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Life-course social class is associated with later-life diabetes prevalence in women: evidence from the Irish Longitudinal Study on Ageing

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This study aimed to investigate the independent and synergistic effects of childhood and adult social class, as well as the effect of social mobility, on type 2 diabetes (T2D) risk in later life. Cross-sectional data from The Irish Longitudinal Study of Ageing (TILDA) (n = 4,998), a nationally representative probability sample of adults aged 50 and older, were analysed. Prevalent diabetes was defined using subjective (self-reported doctor’s diagnosis) and objective data (medications usage and glycated haemoglobin testing). Social class was classified as a three-level variable based on fathers’ occupation in childhood and respondents’ primary occupation in adulthood. A five-level social mobility variable was created from cross-classification of childhood and adulthood social class. Logistic regression was employed to assess the relationship between social class variables and T2D. Mean (SD) age of the sample was 63.8y (9.9) and 46.4% were male. Incidence of T2D was 11.6% of men and 7.7% of women. Some 57.4% of the sample were classified as Manual social class in childhood. Compared to those in Professional/Managerial occupations, belonging to the Manual social class in childhood was associated with an increased risk of T2D in men (Odds Ratio (OR): 1.36, 95% CI: 0.88, 2.10) and women (OR: 2.16, 95% CI: 1.21, 3.85). This association was attenuated in women when controlled for adulthood social class (OR: 1.84, 95% CI: 1.00–3.37), suggesting that the effect of childhood social class may be modified by improving social circumstance over the life course.

Key messages
  1. We investigated the association between life-course social class and diabetes prevalence in older adults.

  2. Our findings confirm the relationship between early-life social class and the risk of developing diabetes in later life.

  3. Women who remain in low social class in childhood and adulthood are most at risk of developing diabetes.

  4. Interventions to prevent diabetes should be targeted at high-risk groups throughout the life course.

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Keywords: cohort study; diabetes; disadvantage; life course; social class

Affiliations: 1: Ageing Research Centre, Health Research Institute, University of Limerick, Ireland 2: The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland

Appeared or available online: February 10, 2020

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