266154 Lifecourse Socioeconomic Position, Race and Prevalence of Diabetes among US Women and Men

Sunday, October 28, 2012

David Strogatz , Bassett Research Institute, Bassett Healthcare Network, Cooperstown, NY
Tabassum Insaf, MBBS, MPH , Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, Troy, NY
Benjamin Shaw, PhD , Department of Health Policy, Management and Behavior, University at Albany, School of Public Health, Rensselaer, NY
Lisa Chasan-Taber, ScD , Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA
Recai Yucel , Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, SUNY, Rensselaer, NY
Few studies have examined the degree to which a lifecourse perspective on socioeconomic position (SEP) accounts for Black-White differences in the development of diabetes. This question was addressed in data from the Americans' Changing Lives study of 3,497 adults aged 25 years and older. Sex-specific generalized estimating equations were used to compute prevalence ratios (PR) for associations of race and SEP with self-reported diagnoses of diabetes recorded at four waves of data collection during the 16 year study period (1986-2002). For men, childhood and adult SEP were unrelated to prevalence of diabetes and adjustment for lifecourse SEP had little effect on the excess prevalence of diabetes in Blacks (PR=1.56, 95%CI: 1.11, 2.21). In contrast, low father and low respondent education were each associated with increased diabetes in women (PR=1.69, 95%CI: 1.08, 2.63 and 1.78, 95%CI: 1.26, 2.51, respectively) and the combination of low SEP as a child and adult was associated with nearly a threefold increase (PR=2.89, 95%CI: 2.10, 3.99) in the prevalence of diabetes. The adjustment for lifecourse SEP reduced the PR for the association between race and diabetes in women from 1.96 (95%CI: 1.52, 2.54) to 1.40 (95%CI: 1.04, 1.87). The results suggest that the pathway and cumulative hypotheses for lifecourse SEP effects on diabetes may be especially salient for women.

Learning Areas:

Learning Objectives:
Describe how socioeconomic position at different points in lifecourse are related to prevalence of diabetes in a sample of US adults. Assess the degree to which socioeconomic position across the lifecourse accounts for racial differences in the prevalence of diabetes.

Keywords: Diabetes, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I direct the Research Core of the NIH-funded Center for the Elimination of Minority Health Disparities at the University at Albany, School of Public Health. I have a a PhD in epidemiology and a major research focus has been disparities in chronic disease affecting minority and low SES populations.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.