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Perez N, He N, Wright F, Condon E, Weiser S, Aouizerat B. Social determinants of inflammatory markers linking depression and type 2 diabetes among women: A scoping review. J Psychosom Res 2024; 184:111831. [PMID: 38905780 DOI: 10.1016/j.jpsychores.2024.111831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/03/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Inflammation is implicated in the pathophysiology of depression and type 2 diabetes (T2D) and is linked to social determinants of health (SDoH) associated with socioeconomic disadvantage. The objective of this review is to identify and map the range of SDoHs associated with inflammation in depression, T2D, or their co-occurrence among women. METHODS PubMed, CINAHL, PsychINFO, and Web of Science were searched March-July 2023 to identify studies where 1) an SDoH was a predictor or independent variable, 2) depression or T2D was a clinical focus, 3) inflammatory markers were collected, and 4) analysis was specific to women. We used the National Institute on Minority Health and Health Disparities research framework to guide searching SDoHs, organize findings, and identify gaps. RESULTS Of the 1135 studies retrieved, 46 met criteria. Within the reviewed studies, the most used inflammatory measures were C-reactive protein, interleukin-6, and tumor necrosis factor-α, and the most studied SDoHs were early life stress and socioeconomic status. Individual and interpersonal-level variables comprised the bulk of SDoHs in the included studies, while few to no studies examined built environment (n = 6) or health system level (n = 0) factors. Disadvantageous SDoHs were associated with higher levels of inflammation across the included studies. CONCLUSION The scope and intersection of depression and T2D represent a syndemic that contributes to and results from socioeconomic inequities and disproportionately affects women. Simultaneous inclusion of social and inflammatory measures, particularly understudied SDoHs, is needed to clarify potent targets aimed at advancing health and equity.
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Affiliation(s)
- Nicole Perez
- New York University, Rory Meyers College of Nursing, 433 1(st) Ave, New York, NY 10010, USA.
| | - Ning He
- New York University, Silver School of Social Work, 1 Washington Squire North, New York, NY 10003, United States of America.
| | - Fay Wright
- Northwell Health Northern Westchester Hospital, 400 East Main Street, Mt Kisco, NY 10549, United States of America.
| | - Eileen Condon
- University of Connecticut, College of Nursing, 231 Glenbrook Rd, Storrs, CT 06269, United States of America.
| | - Sheri Weiser
- University of San Francisco, School of Medicine, 533 Parnassus Ave, San Francisco, CA 94143, United States of America.
| | - Brad Aouizerat
- New York University, College of Dentistry, 345 E 24th St, New York, NY 10010, United States of America; University of San Francisco, School of Pharmacy, 513 Parnassus Ave, San Francisco, CA 94143, United States of America.
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Seixas BV, Macinko J. Distinct domains of childhood disadvantage and cognitive performance among older Brazilians: Evidence from ELSI-Brazil. SSM Popul Health 2023; 22:101416. [PMID: 37215155 PMCID: PMC10193012 DOI: 10.1016/j.ssmph.2023.101416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Objective To investigate the relationship between of distinct domains of childhood disadvantage and cognitive performance among older adults within the context of a middle-income country. Methods This study used baseline data (2015/2016) from the Brazilian Longitudinal Study of Aging (ELSI), a nationally representative cohort of 9412 adults aged 50 and over. Nine childhood exposure variables were grouped into three domains (family SES, childhood health, and cultural capital), for which scores were created. Survey-weighted Ordinary Least Squares (OLS) regressions estimated the association childhood disadvantage with cognitive performance as measured by immediate memory, late memory and semantic verbal fluency. Mediation analysis assessed whether adulthood socioeconomic status (SES) mediated this relationship of interest. Results Important disparities in cognitive performance were observed, particularly in terms of age, education, income, occupational status. Before controlling for adulthood SES in the multivariable analysis, all domains of childhood disadvantage were found to be associated with lower cognitive performance across all three measures. After inclusion of adulthood SES variables, the observed associations only remained for semantic verbal fluency. Formal mediation analysis indicated that adulthood SES mediates 47.9% (95% CI: 34.3%-78.6%) of the association between later-life verbal fluency and poor childhood health, and 49.9% (95% CI: 43.6%-57.8%) of the association between later-life verbal fluency and low childhood cultural capital. Conclusions We found that childhood disadvantage is associated with low performance in memory tests and semantic verbal fluency tests among older Brazilians. Adulthood SES fully mediated the association between all domains of childhood disadvantage and memory performance and only partially mediated its association with verbal fluency. Our findings support policy efforts to enhance early childhood development and improve adulthood SES, and guide additional research to better the mechanisms driving these relationships.
