Gender differences in cumulative life-course socioeconomic position and social mobility in relation to new onset diabetes in adultsdthe Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
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Date
2016
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Abstract
Purpose: We investigated gender-specific associations of cumulative socioeconomic position across life
course and social mobility with new onset diabetes mellitus (NODM) in over 12,000 civil servants in
Brazil.
Methods: We used data from ELSA-Brasil baseline (2008e2010). The accumulation of risk was assessed
using an education-based score and an occupation-based score. Educational and occupational social
mobility were also evaluated.
Results: In minimally adjusted models, NODM increased with increasing exposure to life-course social
disadvantages, especially in men. This gender difference was pronounced when cumulative processes
were evaluated by education-based scores (high vs. low cumulative social disadvantage, odds ratio
[OR] ¼ 4.7; 95% confidence interval [CI]: 2.6e8.5 in men and OR ¼ 2.0; 95% CI: 1.1e3.6 in women). After
including proximal diabetes risk factors possibly acting as mediators, these associations remained high
only in men (high vs. low cumulative social disadvantage, OR ¼ 4.4; 95% CI: 2.4e8.1). Social mobility was
associated with NODM in men. Compared to the high-stable trajectory, downward had greater associations
than upward mobility. In women, when considering metabolic syndromeerelated variables,
changes in social hierarchy did not seem to have an influence on their risk of diabetes.
Conclusions: Accumulation of risk and social mobility were associated with NODM with gender-specific
patterns, suggesting differences in mechanisms connecting life-course socioeconomic position and
diabetes in men and women.
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Keywords
Life-course epidemiology, Diabetes, Health inequalities, Social mobility
Citation
CAMELO, L. do V. et al. Gender differences in cumulative life-course socioeconomic position and social mobility in relation to new onset diabetes in adultsdthe Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Annals of Epidemiology, v. 26, p. 858-864.e1, 2016. Disponível em: <http://www.sciencedirect.com/science/article/pii/S1047279716303714>. Acesso em: 29 ago. 2017.