title: The contribution of biogeographical ancestry and socioeconomic status to racial/ethnic disparities in type 2 diabetes mellitus: results from the Boston Area Community Health Survey.
abstract: OBJECTIVE
  Racial/ethnic disparities in the incidence of type 2 diabetes mellitus (T2DM) are well documented, and many researchers have proposed that biogeographical ancestry (BGA) may play a role in these disparities. However, studies examining the role of BGA on T2DM have produced mixed results to date. Therefore, the objective of this research was to quantify the contribution of BGA to racial/ethnic disparities in T2DM incidence controlling for the mediating influences of socioeconomic factors.
  
  
  METHODS
  We analyzed data from the Boston Area Community Health Survey, a prospective cohort with approximately equal numbers of black, Hispanic, and white participants. We used 63 ancestry-informative markers to calculate the percentages of participants with West African and Native American ancestry. We used logistic regression with G-computation to analyze the contribution of BGA and socioeconomic factors to racial/ethnic disparities in T2DM incidence.
  
  
  RESULTS
  We found that socioeconomic factors accounted for 44.7% of the total effect of T2DM attributed to black race and 54.9% of the effect attributed to Hispanic ethnicity. We found that BGA had almost no direct association with T2DM and was almost entirely mediated by self-identified race/ethnicity and socioeconomic factors.
  
  
  CONCLUSIONS
  It is likely that nongenetic factors, specifically socioeconomic factors, account for much of the reported racial/ethnic disparities in T2DM incidence.
authors.affiliation: Department of Epidemiology, New England Research Institutes, 480 Pleasant Street, Watertown, MA; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. Electronic address: rpiccolo@neriscience.com.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Piccolo
authors.affiliation: Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Pearce
authors.affiliation: Department of Epidemiology, New England Research Institutes, 480 Pleasant Street, Watertown, MA.
authors.forename: Andre B
authors.initials: AB
authors.lastname: Araujo
authors.affiliation: Department of Epidemiology, New England Research Institutes, 480 Pleasant Street, Watertown, MA.
authors.forename: John B
authors.initials: JB
authors.lastname: McKinlay
mesh_terms: D000328:Adult; D000368:Aged; D044467:American Indian or Alaska Native / Q000235:genetics / Q000706:statistics & numerical data; D044383:Black People / Q000235:genetics / Q000706:statistics & numerical data; D001900:Boston / Q000453:epidemiology; D015984:Causality; D039301:Computers, Molecular; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000209:etiology / Q000235:genetics; D015987:Effect Modifier, Epidemiologic; D005006:Ethnicity / Q000235:genetics / Q000706:statistics & numerical data*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000208:ethnology / Q000235:genetics; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D019655:Quantitative Trait, Heritable; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D044465:White People / Q000235:genetics / Q000706:statistics & numerical data; D001741:Black or African American
keywords: Biogeographic ancestry; Causal modeling; Mediation; Racial/ethnic disparities; Socioeconomic status; Type 2 diabetes
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