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Affiliation(s)
- Brayan V. Seixas
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
| | - James Macinko
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E Young Dr S, Los Angeles, CA, 90095, USA
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Varanka-Ruuska T, Rautio N, Sebert S, Ala-Mursula L. Glucose Metabolism in Midlife Is Associated With Preceding 30-Year Employment Trajectories: A Northern Finland Birth Cohort 1966 Study. J Occup Environ Med 2023; 65:104-112. [PMID: 36253928 DOI: 10.1097/jom.0000000000002732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of the study is to evaluate how glucose metabolism in midlife is related to preceding 30-year-long employment trajectories. METHODS In the Northern Finland Birth Cohort 1966, we compared glucose metabolism at 46 to employment trajectories (previously defined for men and women and named as high-educated, traditional, self-employed, delayed, and floundering; n = 6399). RESULTS Compared with individuals in high-educated trajectories, odds ratios for type 2 diabetes (T2D, 95% confidence interval) in traditional and floundering trajectories in men were 1.65 (1.02-2.68) and 2.42 (1.38-4.23) and in women 1.89 (1.04-3.43) and 2.60 (1.46-4.62), respectively. In self-employed trajectory in women, odds ratios for prediabetes and T2D were 1.66 (1.09-2.51) and 2.47 (1.21-5.04). CONCLUSIONS The highest risks for T2D in midlife were associated after traditional and floundering trajectories in men and women and after self-employment trajectory in women.
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Papamichael MM, Karatzi K, Mavrogianni C, Cardon G, De Vylder F, Iotova V, Usheva N, Tankova T, González-Gil EM, Kivelä J, Wikström K, Moreno L, Liatis S, Makrilakis K, Manios Y. Socio-economic vulnerabilities and food intake in European children: The Feel4Diabetes Study. Nutrition 2022; 103-104:111744. [DOI: 10.1016/j.nut.2022.111744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/05/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
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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. Prev Med 2021; 153:106848. [PMID: 34673080 PMCID: PMC8658048 DOI: 10.1016/j.ypmed.2021.106848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 09/24/2021] [Accepted: 10/11/2021] [Indexed: 11/22/2022]
Abstract
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.
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Life-course pathways from childhood socioeconomic status to type 2 diabetes in mid-late Chinese adulthood. Sci Rep 2021; 11:13051. [PMID: 34158532 PMCID: PMC8219676 DOI: 10.1038/s41598-021-91768-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The relationship between childhood socioeconomic status (SES) and type 2 diabetes (T2D) remains inconclusive, and the pathways and mechanisms driving this relationship have yet to be clarified. This study aimed to examine the pathways linking childhood SES to T2D prevalence in mid-late adulthood in a low- and middle-income country. The incidence of T2D diagnosed in mid-late Chinese adulthood was assessed using self-reports from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was assessed by the education, occupation, survivorship of the parents and the financial situation of the family, whereas adulthood SES was assessed by education and wage. This study performed structural equation modeling to clarify the direct and indirect pathways from childhood SES to T2D via childhood health, childhood food shortage, adulthood SES and physical activity. A total of 15,132 participants were included, and the prevalence of T2D was 5.24%. This study found that childhood SES was directly associated with T2D in mid-late adulthood, the probability of developing T2D increased by 9.20% of the standard deviation for each decrease in standard deviation in childhood SES. Childhood SES was indirectly associated with T2D via adulthood SES, physical activity, childhood health and food shortage. Adulthood SES and physical activity mainly mediated the indirect pathway from childhood SES and T2D. This study showed direct and indirect pathways from disadvantaged childhood SES to increased risk of T2D in mid-late Chinese adulthood. Childhood SES, adulthood SES, physical activity, childhood health and food shortage were identified as life-course interventional targets that should be considered in the development of effective strategies to reduce the burden of T2D and SES-related health inequities in childhood.
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Bjerregaard LG, Damborg ML, Osler M, Sørensen TIA, Baker JL. Body mass index and height in relation to type 2 diabetes by levels of intelligence and education in a large cohort of Danish men. Eur J Epidemiol 2020; 35:1167-1175. [PMID: 32372338 DOI: 10.1007/s10654-020-00641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
Abstract
Socioeconomic status (SES) is inversely associated with risks of type 2 diabetes (T2D). We investigated if young men's cognitive function, measured by intelligence test scores and educational level, as determinants of SES modified associations between body mass index (BMI) and height with the risk of T2D. 369 989 young men from the Danish Conscription Database born between 1939 and 1959 with information on measured height, weight, intelligence test scores, and education were linked to the Danish National Patient Register. During follow-up from 1977 through 2015, T2D was recorded in 32 188 men. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated by Cox regressions. BMIs below-average (z-scores ≤ 0) were not related to risks of T2D. For BMIs above-average (z-scores > 0), positive associations between BMI and T2D were slightly stronger among men with higher intelligence test scores or longer educations than among men with lower levels of these factors (pinteraction-values < 0.004). Irrespective of BMI, incidence rates of T2D were higher among men with low levels of intelligence test score and education. Height was inversely associated with T2D (per z-score, HR = 0.96 (95% CI 0.95-0.97) and the association did not vary by intelligence test scores or education (all pinteraction-values > 0.59). While below-average BMI was not associated with T2D risk, above-average BMIs were and these association were stronger among men with high cognitive function. Nevertheless, T2D risk was higher at lower levels of cognitive function throughout the range of BMI. Height was inversely associated with T2D and it was not modified by cognitive function.
