatively well-educated cohort. This relationship was largely explained by behavioral factors, particularly body mass index.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Percentage of socioeconomic status-incident diabetes association that is explained by mediators.
The proportion of the risk attributable to increasing education levels; 1A) and for increasing income levels; 1B) that is explained by each mediator or set of mediators calculated as follows: (HR base model−HR adjusted model)/(HR base model−1)×100% –. HRs for the highest education or income categories compared with the HRs of the women with the lowest education or income without control for risk factors represented the base model whereas the adjusted model reflects control for each risk factor/risk factor category. Base model is adjusted for age, race/ethnicity and family history of diabetes.
See this image and copyright information in PMC

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