The role of childhood social position in adult type 2 diabetes: evidence from the English Longitudinal Study of Ageing

Article

Pikhartova, Jitka, Blane, David and Netuveli, G. 2014. The role of childhood social position in adult type 2 diabetes: evidence from the English Longitudinal Study of Ageing. BMC Public Health. 14 (1), p. 505.
AuthorsPikhartova, Jitka, Blane, David and Netuveli, G.
Abstract

Background

Socioeconomic circumstances in childhood and early adulthood may influence the later onset of chronic disease, although such research is limited for type 2 diabetes and its risk factors at the different stages of life. The main aim of the present study is to examine the role of childhood social position and later inflammatory markers and health behaviours in developing type 2 diabetes at older ages using a pathway analytic approach.

Methods

Data on childhood and adult life circumstances of 2,994 men and 4,021 women from English Longitudinal Study of Ageing (ELSA) were used to evaluate their association with diabetes at age 50 years and more. The cases of diabetes were based on having increased blood levels of glycated haemoglobin and/or self-reported medication for diabetes and/or being diagnosed with type 2 diabetes. Father’s job when ELSA participants were aged 14 years was used as the measure of childhood social position. Current social characteristics, health behaviours and inflammatory biomarkers were used as potential mediators in the statistical analysis to assess direct and indirect effects of childhood circumstances on diabetes in later life.

Results

12.6 per cent of participants were classified as having diabetes. A disadvantaged social position in childhood, as measured by father’s manual occupation, was associated at conventional levels of statistical significance with an increased risk of type 2 diabetes in adulthood, both directly and indirectly through inflammation, adulthood social position and a risk score constructed from adult health behaviours including tobacco smoking and limited physical activity. The direct effect of childhood social position was reduced by mediation analysis (standardised coefficient decreased from 0.089 to 0.043) but remained statistically significant (p = 0.035). All three indirect pathways made a statistically significantly contribution to the overall effect of childhood social position on adulthood type 2 diabetes.

Conclusions

Childhood social position influences adult diabetes directly and indirectly through inflammatory markers, adulthood social position and adult health behaviours.

JournalBMC Public Health
Journal citation14 (1), p. 505
ISSN1471-2458
Year2014
PublisherBioMed Central
Publisher's version
License
CC BY
Web address (URL)http://dx.doi.org/10.1186/1471-2458-14-505
Publication dates
Print26 May 2014
Publication process dates
Deposited02 Jun 2014
FunderEconomic and Social Research Council
Copyright information© 2014 Pikhartova et al.; licensee BioMed Central Ltd. Issued under Creative Commons Attribution CC-BY 2.0.
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