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Affiliation(s)
- Lise G Bjerregaard
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Hovedvejen 5, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark
| | - Mille L Damborg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Hovedvejen 5, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark
| | - Merete Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Hovedvejen 5, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark.,Department of Public Health, Section of Epidemiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Hovedvejen 5, Nordre Fasanvej 57, 2000, Frederiksberg, Copenhagen, Denmark. .,Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark.
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8
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Milaniak I, Jaffee SR. Childhood socioeconomic status and inflammation: A systematic review and meta-analysis. Brain Behav Immun 2019; 78:161-176. [PMID: 30738842 DOI: 10.1016/j.bbi.2019.01.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/21/2018] [Accepted: 01/19/2019] [Indexed: 12/26/2022] Open
Abstract
Recent research suggests that risk for chronic diseases of aging including cardiovascular disease, diabetes, and even cancer can be programmed early in the lifespan as a result of exposure to chronic stressors like low socioeconomic status (SES) that are hypothesized to promote a pro-inflammatory response in immune cells that results in chronic, systemic inflammation. The present paper conducted a meta-analysis to establish whether exposure to low (versus higher) SES in childhood and adolescence is associated with higher levels of inflammation (as measured by C-reactive protein, IL-6, and fibrinogen) concurrently and in adulthood. We conducted meta-analyses with both unadjusted bivariate associations between SES and inflammation and with adjusted associations that controlled for a range of covariates including demographic factors, body mass index, smoking, physical activity and current SES. A systematic review of Pubmed and PsycINFO identified a total 35 studies (26 with unadjusted and 31 adjusted effect sizes) to be included in the meta-analysis. Random-effects meta-analysis showed that individuals who were exposed to low SES in childhood and adolescence had significantly higher levels of inflammatory markers (r = -0.07, p < .001, 95% CI = -0.09, -0.05). This association remained significant in adjusted analyses (r = -0.06, p < .001, 95% CI = -0.09, -0.03). However, the relationship between childhood SES and inflammation was non-significant in a meta-analysis with longitudinal studies that all controlled for adulthood SES (r = -0.03, p = .356, 95% CI = -0.08, 0.03). Future longitudinal research should utilize measurement of inflammatory markers at multiple time points to further examine the complex relationships between SES and health both in childhood and adulthood.
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Affiliation(s)
- Izabela Milaniak
- University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States.
| | - Sara R Jaffee
- University of Pennsylvania, Department of Psychology, 425 S. University Avenue, Philadelphia, PA 19104, United States
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Sankar UV, Kutty VR, Anand TN. Measuring childhood socioeconomic position in health research: Development and validation of childhood socioeconomic position questionnaire using mixed method approach. Health Promot Perspect 2019; 9:40-49. [PMID: 30788266 PMCID: PMC6377695 DOI: 10.15171/hpp.2019.05] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 11/12/2018] [Indexed: 12/31/2022] Open
Abstract
Background: There is no single best indicator to assess the childhood socioeconomic position (CSEP) in public health research. The aim of the study is to develop and validate a new questionnaire, with adequate psychometric properties, to measure the childhood SEP of the young adults. Methods: The first phase consisted of a qualitative phase to identify the variables to measure childhood SEP through the in-depth interviews among 15 young adults (18-45 years) of rural Kerala. The second phase was a quantitative phase to validate the questionnaire through a cross sectional survey among 200 young adults of Kerala. We did content validity, reliability tests and construct validity by using exploratory factor analysis of the questionnaire to demonstrate its psychometric properties. Results: The qualitative analysis reported 26 variables spread across 5 domains to measure the CSEP. Finally, the questionnaire has 11 questions with 3 domains named as value added through paternity, maternal occupation-related factors and parental education. The questionnaire has good reliability (Cronbach's α=0.88) also. Conclusion: We have developed a reliable and valid questionnaire to measure the childhood SEP of younger adults and can be used in various public health research.
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Affiliation(s)
- Uma Vadassery Sankar
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, Kerala, India
| | - V Raman Kutty
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Trivandrum, Kerala, India
| | - T N Anand
- Research Fellow, Health Action by People, Thiruvananathapuram, Kerala, India
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Whitley JC, Peralta CA, Haan M, Aiello AE, Lee A, Ward J, Zeki Al Hazzouri A, Neuhaus J, Moyce S, López L. The association of parental and offspring educational attainment with systolic blood pressure, fasting blood glucose and waist circumference in Latino adults. Obes Sci Pract 2018; 4:582-590. [PMID: 30574351 PMCID: PMC6298209 DOI: 10.1002/osp4.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 12/29/2022] Open
Abstract
Objective The objective of the study is to evaluate the association of intergenerational educational attainment with cardiovascular disease (CVD) risk factors among US Latinos. Methods We used cross‐sectional data from the Niños Lifestyle and Diabetes Study, an offspring cohort of middle‐aged Mexican‐Americans whose parents participated in the Sacramento Latino Study on Aging. We collected educational attainment, demographic and health behaviours and measured systolic blood pressure (SBP), fasting glucose and waist circumference. We evaluated the association of parental, offspring and a combined parent–offspring education variable with each CVD risk factor using multivariable regression. Results Higher parental education was associated only with smaller offspring waist circumference. In contrast, higher offspring education was associated with lower SBP, fasting glucose and smaller waist circumference. Adjustment for parental health behaviours modestly attenuated these offspring associations, whereas adjustment for offspring health behaviours and income attenuated the associations of offspring education with offspring SBP and fasting glucose but not smaller waist circumference, even among offspring with low parental education. Conclusions Higher offspring education is associated with lower levels of CVD risk factors in adulthood, despite intergenerational exposure to low parental education.
