Date: 2023
Type: Article
Socioeconomic inequalities in type 2 diabetes : mediation through status anxiety?
International journal of public health, 2023, Vol. 68, Art. 1606069, OnlineOnly
CRIELAARD, Loes, MOTAZEDI, Ehsan, GALENKAMP, Henrike, VAN DE WERFHORST, Herman G., ROD, Naja Hulvej, KUIPERS, Mirte A. G., NICOLAOU, Mary, STRONKS, Karien, Socioeconomic inequalities in type 2 diabetes : mediation through status anxiety?, International journal of public health, 2023, Vol. 68, Art. 1606069, OnlineOnly
- https://hdl.handle.net/1814/75934
Retrieved from Cadmus, EUI Research Repository
-- Objectives: While status anxiety has received attention as a potential mechanism generating health inequalities, empirical evidence is still limited. Studies have been ecological and have largely focused on mental and not physical health outcomes.
-- Methods: We conducted individual-level analyses to assess status anxiety (feelings of inferiority resulting from social comparisons) and resources (financial difficulties) as mediators of the relationship between socioeconomic status (SES) (education/occupation/employment status) and type 2 diabetes (T2D). We used cross-sectional data of 21,150 participants (aged 18–70 years) from the Amsterdam-based HELIUS study. We estimated associations using logistic regression models and estimated mediated proportions using natural effect modelling.
-- Results: Odds of status anxiety were higher among participants with a low SES [e.g., OR = 2.66 (95% CI: 2.06–3.45) for elementary versus academic occupation]. Odds of T2D were 1.49 (95% CI: 1.12–1.97) times higher among participants experiencing status anxiety. Proportion of the SES–T2D relationship mediated was 3.2% (95% CI: 1.5%–7.0%) through status anxiety and 10.9% (95% CI: 6.6%–18.0%) through financial difficulties.
-- Conclusion: Status anxiety and financial difficulties played small but consistent mediating roles. These individual-level analyses underline status anxiety’s importance and imply that status anxiety requires attention in efforts to reduce health inequalities.
Additional information:
Published online: 02 October 2023
Cadmus permanent link: https://hdl.handle.net/1814/75934
Full-text via DOI: 10.3389/ijph.2023.1606069
ISSN: 1661-8556; 1661-8564
Publisher: Frontiers Media
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