Effects of Education and Income on Incident Type 2 Diabetes and Cardiovascular Diseases: a Dutch Prospective Study

Abstract Background Education and income, as two primary socioeconomic indicators, are often used interchangeably in health research. However, there is a lack of clear distinction between these two indicators concerning their associations with health. Objective This study aimed to investigate the separate and combined effects of education and income in relation to incident type 2 diabetes and cardiovascular diseases in the general population. Design and Participants Participants aged between 30 and 65 years from the prospective Dutch Lifelines cohort study were included. Two sub-cohorts were s... Mehr ...

Verfasser: Duan, Ming-Jie F.
Zhu, Yinjie
Dekker, Louise H.
Mierau, Jochen O.
Corpeleijn, Eva
Bakker, Stephan J.L.
Navis, Gerjan
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Reihe/Periodikum: Journal of General Internal Medicine ; volume 37, issue 15, page 3907-3916 ; ISSN 0884-8734 1525-1497
Verlag/Hrsg.: Springer Science and Business Media LLC
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29039830
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1007/s11606-022-07548-8

Abstract Background Education and income, as two primary socioeconomic indicators, are often used interchangeably in health research. However, there is a lack of clear distinction between these two indicators concerning their associations with health. Objective This study aimed to investigate the separate and combined effects of education and income in relation to incident type 2 diabetes and cardiovascular diseases in the general population. Design and Participants Participants aged between 30 and 65 years from the prospective Dutch Lifelines cohort study were included. Two sub-cohorts were subsequently created, including 83,759 and 91,083 participants for a type 2 diabetes cohort and a cardiovascular diseases cohort, respectively. Main Measures Education and income level were assessed by self-report questionnaires. The outcomes were incident type 2 diabetes and cardiovascular diseases (defined as the earliest non-fatal cardiovascular event). Key Results A total of 1228 new cases of type 2 diabetes (incidence 1.5%) and 3286 (incidence 3.6%) new cases of cardiovascular diseases were identified, after a median follow-up of 43 and 44 months, respectively. Low education and low income (<1000 euro/month) were both positively associated with a higher risk of incident type 2 diabetes (OR 1.24 [95%CI 1.04–1.48] and OR 1.71 [95%CI 1.30–2.26], respectively); and with a higher risk of incident cardiovascular diseases (OR 1.15 [95%CI 1.04–1.28] and OR 1.24 [95%CI 1.02–1.52], respectively); independent of age, sex, lifestyle factors, BMI, clinical biomarkers, comorbid conditions at baseline, and each other. Results from the combined associations of education and income showed that within each education group, a higher income was associated with better health; and similarly, a higher education was associated with better health within each income group, except for the low-income group. Conclusions Education and income were both independently associated with incident type 2 diabetes and cardiovascular diseases. The combined ...