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Affiliation(s)
- J C Whitley
- University of California, San Francisco San Francisco CA USA
| | - C A Peralta
- University of California, San Francisco San Francisco CA USA
| | - M Haan
- University of California, San Francisco San Francisco CA USA
| | - A E Aiello
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | - A Lee
- University of California, San Francisco San Francisco CA USA
| | - J Ward
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | | | - J Neuhaus
- University of California, San Francisco San Francisco CA USA
| | - S Moyce
- College of Nursing Montana State University MT USA
| | - L López
- University of California, San Francisco San Francisco CA USA
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The influence of lifecourse financial strains on the later-life health of the Japanese as assessed by four models based on different health indicators. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIn this study, four models used for assessing the influence of lifecourse financial strains on later-life health (the latent period effects, pathway, social mobility and accumulative effects models) were tested in the context of Japan by using different types of health indicators: comorbidity, disabled activities of daily living, disabled cognitive function, self-rated health and depressive symptoms. We hypothesised that suitable models for describing the influence of financial strain would differ according to the type of health indicator used. Participants aged 60–92 years (N = 2,500) were obtained in 2012 by using a two-stage stratified random sampling method. The final number of participants in the sample was 1,324. The results indicate that three models – pathway, accumulative effects and social mobility – describe the influence of a person's lifecourse financial strain on comorbidity, cognitive function, self-rated health and depressive symptoms. In turn, the latent period effects model explains the influence of lifecourse financial strain on comorbidity. However, only the pathway model described the influence of lifecourse financial strain on activities of daily living. These results suggest that disadvantages in lifecourse socio-economic status influence the decline of health in elderly Japanese people, similar to people in Western countries. However, the finding that suitable models for describing the influence of socio-economic status on health will differ according to the type of health indicator is an original contribution of this study.
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Horner EM, Strombotne K, Huang A, Lapham S. Investigating the Early Life Determinants of Type-II Diabetes Using a Project Talent-Medicare Linked Data-set. SSM Popul Health 2018; 4:189-196. [PMID: 29854904 PMCID: PMC5976829 DOI: 10.1016/j.ssmph.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 12/25/2017] [Accepted: 01/23/2018] [Indexed: 12/23/2022] Open
Abstract
The increasing prevalence of Type II Diabetes (T2D) presents a serious health and financial public crisis. Our study examines the hypothesis that adolescents' perceptions of economic insecurity, along with absolute and relative socioeconomic status (SES), can contribute to T2D prevalence later in life. Project Talent (PT) Survey data, collected on high school students in 1960, have been linked to Medicare records from 2012, presenting a unique opportunity to examine measures gathered in adolescence and T2D prevalence later-in-life among a large, national, and diverse sample (n=88,849). Our results provide compelling evidence that real, perceived, and relative SES in adolescence have persistent impacts on later-in-life diabetes risk, even when controlling for possible confounders such as cognitive ability, conscientiousness, and early-adulthood educational attainment.
