Childhood Socioeconomic Disadvantage and Prediabetes and Diabetes in Later Life

Abstract

Objective We examined the relationship between childhood socioeconomic status (SES) and glucoregulation in later life and used a life-course framework to examine critical periods and underlying pathways. Methods Data came from the MIDUS (Midlife in the U.S.) national study (n=895). Childhood SES indicators retrospectively reported at MIDUS I were used to create a childhood SES disadvantage index. Adult SES disadvantage and potential pathways were measured at MIDUS I and included waist circumference, depressive symptoms, and physical activity. Glucose and HbA1c, measured approximately 9-10 years later at MIDUS II, were used to create the ordinal outcome measure (no diabetes/prediabetes/diabetes). Results Childhood SES disadvantage predicted increased odds of prediabetes and diabetes net of age, gender, race, and smoking (OR=1.11, 95% CI: 1.01-1.22). Childhood SES disadvantage predicted adult SES disadvantage (β=.26, p=.001) and the three key mediators: higher waist circumference (β=.10, p=.002), lower physical activity (β=−.11, p=.001), and marginally higher depressive symptoms (β=.07, p=.072). When childhood and adult SES disadvantage were in the same model, only adult SES predicted glucoregulation (OR=1.07, 95% CI: 1.01-1.13). The SES disadvantage measures were no longer significantly associated with glucoregulation after including waist circumference, physical activity, and depressive symptoms, all of which were significant predictors of glucoregulation. Conclusions The consequences of childhood SES disadvantage are complex and include both critical period and pathway effects. The lack of a direct effect of childhood SES on glucoregulation does not negate the importance of early environment but suggests that early-life socioeconomic factors propel unequal life-course trajectories that ultimately influence health.

Aging and Neurocognitive Functioning in HIV-Infected Women: a Review of the Literature Involving the Women’s Interagency HIV Study

“…59 Such stress may lead to metabolic disorders such as insulin resistance and diabetes. 60,61 Furthermore, it is well documented that HIV-infected women experience a high number of stressors. Among HIV-infected women in the WIHS, 31% reported childhood sexual abuse, 66% reported domestic violence within their lifetime, and 21% reported domestic violence within the past 3 months.…”

The association of early life socioeconomic conditions with prediabetes and type 2 diabetes: results from the Maastricht study

“…Previous studies have confirmed the importance of early life socioeconomic conditions for T2DM [13], whether it was only via adulthood socioeconomic conditions [3, 6, 8, 10, 14] or also independently [7, 9, 11, 12, 15]. Some of these studies confirm the pathway via (abdominal) obesity [3, 9, 12, 14, 15]. In other studies, the relationship between early life socioeconomic conditions and T2DM was particularly found in women [3, 7, 9, 11].…”

“…The progression towards T2DM can more easily be prevented and the prediabetic state can even be inverted [23, 26–28]. Only one previous study examined the association of early life socioeconomic conditions with prediabetes; the authors reported that they only found evidence for an indirect association [14]. …”

Emotional and instrumental support during childhood and biological dysregulation in midlife

“…Following prior MIDUS research (Gruenewald et al, 2012; Karlamangla et al, 2013; Tsenkova et al, 2014), a childhood socioeconomic disadvantage score was constructed by summing across three retrospectively-reported indicators of SES in participants‘ childhood and adolescence: family finances (worse off than others=2; same as average family=1; better off than others=0), highest parental education (less than high school=2; high school=1; college or more=0), and welfare for ≥6 months (ever=2; never=0).…”