Abstract
BackgroundThere is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes. However, the independent roles of socioeconomic status, country of birth and lifestyle factors in the occurrence of type 2 diabetes have not been clearly identified. This study investigated the relationships between socioeconomic status, country of birth and type 2 diabetes in a large diverse sample of residents of New South Wales, Australia, and aged 45 years and over.MethodsThe analysis used self-reported baseline questionnaire data from 266,848 participants in the 45 and Up Study. Educational attainment, work status and income were used as indicators of socioeconomic status. Logistic regression models were built to investigate associations between socioeconomic status, country of birth and type 2 diabetes.ResultsThe adjusted odds of type 2 diabetes were significantly higher for people born in many overseas countries, compared to Australian-born participants. Compared with participants who had a university degree or higher qualification, the adjusted odds ratio (OR) for diabetes was higher in all other educational categories. Diabetes was more prevalent in people who were retired, unemployed or engaged in other types of work, compared with people who were in paid work. The prevalence of diabetes was higher in people with lower incomes. Compared with people who earned more than $50,000, the adjusted OR for diabetes was 2.05 (95% CI 1.95-2.14) for people who had an income less than $20,000 per annum. The relationships between socioeconomic factors and country of birth and diabetes were attenuated slightly when all were included in the model. Addition of smoking, obesity and physical activity to the model had marked impacts on adjusted ORs for some countries of birth, but relationships between diabetes and all measures of socioeconomic status and country of birth remained strong and significant.ConclusionsCountry of birth and socioeconomic status are independent predictors of type 2 diabetes. However, in this population, country of birth had a stronger association with type 2 diabetes.
Highlights
There is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes
There is strong evidence based on previous studies around the world that ethnicity is an important determinant of diversity in the occurrence of diabetes [6]
We explored the relationships between country of birth, socioeconomic status and type 2 diabetes in a large diverse population sample of residents of New South Wales (NSW), Australia, and aged 45 years and over
Summary
There is strong evidence based on previous studies that ethnicity and socioeconomic status are important determinants of diversity in the occurrence of diabetes. The independent roles of socioeconomic status, country of birth and lifestyle factors in the occurrence of type 2 diabetes have not been clearly identified. This study investigated the relationships between socioeconomic status, country of birth and type 2 diabetes in a large diverse sample of residents of New South Wales, Australia, and aged 45 years and over. Type 2 diabetes is a major health problem that is increasing at an alarming rate around the world. In 2010, there were 285 million people with diabetes globally This number will increase to reach 439 million people during the two decades, potentially leading to major medical, social, and economic problems [1]. People born in Italy, China, and Vietnam were the largest overseas-born group [5]
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