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Derks IPM, Koster A, Schram MT, Stehouwer CDA, Dagnelie PC, Groffen DAI, Bosma H. The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study. Int J Equity Health 2017; 16:61. [PMID: 28381297 PMCID: PMC5382485 DOI: 10.1186/s12939-017-0553-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/20/2017] [Indexed: 02/06/2023] Open
Abstract
Background Using cross-sectional data from The Maastricht Study, we examined the association of socioeconomic conditions in early life with prediabetes and T2DM in adulthood. We also examined potential mediating pathways via both adulthood socioeconomic conditions and adult BMI and health behaviours. Methods Of the 3263 participants (aged 40–75 years), 493 had prediabetes and 906 were diagnosed with T2DM. By using logistic regression analyses, the associations and possible mediating pathways were examined. Results Participants with low early life socioeconomic conditions had a 1.56 times higher odds of prediabetes (95% confidence interval (CI) = 1.21-2.02) and a 1.61 times higher odds of T2DM (95% CI = 1.31-1.99). The relation between low early life socioeconomic conditions and prediabetes was independent of current socioeconomic conditions (OR = 1.38, 95% CI = 1.05-1.80), whereas the relation with T2DM was not independent of current socioeconomic conditions (OR = 1.10, 95% CI = 0.87-1.37). BMI party mediated the association between early life socioeconomic conditions and prediabetes. Conclusions Socioeconomic inequalities starting in early life were associated with diabetes-related outcomes in adulthood and suggest the usefulness of early life interventions aimed at tackling these inequalities. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0553-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ivonne P M Derks
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,The Generation R Study Group, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
| | - Annemarie Koster
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Miranda T Schram
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Pieter C Dagnelie
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.,Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Danielle A I Groffen
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Department of Social Medicine, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Desigualdades sociales en los factores de riesgo cardiovascular de los adultos mayores de España: estudio ENRICA-Seniors. Rev Esp Cardiol 2017. [DOI: 10.1016/j.recesp.2016.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mantziki K, Renders CM, Vassilopoulos A, Radulian G, Borys JM, du Plessis H, Gregório MJ, Graça P, de Henauw S, Handjiev S, Visscher TLS, Seidell JC. Inequalities in energy-balance related behaviours and family environmental determinants in European children: changes and sustainability within the EPHE evaluation study. Int J Equity Health 2016; 15:160. [PMID: 27680964 PMCID: PMC5041563 DOI: 10.1186/s12939-016-0438-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 09/07/2016] [Indexed: 11/17/2022] Open
Abstract
Background Increasing social inequalities in health across Europe are widening the gap between low and high socio-economic groups, notably in the prevalence of obesity. Public health interventions may result in differential effects across population groups. Therefore, the EPHE (EPODE for the Promotion of Health Equity) project analysed the added value of community-based programmes, based on the EPODE (Ensemble Prévenons l’Obésité Des Enfants-Together Let’s Prevent Obesity) model, to reduce socio-economic inequalities in energy balance-related behaviours of children and their family-environmental related determinants in seven European communities. This study presents the changes between baseline and follow-up after the one-year interventions and their sustainability one year after. Methods This is a prospective study with a one school-year intervention, followed by one year of follow-up. In all, 1266 children (age 6-8 years) and their families from different socio-economic backgrounds were recruited at baseline. For 1062 children, information was available after one year (T1) and for 921 children after two years (T2). A self-reported questionnaire was completed by the parents to examine the children’s energy balance-related behaviours and family- environmental determinants. Socio-economic status was defined by the educational level of the mother. The Wilcoxon signed-rank test for paired data was used to test the differences between baseline and intermediate, and between intermediate and final, measurements for each of the socio-economic status groups. Results Post-intervention effects in energy-balance related behaviours showed the following improvements among the low socio-economic status groups: increased fruit consumption (Netherlands), decreased fruit juices amount consumed (Romania) and decreased TV time on weekdays (Belgium). Whereas in only the latter case the behavioural change was accompanied with an improvement in a family-environmental determinant (monitoring the time the child watches TV), other improvements in parental rules and practices related to soft drinks/fruit juices and TV exposure were observed. A few of those effects were sustainable, notably in the case of Belgium. Conclusions Inequalities in obesity-related behaviours could be potentially reduced when implementing community-based interventions, tailored to inequality gaps and using the EPODE methodology. Within-group changes varied widely, whereas monitoring of interventions and process evaluation are crucial to understand the observed results. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0438-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.
| | - Carry M Renders
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
| | - Achilleas Vassilopoulos
- Department of Agricultural Economics and Rural Development, Agricultural University of Athens, Athens, Greece
| | | | | | | | - Maria João Gregório
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Directorate General of Health, Lisbon, Portugal
| | | | - Svetoslav Handjiev
- Bulgarian Association for the study of Obesity and related diseases, Sofia, Bulgaria
| | - Tommy L S Visscher
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands.,Research Centre for the Prevention of Overweight, Windesheim University of Applied Sciences Zwolle, Zwolle, The Netherlands.,Research Centre for the Prevention of Overweight, VU University, Zwolle, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, De Boelelaan 1085, 1081HV, Amsterdam, The Netherlands
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16
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Stroup AM, Herget KA, Hanson HA, Reed DL, Butler JT, Henry KA, Harrell CJ, Sweeney C, Smith KR. Baby Boomers and Birth Certificates: Early-Life Socioeconomic Status and Cancer Risk in Adulthood. Cancer Epidemiol Biomarkers Prev 2016; 26:75-84. [PMID: 27655898 DOI: 10.1158/1055-9965.epi-16-0371] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 09/09/2016] [Accepted: 09/12/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Early-life socioeconomic status (SES) may play a role in cancer risk in adulthood. However, measuring SES retrospectively presents challenges. Parental occupation on the birth certificate is a novel method of ascertaining early-life SES that has not been applied in cancer epidemiology. METHODS For a Baby-Boom cohort born from 1945-1959 in two Utah counties, individual-level Nam-Powers SES (Np-SES) was derived from parental industry/occupation reported on birth certificates. Neighborhood SES was estimated from average household income of census tract at birth. Cancer incidence was determined by linkage to Utah Cancer Registry records through the Utah Population Database. Hazard ratios (HR) for cancer risk by SES quartile were estimated using Cox proportional hazards regression. RESULTS Females with low Np-SES at birth had lower risk of breast cancer compared with those in the highest Np-SES group [HRQ1/Q4 = 0.83; 95% confidence interval (CI), 0.72-0.97; HRQ2/Q4 = 0.81; 95% CI, 0.69-0.96]. Np-SES was inversely associated with melanoma (HRQ1/Q4 = 0.81; 95% CI, 0.67-0.98) and prostate cancer (HRQ1/Q4 = 0.70; 95% CI, 0.56-0.88). Women born into lower SES neighborhoods had significantly increased risk for invasive cervical cancer (HRQ1/Q4 = 1.44; 95% CI, 1.12-1.85; HRQ2/Q4 = 1.33; 95% CI, 1.04-1.72). Neighborhood SES had similar effects for melanoma and prostate cancers, but was not associated with female breast cancer. We found no association with SES for pancreas, lung, and colon and rectal cancers. CONCLUSIONS Individual SES derived from parental occupation at birth was associated with altered risk for several cancer sites. IMPACT This novel methodology can contribute to improved understanding of the role of early-life SES on cancer risk. Cancer Epidemiol Biomarkers Prev; 26(1); 75-84. ©2016 AACR.
