14-year Diabetes Incidence: The Role of Socioeconomic Status (Summary)

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Summary

Lower levels of household income and education are associated with the onset of type 2 diabetes in Canadian women, independent of other factors such as the well-establishedrelationship with excess weight.

Even allowing for the effects of overweight, obesity and ethno-cultural origin, lower-income women were significantly more likely to develop type 2 diabetes than were their counterpartsin high-incomehouseholds.

By contrast, among men, any relationship between household income and the onset of diabetes disappeared when other factors were taken into account. Instead, the development of diabetes among men was related to being overweight or obese, and to the number of secondary behavioural factors they reported, such as heavy drinking, smoking and physical inactivity.

These findings are derived from the results of the latest release of data from the National Population Health Survey (NPHS), a longitudinal survey that has tracked the health status of a cohort of more than 17,000 Canadians since 1994/1995.

The study of the onset of diabetes is based on 12,333 NPHS respondents who were aged 18 or older in 1994/1995. Among those who had been free of diabetes in 1994/1995, 7.3% of men and 6.2% of women had either developed or died from the disease by 2008/2009.

The study analysed the relationship between the incidence of type 2 diabetes and household income and individual educational attainment. It also examined demographic and behavioural factors that may contribute to this relationship.

For women, even when other factors were considered, a modest association between type 2 diabetes and lower education attainment persisted among those who had only secondary education compared with postsecondary.

For men, the association between type 2 diabetes and lower education attainment disappeared entirely when weight and behavioural factors were taken into account.

In type 2 diabetes, the pancreas produces insulin, but the body develops resistance to its effects, resulting in a relative insulin deficiency. Type 2, which typically occurs in adulthood, accounts for up to 95% of cases. In type 1 diabetes, the pancreas cannot produce insulin, so it must be replaced. Type 1 usually develops in childhood or adolescence.