Neighborhood socioeconomic disadvantage shapes health throughout life
medwireNews: High neighborhood socioeconomic disadvantage is associated with detrimental lifestyle factors from childhood onwards, and is ultimately linked to an almost fourfold increased likelihood for diabetes by middle age, study findings indicate.
“Through both childhood and adulthood, the present study shows how differences in lifestyles by neighbourhood socioeconomic disadvantage contribute to reduced insulin sensitivity and unfavourable glycaemic biomarkers,” Mika Kivimäki (University of Helsinki, Finland) and co-authors write in The Lancet Public Health.
They add: “It also shows that cumulative high neighbourhood socioeconomic disadvantage is associated with the development of several cardiometabolic risk factors in adulthood that increase diabetes occurrence in middle age, independent of individual socioeconomic disadvantage.”
The findings are based on an analysis of 3002 participants of The Young Finns Study who were aged 6 to 18 years at baseline and were followed up for 31 years.
The researchers report that differences in cardiometabolic and diabetes risk factors by neighborhood socioeconomic disadvantage were initially small but increased with time.
One of the earliest differences the study highlighted was in fruit and vegetable intake. By 6 years of age, children living in neighborhoods with high levels of socioeconomic disadvantage (>0.5 standard deviation [SD] above the national mean) ate significantly less fruit and vegetables than their peers from neighborhoods with low levels of socioeconomic disadvantage (≤0.5 SD below the national mean).
From adolescence (12 years) onwards, living in a neighborhood with high neighborhood socioeconomic disadvantage was associated with significantly decreased physical activity and a significantly increased prevalence of daily smoking.
Significant differences in BMI and systolic blood pressure developed between the two groups at 21 and 24 years, respectively, and by the age of 27 years, fasting glucose and insulin concentrations were significantly higher, and HOMA insulin sensitivity significantly lower among those with high versus low neighborhood socioeconomic disadvantage.
Furthermore, after adjustment for age, sex, and individual socioeconomic disadvantage, people aged 22–48 years consistently exposed to high neighborhood socioeconomic disadvantage were a significant 3.71 times more likely to have diabetes than those consistently exposed to low neighborhood socioeconomic disadvantage.
They were also more likely to be obese (odds ratio [OR]=1.44), hypertensive (OR=1.83), and have a fatty liver (OR=1.73).
“These findings highlight the importance of policies that improve resources and opportunities for those living in socioeconomically disadvantaged areas,” Kivimäki et al conclude.
By Laura Cowen
medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group