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Affiliation(s)
- Antoinette M Stroup
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah. .,Rutgers School of Public Health, Piscataway, New Jersey.,Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Heidi A Hanson
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Diana Lane Reed
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Jared T Butler
- Department of Geography, University of Utah, Salt Lake City, Utah
| | - Kevin A Henry
- Department of Geography, University of Utah, Salt Lake City, Utah.,Department of Geography and Urban Studies, Temple University, Philadelphia, Pennsylvania.,Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania
| | - C Janna Harrell
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah
| | - Carol Sweeney
- Utah Cancer Registry, University of Utah, Salt Lake City, Utah.,Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Ken R Smith
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah.,Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah
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17
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Pérez-Hernández B, García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, León-Muñoz LM, Banegas JR, Rodríguez-Artalejo F. Social Inequalities in Cardiovascular Risk Factors Among Older Adults in Spain: The Seniors-ENRICA Study. ACTA ACUST UNITED AC 2016; 70:145-154. [PMID: 27519455 DOI: 10.1016/j.rec.2016.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 05/27/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVES To examine the distribution of the main cardiovascular risk factors (CVRF) according to socioeconomic level (SEL) among older adults in Spain. METHODS A cross-sectional study conducted in 2008-2010 with 2699 individuals representative of the noninstitutionalized Spanish population aged ≥ 60 years. Socioeconomic level was assessed using educational level, occupation, and father's occupation. The CVRF included behavioral and biological factors and were measured under standardized conditions. RESULTS In age- and sex-adjusted analyses, higher educational level was associated with a higher frequency of moderate alcohol consumption and leisure time physical activity, and less time spent watching television. An inverse educational gradient was observed for frequency of obesity (odds ratio [OR] in university vs primary level or below education, 0.44; 95% confidence interval [95%CI], 0.33-0.57; P-trend < .01), metabolic syndrome (OR = 0.56; 95%CI, 0.43-0.71; P-trend < .01), diabetes (OR = 0.68; 95%CI, 0.49-0.95; P-trend < .05), and cardiovascular disease (OR = 0.52; 95%CI, 0.29-0.91; P-trend < .05). Compared with a nonmanual occupation, having a manual occupation was associated with a higher frequency of several CVRF; this association was stronger than that observed for father's occupation. Differences in CVRF across SELs were generally greater in women than in men. CONCLUSIONS There are significant social inequalities in CVRF among older adults in Spain. Reducing these inequalities, bringing the levels of CVRF in those from lower SEL in line with the levels seen in higher SEL, could substantially reduce the prevalence of CVRF in the older adult population.
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Affiliation(s)
- Bibiana Pérez-Hernández
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther García-Esquinas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain.
| | - Auxiliadora Graciani
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Pilar Guallar-Castillón
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Esther López-García
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Luz M León-Muñoz
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid/IdiPaz, CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain
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18
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GRDADOLNIK U, SOČAN M. The Impact of Socio-Economic Determinants on the Vaccination Rates with Rotavirus and Human Papiloma Virus Vaccine. Zdr Varst 2016; 55:43-52. [PMID: 27647088 PMCID: PMC4820181 DOI: 10.1515/sjph-2016-0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 09/21/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Socio-economic inequalities may have an impact on the uptake of selfpaid vaccines. The aim of the study was to identify the effect of some socio economic determinants on vaccination rates with self-paid human papilloma virus (HPV) and rotavirus (RV) vaccines. METHODS Vaccination coverage data, available in electronic database cepljenje.net (administered by the National Institute of Public Health), were collected at administrative unit level. The socio-economic determinants (the average gross pay in euros, the unemployment rate, the educational and households structure, the population density, the number of inhabitants, the number of children aged from 0 to 4, the number of women aged from 15 to 30) were extracted from Statistical Office of the Republic of Slovenia web page. The strength of the correlation between socioeconomic variables and self-paid HPV and RV vaccination rates was determined. RESULTS Rotavirus vaccination rates show a slight negative correlation with the number of residents per administrative unit (ρ=-0.29, p=0.04), and no correlation with other socio-economic variables. Likewise, no correlation has been found between HPV vaccination rates and the selected socio-economic variables. CONCLUSION Ecological study did not reveal any correlations between socio economic variables and vaccination rates with RV and HPV self-paid vaccines on administrative unit level.
