Although lower socioeconomic status (SES) is associated with increased heart disease risk, information is uncertain about whether or not diabetes, a cardiovascular risk equivalent, is similarly related to SES.
In a recently published manuscript entitled Socioeconomic Status and Incident Type Two Diabetes Mellitus: Data from the Women's Health Study, published in the December 2011 issue of the on-line, peer reviewed journal, PLoS ONE, Timothy Lee MD, MPH and colleagues findings suggest "that women with higher levels of formal health education are less likely to become diabetic than women with lower levels."
In this prospective cohort of female health professionals, the authors observed a progressive decrease in the development of diabetes with increasing levels of education and income. The study consisted of 23,992 women who are participants in the well-known Women's Health Study, a study that originally examined the effect of low-dose aspirin and vitamin E in the development new heart disease and cancer. The trial component of the study was completed several years ago and the women are now followed longitudinally.
Lee, who is co-founder of Alabama Heart & Vascular PC, said “our results indicate that lower SES is associated with increased diabetes risk in these women. While there are other indicators of SES besides education and income, these measures have been most widely used in the medical literature.”
An important feature of this study was the rigorous evaluation of potential factors that contribute to the diabetes and education/income association. This study found that even in this relatively well-educated group of women, factors that relate to behavior, including smoking, physical activity and body weight, largely explained the findings.
The authors conclude that "at a very basic public health level, interventions targeting these behaviors could substantially impact the risk of diabetes.”
Lee performed this research in conjunction with colleagues at the Divisions of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, Massachusetts. The Women's Health study is supported by grants HL-080467, HL-043851 and CA-047988 from the National Heart Lung and Blood Institute and the National Cancer Institute.