Intergenerational educational mobility and type 2 diabetes in the Sacramento Area Latino Study on Aging

United States (US) Latinos have the lowest educational attainment of any US racial/ethnic group, which may contribute to their disparate burden of Type 2 Diabetes. Herein, we aimed to examine the association between intergenerational educational mobility and Type 2 Diabetes among US Latino adults. W...

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Published inAnnals of epidemiology Vol. 65; pp. 93 - 100
Main Authors Fernández-Rhodes, Lindsay, Ward, Julia B., Martin, Chantel L., Zeki Al Hazzouri, Adina, Torres, Jacqueline, Gordon-Larsen, Penny, Haan, Mary N., Aiello, Allison E.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.01.2022
Subjects
Adult
Adult Children
Aging
Diabetes Mellitus, Type 2 - epidemiology
Education
Educational Status
Hispanic or Latino
Hispanics
Humans
Intergenerational
Latinos
Prevalence
SES
Social Mobility
type 2 diabetes
United States - epidemiology
United States
SES
PR
type 2 diabetes
Education
CI
Intergenerational
NLDS
Latinos
SALSA
US
Social mobility
Hispanics
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ISSN1047-2797
1873-2585
1873-2585
DOI10.1016/j.annepidem.2021.07.006

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Summary:United States (US) Latinos have the lowest educational attainment of any US racial/ethnic group, which may contribute to their disparate burden of Type 2 Diabetes. Herein, we aimed to examine the association between intergenerational educational mobility and Type 2 Diabetes among US Latino adults. We used data from the Niños Lifestyle and Diabetes Study (2013–2014) and the Sacramento Area Latino Study on Aging (1998–1999) to link 616 adult Latino children to their parents. Model-based standardization and robust Poisson regression were used to estimate the prevalence of prediabetes, Type 2 Diabetes, treatment and glycemic control, and describe their associations with intergenerational educational mobility. Adult children with stable high intergenerational educational attainment had a higher prevalence of prediabetes (Prevalence Ratio, PR=1.58; 95% Confidence Interval, CI=1.08, 2.34) and lower prevalence of Type 2 Diabetes (PR=0.64, CI=0.41, 0.99), as compared to those who experienced low educational attainment across generations. Downward mobility was associated with a higher prevalence of prediabetes (PR=1.54, CI=1.06, 2.23) and worse glycemic control (PR=2.20, CI=1.13, 4.30), and upward mobility was associated with a lower prevalence of Type 2 Diabetes (PR=0.39, CI=0.22, 0.70). Our findings from a predominantly Mexican-heritage community suggest that higher education across generations may buffer individuals from glycemic dysregulation. As such, higher education may be a promising public health target to address the rising burden of Type 2 Diabetes in the US.
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The authors all contributed at multiple stages to this manuscript. Dr. Fernandez-Rhodes completed the statistical analyses and interpreted the results and drafted the manuscript. Dr. Ward assisted with the data management and linking of SALSA and NLDS datasets. Dr. Aiello conceived of the study, collected the NLDS data, and oversaw the analytical plan and analyses. Dr. Haan was the principal investigator of SALSA and the principal investigator of the NLDS subcontract to the University of California at San Francisco. As such, Dr. Haan supervised the clinical field work and data collection for both SALSA and NLDS. Dr. Gordon-Larsen assisted with the analytical plan. Drs. Martin, Zeki Al Hazzouri, Torres, and Aiello assisted in the interpretation of the results. All coauthors contributed to the drafting of the final version of the manuscript.
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ISSN:1047-2797
1873-2585
1873-2585
DOI:10.1016/j.annepidem.2021.07.006