American Journal of Epidemiology Advance Access originally published online on February 6, 2007
American Journal of Epidemiology 2007 165(8):882-889; doi:10.1093/aje/kwk078
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A Prospective Study of Childhood and Adult Socioeconomic Status and Incidence of Type 2 Diabetes in Women
1 Department of Epidemiology, Harvard School of Public Health, Boston, MA
2 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
3 Department of Nutrition, Harvard School of Public Health, Boston, MA
4 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
5 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
6 Harvard Center for Society and Health, Boston, MA
Correspondence to Dr. Jonas Lidfeldt, Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: nlidfeld{at}hsph.harvard.edu).
Received for publication April 26, 2006. Accepted for publication October 3, 2006.
The influence of childhood socioeconomic status (SES) on incidence of type 2 diabetes mellitus has not previously been studied. The authors prospectively examined the association of childhood SES (father's occupation) with incidence of diabetes in 100,330 US women who were followed from 1980 to 2002. In 55,115 of those women, 10-year follow-up data (1992–2002) were also available on adult SES (spouse's education). In all, 6,916 new cases of type 2 diabetes were documented. Compared with women from white-collar occupational backgrounds, the multivariate-adjusted risks of diabetes were 1.08 (95% confidence interval (CI): 0.95, 1.23) among women whose fathers were laborers and 1.10 (95% CI: 1.03, 1.16) among women whose fathers were blue-collar or lower white-collar workers. Lower adult SES was associated with risk of diabetes independently of childhood SES. Compared with women whose spouses had graduate degrees, women whose spouses were high school graduates had a 1.16 times higher risk of incident diabetes (95% CI: 1.04, 1.29), while women whose spouses had college degrees were at 1.14 times the risk (95% CI: 1.01, 1.29). Compared with women with stable high SES from childhood to adulthood, women with declining SES had a 1.18 times higher risk of incident diabetes (95% CI: 1.06, 1.32). Higher body mass index among women with lower SES accounted for much of these rather modest associations between childhood and adult SES and risk of diabetes.
diabetes mellitus, type 2; incidence; social class; women
Abbreviations: BMI, body mass index; CI, confidence interval; RR, relative risk; SES, socioeconomic status
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