Non‐skilled occupation as a risk factor of diabetes among working population: A population‐based study of community‐dwelling adults in Hong Kong

Abstract

Diabetes among working population brings to society concerns on productivity and social welfare cost, in addition to healthcare burden. While lower socio-economic status has been recognised as a risk factor of diabetes; occupation, compared with other socio-economic status indicators (e.g., education and income), has received less attention. There is some evidence from studies conducted in Europe that occupation is associated with diabetes risk, but less is known in Asia, which has different organisational cultures and management styles from the West. This study examines the association between occupation and diabetes risk in a developed Asian setting, which is experiencing an increasing number of young onset of diabetes and aging working population at the same time. This is a cross-sectional study of working population aged up to 65 with data from a population-based survey collecting demographic, socio-economic, behavioural and metabolic data from Hong Kong residents, through both self-administered questionnaires and clinical health examinations (1,429 participants). Non-skilled occupation was found to be an independent risk factor for diabetes, with an odds ratio (OR) of 3.38 (p < 0.001) and adjusted OR of 2.59 (p = 0.022) after adjusting for demographic, behavioural and metabolic risk factors. Older age (adjusted OR = 1.08, p < 0.001), higher body mass index (adjusted OR = 1.23, p < 0.001) and having hypertriglyceridemia (adjusted OR = 1.93, p = 0.033) were also independently associated with diabetes. Non-skilled workers were disproportionately affected by diabetes with the highest age-standardized prevalence (6.3%) among all occupation groups (4.9%-5.0%). This study provides evidence that nonskilled occupation is an independent diabetes risk factor in a developed Asian setting. Health education on improving lifestyle practices and diabetes screening should prioritise non-skilled workers, in particular through company-based and sector-based diabetes screening programmes.

Uncovering the Burden of Diabetes in Ekiti State, Nigeria: Insights From a Statewide, Household-Based, Cross-Sectional Study

“…Similar to our findings, a review determined that people with white-collar jobs had a higher risk of type 2 DM [ 24 ]. But, in contrast to our findings, some researchers reported a greater risk of DM with non-skilled workers in Asia [ 25 ]. The disparity may be due to differences in work ethics and culture.…”

Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults

“…Moreover, previous research confirmed reasonable sensitivity and specificity of self-reported physician-diagnosed diabetes obtained via health interview surveys to assess social inequalities in prevalence of diabetes [47]. Secondly, although educational attainment and household income are generally deemed as the conventional socioeconomic indicators, they may not fully capture the health impact of other dimensions of socioeconomic disadvantage such as occupation [48,49], housing [50] and material and social deprivation [41,42]. The potential underreporting of income level in surveys may also introduce bias to the nonsignificant association of household income with diabetes prevalence observed in this study.…”