Educational inequalities in metabolic syndrome vary by ethnic group: evidence from the SUNSET study.
BACKGROUND
Compared with Whites, many ethnic minority groups have higher prevalence of metabolic syndrome. The reasons for these ethnic inequalities in health are incompletely understood. The main objective was to examine whether socio-economic position (SEP) as measured by education was related to the prevalence of metabolic syndrome in different ethnic groups in Amsterdam, The Netherlands.


METHODS
A random sample of healthy adults aged 35-60 years. SEP was measured by educational level (secondary school and below (low), and vocational school and above (high)). Metabolic syndrome was measured according to the International Diabetic Federation guidelines.


RESULTS
Low education was negatively related to metabolic syndrome but only in White-Dutch people. Among White-Dutch men, the age adjusted prevalence ratio (95% confidence intervals) for low education was 1.46 (95% CI: 1.01-2.10) versus high education. Among White-Dutch women, the adjusted odds ratios for low education was 2.26 (95% CI: 1.39-3.68) versus high education. In both White-Dutch men and women, low education was related to several components of metabolic syndrome. Among African-Surinamese and Hindustani-Surinamese, no significant associations were found between low education and metabolic syndrome and its components.


CONCLUSIONS
Low education is associated with increased risk of metabolic syndrome among White-Dutch people but not among other ethnic groups. Community-based strategies to improve metabolic profiles may have to be ethnically devised. Among White-Dutch, targeting people with lower SEP may have an impact. However, among ethnic minority groups, both low and high socio-economic groups may have to be equally targeted to have an impact in reducing ethnic inequalities in health.
Agyemang
Charles
C
Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. c.o.agyemang@amc.uva.nl
van Valkengoed
Irene
I
Hosper
Karen
K
Nicolaou
Mary
M
van den Born
Bert-Jan
BJ
Stronks
Karien
K
D000328:Adult; D017677:Age Distribution; D001210:Asia, Southeastern / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000208:ethnology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D013532:Suriname / Q000208:ethnology; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*