Lidyane V Camelo1, Luana Giatti1, Bruce B Duncan2, Dóra Chor3, Rosane Härter Griep4, Maria Inês Schmidt2, Sandhi Maria Barreto5. 1. Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. 2. Postgraduate Program in Epidemiology and Hospital de Clinicas de Porto Alegre, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil. 3. Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 4. Laboratory of Health and Environment Education, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 5. Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Electronic address: sbarreto@medicina.ufmg.br.
Abstract
PURPOSE: We investigated gender-specific associations of cumulative socioeconomic position across life course and social mobility with new onset diabetes mellitus (NODM) in over 12,000 civil servants in Brazil. METHODS: We used data from ELSA-Brasil baseline (2008-2010). The accumulation of risk was assessed using an education-based score and an occupation-based score. Educational and occupational social mobility were also evaluated. RESULTS: In minimally adjusted models, NODM increased with increasing exposure to life-course social disadvantages, especially in men. This gender difference was pronounced when cumulative processes were evaluated by education-based scores (high vs. low cumulative social disadvantage, odds ratio [OR] = 4.7; 95% confidence interval [CI]: 2.6-8.5 in men and OR = 2.0; 95% CI: 1.1-3.6 in women). After including proximal diabetes risk factors possibly acting as mediators, these associations remained high only in men (high vs. low cumulative social disadvantage, OR = 4.4; 95% CI: 2.4-8.1). Social mobility was associated with NODM in men. Compared to the high-stable trajectory, downward had greater associations than upward mobility. In women, when considering metabolic syndrome-related variables, changes in social hierarchy did not seem to have an influence on their risk of diabetes. CONCLUSIONS: Accumulation of risk and social mobility were associated with NODM with gender-specific patterns, suggesting differences in mechanisms connecting life-course socioeconomic position and diabetes in men and women. Copyright Â
PURPOSE: We investigated gender-specific associations of cumulative socioeconomic position across life course and social mobility with new onset diabetes mellitus (NODM) in over 12,000 civil servants in Brazil. METHODS: We used data from ELSA-Brasil baseline (2008-2010). The accumulation of risk was assessed using an education-based score and an occupation-based score. Educational and occupational social mobility were also evaluated. RESULTS: In minimally adjusted models, NODM increased with increasing exposure to life-course social disadvantages, especially in men. This gender difference was pronounced when cumulative processes were evaluated by education-based scores (high vs. low cumulative social disadvantage, odds ratio [OR] = 4.7; 95% confidence interval [CI]: 2.6-8.5 in men and OR = 2.0; 95% CI: 1.1-3.6 in women). After including proximal diabetes risk factors possibly acting as mediators, these associations remained high only in men (high vs. low cumulative social disadvantage, OR = 4.4; 95% CI: 2.4-8.1). Social mobility was associated with NODM in men. Compared to the high-stable trajectory, downward had greater associations than upward mobility. In women, when considering metabolic syndrome-related variables, changes in social hierarchy did not seem to have an influence on their risk of diabetes. CONCLUSIONS: Accumulation of risk and social mobility were associated with NODM with gender-specific patterns, suggesting differences in mechanisms connecting life-course socioeconomic position and diabetes in men and women. Copyright Â
Authors: Dayse Rodrigues de Sousa Andrade; Lidyane V Camelo; Rodrigo Citton P Dos Reis; Itamar S Santos; Antonio Luiz Ribeiro; Luana Giatti; Sandhi Maria Barreto Journal: Int J Public Health Date: 2016-12-02 Impact factor: 3.380
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