Socioeconomic Status and Diagnosed Diabetes Incidence

Aims: To investigate the association between socioeconomic status (SES) and incidence of diabetes.

Methods: We investigated three measures of SES and incidence of diagnosed diabetes among women and men in the NHANES I Epidemiologic Followup Study, 1971-1992, who were free of diagnosed diabetes in 1980.

Results: Among women, diabetes incidence was inversely associated with income (measured as percent of the poverty level), education, and occupational status, adjusting for age and race/ethnicity. The hazard ratio (HR) for women with > 16 years education was 0.26 (95% confidence interval (CI) 0.13-0.54) relative to those with < 9 years of education. Adjustment for potential mediators, including body size variables, diet, physical activity, and alcohol and tobacco use, substantially attenuated the associations with income and education. Among men a trend toward lower diabetes incidence with higher income and higher education was evident (the HR for men with household income > 5 times the poverty level was 0.44 (95% CI 0.19-0.98) relative to those under the poverty line), but there was no inverse association of diabetes incidence with occupational status.

Conclusions: SES, assessed with any of three common measures, is a risk factor for diagnosed diabetes in women. Among men these associations are less consistent.