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Affiliation(s)
- Urška GRDADOLNIK
- University Medical Center Ljubljana, Division of Internal Medicine, Zaloška cesta 2, 1000 Ljubljana, Slovenia
| | - Maja SOČAN
- National Institute of Public Health, Trubarjeva 2, 1000 Ljubljana, Slovenia
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19
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Cirera L, Huerta JM, Chirlaque MD, Molina-Montes E, Altzibar JM, Ardanaz E, Gavrila D, Colorado-Yohar S, Barricarte A, Arriola L, Quirós JR, Sánchez-Cantalejo E, Sánchez MJ, Agudo A, Navarro C. Life-course social position, obesity and diabetes risk in the EPIC-Spain Cohort. Eur J Public Health 2015; 26:439-45. [PMID: 26635012 DOI: 10.1093/eurpub/ckv218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The literature has consistently shown that extreme social-economic groups predicted type 2 diabetes mellitus (T2D), rather than summarising the social gradient throughout all society stratification. Body mass index (BMI) was established as the principal mediator, with little support for other anthropometries. Our aim was to investigate an individual life-course social position (LiSoP) gradient and its mediators with T2D risk in the EPIC-Spain cohort. METHODS 36 296 participants (62% women), mostly aged 30-65 years, and free of T2D at baseline (1992-1996) were followed up for a mean of 12.1 years. A combined score of paternal occupation in childhood and own adult education assessed individual life-course social risk accumulation. Hazard ratios of T2D were estimated using Cox regression, stratifying by centre and age, and adjusting for different explanatory models, including anthropometric indices; dietary history; smoking and physical activity lifestyles; and clinical information. RESULTS Final models evidenced significant risks in excess of 63% for middle and 90% for lower classes of LiSoP in men; and of 104 and 126%, respectively, in women. Concurrently, LiSoP presented significant social gradients for T2D risk (P < 0.01) in both sexes. Waist circumference (WC) accounted for most of the risk excess in women, and BMI and WC in men. CONCLUSIONS LiSoP gradient was related to T2D risk in Spanish men and women. WC mostly explained the relationship in both genders, together with BMI in men, yet LiSoP retained an independent effect in final models.
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Affiliation(s)
- Lluís Cirera
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - José María Huerta
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - María Dolores Chirlaque
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Esther Molina-Montes
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Jone Miren Altzibar
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, Donostia-San Sebastián, Spain
| | - Eva Ardanaz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Public Health Institute of Navarra, Pamplona, Spain
| | - Diana Gavrila
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sandra Colorado-Yohar
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Public Health Institute of Navarra, Pamplona, Spain
| | - Larraitz Arriola
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Public Health Division of Gipuzkoa, Instituto BIO-Donostia, Basque Government, Donostia-San Sebastián, Spain
| | | | - Emilio Sánchez-Cantalejo
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - María José Sánchez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA. Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Antonio Agudo
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, l'Hospitalet de Llobregat, Barcelona, Spain
| | - Carmen Navarro
- Department of Epidemiology, Murcia Regional Health Council, IMIB - Arrixaca, Murcia, Spain CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain Department of Health and Social Sciences, University of Murcia, Murcia, Spain
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20
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Mantziki K, Vassilopoulos A, Radulian G, Borys JM, Du Plessis H, Gregório MJ, Graça P, De Henauw S, Handjiev S, Visscher TL, Seidell JC. Inequities in energy-balance related behaviours and family environmental determinants in European children: baseline results of the prospective EPHE evaluation study. BMC Public Health 2015; 15:1203. [PMID: 26630926 PMCID: PMC4668694 DOI: 10.1186/s12889-015-2540-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/23/2015] [Indexed: 11/24/2022] Open
Abstract
Background Tackling inequalities in overweight, obesity and related determinants has become a top priority for the European research and policy agendas. Although it has been established that such inequalities accumulate from early childhood onward, they have not been studied extensively in children. The current article discusses the results of an explorative analysis for the identification of inequalities in behaviours and their determinants between groups with high and low socio-economic status. Methods This study is part of the Epode for the Promotion of Health Equity (EPHE) evaluation study, the overall aim of which is to assess the impact and sustainability of EPODE methodology to diminish inequalities in childhood obesity and overweight. Seven community-based programmes from different European countries (Belgium, Bulgaria, France, Greece, Portugal, Romania, The Netherlands) participate in the EPHE study. In each of the communities, children aged 6–8 years participated, resulting in a total sample of 1266 children and their families. A parental self-administrated questionnaire was disseminated in order to assess the socio-economic status of the household, selected energy balance-related behaviours (1. fruit and vegetable consumption; 2. soft drink/ fruit juices and water consumption; 3. screen