Type 2 diabetes in Canada: concentration of risk among most disadvantaged men but inverse social gradient across groups in women
- 21 April 2010
- journal article
- research article
- Published by Wiley in Diabetic Medicine
- Vol. 27 (5), 522-531
- https://doi.org/10.1111/j.1464-5491.2010.02982.x
Abstract
Diabet. Med. 27, 522–531 (2010) Abstract Aims To assess sex‐specific associations of educational and income levels with Type 2 diabetes mellitus. Methods Logistic regression analyses (Canadian Community Health Survey, cross‐sectional) adjusted for ethnicity, immigration, urban/rural, overweight/obesity, physical inactivity, smoking, chronic conditions and regular physician. Results Compared to women with some post‐secondary education, Type 2 diabetes was more likely in both high school graduates without post‐secondary education [odds ratio (OR) 1.27, 95% confidence interval (CI) 1.07–1.51] and high school non‐completers (OR 1.73, 95% CI 1.47–2.04); among men, definitive conclusions in high school graduates without post‐secondary education could not be drawn (OR 0.93, 95% CI 0.78–1.12), but Type 2 diabetes was more likely in high school non‐completers (OR 1.26, 95% CI 1.08–1.48). Compared to women with the highest income, Type 2 diabetes was three times more likely in the lowest income group (OR 2.90, 95% CI 2.25–3.73), 2.53 times more likely in the low middle income group (OR 2.53, 95% CI 1.98–3.24) and 55% more likely in the high middle income group (OR 1.55, 95% CI 1.20–2.01). Among men, Type 2 diabetes was approximately 40% more likely in both the lowest (OR 1.41, 95% CI 1.10–1.80) and low middle income groups (OR 1.39, 95% CI 1.12–1.71); definitive conclusions in the high middle income group could not be drawn (OR 1.05, 95% CI 0.87–1.28). Conclusions In women, Type 2 diabetes increased monotonically with lower educational and income levels; in men, Type 2 diabetes was concentrated in the least educated and least affluent. Our findings support the need for policies and practices that lower diabetes risk among the most disadvantaged women and men and moderately disadvantaged women.Keywords
This publication has 26 references indexed in Scilit:
- The Danish National Diabetes Register: trends in incidence, prevalence and mortalityDiabetologia, 2008
- Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995–2005: a population-based studyThe Lancet, 2007
- Socio-economic position at three points in life in association with type 2 diabetes and impaired glucose tolerance in middle-aged Swedish men and womenInternational Journal of Epidemiology, 2007
- Sex differences in the associations of socioeconomic status with undiagnosed diabetes mellitus and impaired glucose tolerance in the elderly population: the KORA Survey 2000European Journal of Public Health, 2005
- Socio‐economic inequalities in the prevalence of Type 2 diabetes, cardiovascular risk factors and chronic diabetic complications in the Basque Country, SpainDiabetic Medicine, 2005
- Obesity and the Environment: Where Do We Go from Here?Science, 2003
- Risk factors for diabetes mellitus by age and sex: results of the National Population Health SurveyDiabetologia, 2001
- Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areasJournal of Epidemiology and Community Health, 2000
- Diabetes mellitus, race, and socioeconomic status a population-based studyAnnals of Epidemiology, 1996
- Health inequalities among British civil servants: the Whitehall II studyThe Lancet, 1991