HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.123653v1 98/8/1486    most recent Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Maty, S. C. Articles by Kaplan, G. A. PubMed PubMed Citation Articles by Maty, S. C. Articles by Kaplan, G. A. Related Collections Obesity, Overweight, Underweight Diabetes Gender Epidemiology Socioeconomic Factors

Siobhan C. Maty, PhD, MPH, John W. Lynch, PhD, MPH, MEd, Trivellore E. Raghunathan, PhD and George A. Kaplan, PhD

Siobhan C. Maty is with the School of Community Health, Portland State University, Portland, OR. John W. Lynch is with the Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec. Trivellore E. Raghunathan is with the Department of Biostatistics and the Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor. George A. Kaplan is with the Department of Epidemiology and the Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor.

Correspondence: Requests for reprints should be sent to Siobhan C. Maty, PhD, MPH, Assistant Professor, School of Community Health, Portland State University, PO Box 751, Portland, OR 97207-0751 (e-mail: maty{at}pdx.edu).

Objectives. We examined the association between childhood socioeconomic position and incidence of type 2 diabetes and the effects of gender and adult body mass index (BMI).

Methods. We studied 5913 participants in the Alameda County Study from 1965 to 1999 who were diabetes free at baseline (1965). Cox proportional hazards models estimated diabetes risk associated with childhood socioeconomic position and combined childhood socioeconomic position–adult BMI categories in pooled and gender-stratified samples. Demographic confounders and potential pathway components (physical inactivity, smoking, alcohol consumption, hypertension, depression, health care access) were included as covariates.

Results. Low childhood socioeconomic position was associated with excess diabetes risk, especially among women. Race and body composition accounted for some of this excess risk. The association between childhood socioeconomic position and diabetes incidence differed by adult BMI category in the pooled and women-only groups. Adjustment for race and behaviors attenuated the risk attributable to low childhood socioeconomic position among the obese group only.

Conclusions. Childhood socioeconomic position was a robust predictor of incident diabetes, especially among women. A cumulative risk effect was observed for both childhood socioeconomic position and adult BMI, especially among women.