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Lifecourse socioeconomic position and diabetes incidence in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, 2003 to 2016
Journal article   Open access   Peer reviewed

Lifecourse socioeconomic position and diabetes incidence in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, 2003 to 2016

Kimberly D. Martin, Gloria L. Beckles, Chengyi Wu, Leslie A. McClure, April P. Carson, Aleena Bennett, Kai McKeever Bullard, M. Maria Glymour, Fred Unverzagt, Solveig Cunningham, …
Preventive medicine, v 153, 106848
Dec 2021
DOI: https://doi.org/10.1016/j.ypmed.2021.106848
PMID: 34673080
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658048View
Accepted (AM)Open Access (License Unspecified),  Open

Abstract

African American Lifecourse socioeconomic position Social mobility Type 2 diabetes mellitus
Low socioeconomic position (SEP) across the lifecourse is associated with Type 2 diabetes (T2DM). We examined whether these economic disparities differ by race and sex. We included 5448 African American (AA) and white participants aged ≥45 years from the national (United States) REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort without T2DM at baseline (2003–07). Incident T2DM was defined by fasting glucose ≥126 mg/dL, random glucose ≥200 mg/dL, or using T2DM medications at follow-up (2013–16). Derived SEP scores in childhood (CSEP) and adulthood (ASEP) were used to calculate a cumulative (CumSEP) score. Social mobility was defined as change in SEP. We fitted race-stratified logistic regression models to estimate the association between each lifecourse SEP indicator and T2DM, adjusting for covariates; additionally, we tested SEP-sex interactions. Over a median of 9.0 (range 7–14) years of follow-up, T2DM incidence was 167.1 per 1000 persons among AA and 89.9 per 1000 persons among white participants. Low CSEP was associated with T2DM incidence among AA (OR = 1.61; 95%CI 1.05–2.46) but not white (1.06; 0.74–2.33) participants; this was attenuated after adjustment for ASEP. In contrast, low CumSEP was associated with T2DM incidence for both racial groups. T2DM risk was similar for stable low SEP and increased for downward mobility when compared with stable high SEP in both groups, whereas upward mobility increased T2DM risk among AAs only. No differences by sex were observed. Among AAs, low CSEP was not independently associated with T2DM, but CSEP may shape later-life experiences and health risks. •We compared three lifecourse hypotheses as it relates to socioeconomic position and incident type 2 diabetes by race.•Childhood socioeconomic position may shape later-life health risks, especially for African American participants.•Cumulative exposure to low socioeconomic position was associated with increased odds of type 2 diabetes in both groups.•Upward mobility was associated with increased odds of type 2 diabetes among African American participants only.

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4 citations in Web of Science
2 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#10 Reduced Inequalities

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Collaboration types
Domestic collaboration
Web of Science research areas
Public, Environmental & Occupational Health
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