Socioeconomic inequalities in type 2 diabetes in employed individuals, nonworking spouses and pensioners.

Claims data Germany Prevalence Socioeconomic inequalities Type 2 diabetes

Journal

SSM - population health
ISSN: 2352-8273
Titre abrégé: SSM Popul Health
Pays: England
ID NLM: 101678841

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 03 02 2020
revised: 08 04 2020
accepted: 05 05 2020
entrez: 29 5 2020
pubmed: 29 5 2020
medline: 29 5 2020
Statut: epublish

Résumé

Type 2 diabetes (T2D) is a rising global epidemic with lower socioeconomic groups being more affected. Considering specific population subgroups to examine prevalence and socioeconomic inequalities in T2D is rare. Moreover, using one indicator to depict socioeconomic inequalities in health is a common practice despite evidence on differences in what different socioeconomic indicators ought to measure. This study has two aims: 1. Examine the prevalence of T2D in employed individuals, nonworking spouses and pensioners. 2. Examine socioeconomic inequalities in T2D in the three population subgroups and determine the explanatory power of income, education and occupation in employed individuals and nonworking spouses. This study is based on claims data from a statutory health insurance provider in Lower Saxony, Germany. T2D prevalence in the period between 2013 and 2017 was examined in employed individuals, nonworking spouses and pensioners. Multivariate logistic regression analysis was applied to examine socioeconomic inequalities in T2D in the three population subgroups. Explanatory power of the three socioeconomic indicators was determined by deviance analysis. Results showed that T2D prevalence was four times higher in male nonworking spouses (24.2%) and 2.6 times higher in female nonworking spouses (12.7%) compared to employed men (6.4%) and women (4.7%) respectively, while it accounted for 40% of men and 36% of women in pensioners. T2D inequalities emerged for all three socioeconomic indicators and were observed in the three subgroups. School education had the highest explanatory power in employed men and women and male nonworking spouses. Nonworking spouses are an important target group in T2D prevention interventions. The three socioeconomic indicators have independent effects and differ in their explanatory power where low school education appears to be a major risk factor. It can be discussed that health literacy and the associated health behavior play a role in mediating the association between school education and T2D.

Identifiants

pubmed: 32462074
doi: 10.1016/j.ssmph.2020.100596
pii: S2352-8273(20)30233-0
pii: 100596
pmc: PMC7240220
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100596

Informations de copyright

© 2020 The Authors.

Déclaration de conflit d'intérêts

None.

Références

N Engl J Med. 2017 Apr 13;376(15):1407-1418
pubmed: 28402770
Diabetes Care. 2014 Jan;37 Suppl 1:S112-7
pubmed: 24357206
Indian J Occup Environ Med. 2009 Aug;13(2):77-9
pubmed: 20386623
J Health Soc Behav. 1994 Jun;35(2):179-91
pubmed: 8064124
J Epidemiol Community Health. 1995 Feb;49(1):10-5
pubmed: 7706992
Int J Epidemiol. 2012 Aug;41(4):1162-73
pubmed: 22736421
Soz Praventivmed. 2004;49(5):328-35
pubmed: 15497652
PLoS One. 2019 Jan 30;14(1):e0211208
pubmed: 30699173
Can J Public Health. 2015 Mar 12;106(3):e132-9
pubmed: 26125239
J Health Commun. 2013;18 Suppl 1:172-84
pubmed: 24093354
Am J Epidemiol. 2007 Apr 15;165(8):882-9
pubmed: 17284723
J Epidemiol Community Health. 2006 Sep;60(9):804-10
pubmed: 16905727
Occup Med (Lond). 2015 Jan;65(1):67-71
pubmed: 25342711
J Epidemiol Community Health. 2004 Apr;58(4):327-32
pubmed: 15026449
BMJ Open. 2018 Apr 28;8(4):e020207
pubmed: 29705759
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Mar;56(3):447-54
pubmed: 23334292
BMC Med. 2014 Jan 24;12:12
pubmed: 24460622
Curr Cardiol Rep. 2019 Apr 22;21(6):45
pubmed: 31011838
Lancet. 2018 Nov 10;392(10159):1789-1858
pubmed: 30496104
Popul Health Metr. 2017 Feb 13;15(1):5
pubmed: 28193279
Addict Behav. 2016 Mar;54:59-63
pubmed: 26722991
Int J Epidemiol. 2011 Jun;40(3):804-18
pubmed: 21335614
Am J Epidemiol. 2009 Jan 1;169(1):1-8
pubmed: 18845552
Soc Sci Med. 1993 Feb;36(3):217-25
pubmed: 8426965
Soc Sci Med. 2017 Apr;178:196-205
pubmed: 28262326
Gesundheitswesen. 2008 May;70(5):281-8
pubmed: 18604766
J Epidemiol Community Health. 2000 Apr;54(4):299-305
pubmed: 10827913
J Epidemiol Community Health. 2006 Jun;60(6):484-9
pubmed: 16698977
BMJ Open. 2016 May 27;6(5):e011077
pubmed: 27235299
Swiss Med Wkly. 2009 Feb 21;139(7-8):103-9
pubmed: 19234878
J Behav Med. 2015 Feb;38(1):9-16
pubmed: 23645146
BMC Public Health. 2010 Sep 01;10:525
pubmed: 20809937
Diabetes Metab J. 2018 Oct;42(5):380-393
pubmed: 30113143
Diabetologia. 2018 Dec;61(12):2461-2498
pubmed: 30288571
Soc Sci Med. 2011 Mar;72(6):840-54
pubmed: 21330027
Int J Public Health. 2015 Dec;60(8):953-60
pubmed: 26446083
Patient. 2013;6(1):1-10
pubmed: 23322536
Dtsch Arztebl Int. 2016 Mar 18;113(11):177-82
pubmed: 27118665
JAMA Intern Med. 2016 Aug 1;176(8):1146-54
pubmed: 27367969
Women Health. 2009 Mar-May;49(2-3):144-63
pubmed: 19533507
BMC Public Health. 2019 Jan 7;19(1):25
pubmed: 30616606
Diabet Med. 2010 Mar;27(3):360-2
pubmed: 20536501
BMC Public Health. 2019 May 6;19(1):512
pubmed: 31060532
Gac Sanit. 2013 Nov-Dec;27(6):494-501
pubmed: 23643719
J Health Soc Behav. 1981 Dec;22(4):379-93
pubmed: 7320475

Auteurs

Batoul Safieddine (B)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Stefanie Sperlich (S)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Johannes Beller (J)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Karin Lange (K)

Medical Psychology Unit OE 5430, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Jelena Epping (J)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Juliane Tetzlaff (J)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Fabian Tetzlaff (F)

Institute for General Practice, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Siegfried Geyer (S)

Medical Sociology Unit OE 5420, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.

Classifications MeSH