title: Socioeconomic status and incident type 2 diabetes mellitus: data from the Women's Health Study.
abstract: OBJECTIVE
  We prospectively examined whether socioeconomic status (SES) predicts incident type II diabetes (diabetes), a cardiovascular risk equivalent and burgeoning public health epidemic among women.
  
  
  METHODS
  Participants include 23,992 women with Hb(A1c) levels <6% and no CVD or diabetes at baseline followed from February 1993 to March 2007. SES was measured by education and income while diabetes was self-reported.
  
  
  RESULTS
  Over 12.3 years of follow-up, 1,262 women developed diabetes. In age and race adjusted models, the relative risk of diabetes decreased with increasing education (<2 years of nursing, 2 to <4 years of nursing, bachelor's degree, master's degree, and doctorate: 1.0, 0.7 [95% Confidence Interval (CI), 0.6-0.8], 0.6 (95% CI, 0.5-0.7), 0.5 (95% CI, 0.4-0.6), 0.4 (95% CI, 0.3-0.5); p(trend)<0.001). Adjustment for traditional and non-traditional cardiovascular risk factors attenuated this relationship (education: p(trend) = 0.96). Similar associations were observed between income categories and diabetes.
  
  
  CONCLUSIONS
  Advanced education and increasing income were both inversely associated with incident diabetes even in this relatively well-educated cohort. This relationship was largely explained by behavioral factors, particularly body mass index.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Lee
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Glynn
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Peña
authors.forename: Nina P
authors.initials: NP
authors.lastname: Paynter
authors.forename: David
authors.initials: D
authors.lastname: Conen
authors.forename: Paul M
authors.initials: PM
authors.lastname: Ridker
authors.forename: Aruna D
authors.initials: AD
authors.lastname: Pradhan
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Albert
mesh_terms: D015415:Biomarkers / Q000097:blood; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D006801:Humans; D015994:Incidence; D007182:Income; D018836:Inflammation Mediators / Q000097:blood; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D016016:Proportional Hazards Models; D012923:Social Class; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D016387:Women's Health / Q000706:statistics & numerical data*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators; D008055:Lipids