time and 4. sleep duration) of the children and associated family environmental determinants. The Mann–Whitney U test and Pearson’s chi-square test were used to test differences between the low and high education groups. The country-specific median was chosen as the cut-off point to determine the educational level, given the different average educational level in every country. Results Children with mothers of relatively high educational level consumed fruits and vegetables more frequently than their peers of low socio-economic status. The latter group of children had a higher intake of fruit juices and/or soft drinks and had higher screen time. Parental rules and home availability were consistently different between the two socio-economic groups in our study in all countries. However we did not find a common pattern for all behaviours and the variability across the countries was large. Conclusions Our findings are indicative of socio-economic inequalities in our samples, although the variability across the countries was large. The effectiveness of interventions aimed at chancing parental rules and behaviour on health inequalities should be studied. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2540-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krystallia Mantziki
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
| | - Achilleas Vassilopoulos
- Department of Agricultural Economics and Rural Development, Agricultural University of Athens, Athens, Greece
| | | | | | | | - Maria João Gregório
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Pedro Graça
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.,Directorate General of Health, Lisbon, Portugal
| | | | - Svetoslav Handjiev
- Bulgarian Association for the study of Obesity and related diseases, Sofia, Bulgaria
| | - Tommy Ls Visscher
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Research Centre for the Prevention of Overweight, Windesheim University of Applied Sciences Zwolle & VU University, Zwolle, The Netherlands
| | - Jacob C Seidell
- Department of Health Sciences, VU University Amsterdam, Amsterdam, The Netherlands
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21
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Li A, Tu MT, Sousa AC, Alvarado B, Kone GK, Guralnik J, Zunzunegui MV. Early life adversity and C-reactive protein in diverse populations of older adults: a cross-sectional analysis from the International Mobility in Aging Study (IMIAS). BMC Geriatr 2015; 15:102. [PMID: 26286183 PMCID: PMC4544803 DOI: 10.1186/s12877-015-0104-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 08/06/2015] [Indexed: 12/15/2022] Open
Abstract
Background Recent studies suggest potential associations between childhood adversity and chronic inflammation at older ages. Our aim is to compare associations between childhood health, social and economic adversity and high sensitivity C-reactive protein (hsCRP) in populations of older adults living in different countries. Methods We used the 2012 baseline data (n = 1340) from the International Mobility in Aging Study (IMIAS) of community-dwelling people aged 65–74 years in Natal (Brazil), Manizales (Colombia) and Canada (Kingston, Ontario; Saint-Hyacinthe, Quebec). Multiple linear and Poisson regressions with robust covariance were fitted to examine the associations between early life health, social, and economic adversity and hsCRP, controlling for age, sex, financial strain, marital status, physical activity, smoking and chronic conditions both in the Canadian and in the Latin American samples. Results Participants from Canadian cities have less adverse childhood conditions and better childhood self-reported health. Inflammation was lower in the Canadian cities than in Manizales and Natal. Significant associations were found between hsCRP and childhood social adversity in the Canadian but not in the Latin American samples. Among Canadian older adults, the fully-adjusted mean hsCRP was 2.2 (95 % CI 1.7; 2.8) among those with none or one childhood social adversity compared with 2.8 (95 % CI 2.1; 3.8) for those with two or more childhood social adversities (p = 0.053). Similarly, the prevalence of hsCRP > 3 mg/dL was 40 % higher among those with higher childhood social adversity but after adjustment by health behaviors and chronic conditions the association was attenuated. No associations were observed between hsCRP and childhood poor health or childhood economic adversity. Conclusions Inflammation was higher in older participants living in the Latin American cities compared with their Canadian counterparts. Childhood social adversity, not childhood economic adversity or poor health during childhood, was an independent predictor of chronic inflammation in old age in the Canadian sample. Selective survival could possibly explain the lack of association between social adversity and hsCRP in the Latin American samples.
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Affiliation(s)
- Annie Li
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.
| | - Mai Thanh Tu
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
| | - Ana Carolina Sousa
- CNPQ Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
| | - Beatriz Alvarado
- Department of Public Health Sciences, 2nd and 3rd Floors, Carruthers Hall, Kingston, ON, K7L 3 N6, Canada.
| | - Georges Karna Kone
- Centre de recherche du CHUM (CRCHUM), 900, rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.
| | - Jack Guralnik
- Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Howard Hall Suite 200, 660 W. Redwood Street, Baltimore, MD, 21201, USA.
| | - Maria Victoria Zunzunegui
- Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101 avenue du Parc, C.P. 6128, Succ. Centre-Ville, Montréal, Québec, H3C 3 J7, Canada.
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