ArticleBMJ (Clinical research ed.)2012
Contribution of modifiable risk factors to social inequalities in type 2 diabetes: prospective Whitehall II cohort study.
Article in BMJ (Clinical research ed.), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 81 papers, 3 of them syntheses that pooled it.
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Who cites it
81 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Hypertriglyceridemia is a dose-dependent risk factor for type 2 diabetes mellitus: a systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis.European journal of epidemiology · 2015Pooled it
- Inequalities in health care among patients with type 2 diabetes by individual socio-economic status (SES) and regional deprivation: a systematic literature review.International journal for equity in health · 2014Pooled it
- Effectiveness of a family-, school- and community-based intervention on physical activity and its correlates in Belgian families with an increased risk for type 2 diabetes mellitus: the Feel4Diabetes-study.BMC public health · 2020Trial
- Trial
- Individual and Contextual Socioeconomic Position on Type 2 Diabetes Risk in LMICs: A Multilevel Analysis.Annals of the New York Academy of Sciences · 2026Article
- Co-twin Control Analyses Reveal Genetic Contributions to SES Influences in Mean Level and Longitudinal Change in Physical Aging.Behavior genetics · 2026Article
- Immunocytes Play a Crucial Role as Mediators in the Protective Effects of D-β-Hydroxybutyrate Dehydrogenase 1 against Type 2 Diabetes Mellitus: A Mendelian Randomization StudyEndocrine, metabolic & immune disorders drug targets · 2026Article
- Health effects associated with alcohol consumption: a Burden of Proof study.Nature health · 2026Article
- Addressing gender and social inequities: the challenge of metabolic control in women with type 2 diabetes in Quito.Global health action · 2025Article
- Burden of hypertension and type 2 diabetes in Tamale Metropolis: a case study of Tamale teaching hospital.BMC public health · 2025Article
- Social inequalities in diabetes incidence and quality of care: results from a cohort study in the Lazio region, Italy.BMJ open · 2025Article
- Examining causal relationships between educational attainment and type 2 diabetes using genetic analysis: findings from the EPIC-InterAct study through Mendelian randomisation.Journal of epidemiology and community health · 2025Article
- Socioeconomic Status, Modifiable Factors, and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A Cohort Study From the UK Biobank.Journal of diabetes · 2025Article
- Exploring the gender difference in type 2 diabetes incidence in a Swiss cohort using latent class analysis: an intersectional approach.BMJ public health · 2024Article
- Social deprivation and diabetic kidney disease: A European view.Journal of diabetes investigation · 2024Review
- Diabetes Among Racial and Ethnically Diverse Older Adults in the United States with Cognitive Limitations.Journal of racial and ethnic health disparities · 2024Article
- Review
- Socioeconomic inequalities in health-related functioning among people with type 2 Diabetes: longitudinal analyses in the Maastricht Study.BMC public health · 2024Article
- The impact of social deprivation on development and progression of diabetic kidney disease.HRB open research · 2024Article
21 more citing papers are in PubMed but not listed here.
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10 authors.
Funding
Abstract
objectiveTo assess the contribution of modifiable risk factors to social inequalities in the incidence of type 2 diabetes when these factors are measured at study baseline or repeatedly over follow-up and when long term exposure is accounted for.
designProspective cohort study with risk factors (health behaviours (smoking, alcohol consumption, diet, and physical activity), body mass index, and biological risk markers (systolic blood pressure, triglycerides and high density lipoprotein cholesterol)) measured four times and diabetes status assessed seven times between 1991-93 and 2007-09.
settingCivil service departments in London (Whitehall II study).
participants7237 adults without diabetes (mean age 49.4 years; 2196 women).
main outcome measuresIncidence of type 2 diabetes and contribution of risk factors to its association with socioeconomic status.
resultsOver a mean follow-up of 14.2 years, 818 incident cases of diabetes were identified. Participants in the lowest occupational category had a 1.86-fold (hazard ratio 1.86, 95% confidence interval 1.48 to 2.32) greater risk of developing diabetes relative to those in the highest occupational category. Health behaviours and body mass index explained 33% (-1% to 78%) of this socioeconomic differential when risk factors were assessed at study baseline (attenuation of hazard ratio from 1.86 to 1.51), 36% (22% to 66%) when they were assessed repeatedly over the follow-up (attenuated hazard ratio 1.48), and 45% (28% to 75%) when long term exposure over the follow-up was accounted for (attenuated hazard ratio 1.41). With additional adjustment for biological risk markers, a total of 53% (29% to 88%) of the socioeconomic differential was explained (attenuated hazard ratio 1.35, 1.05 to 1.72).
conclusionsModifiable risk factors such as health behaviours and obesity, when measured repeatedly over time, explain almost half of the social inequalities in incidence of type 2 diabetes. This is more than was seen in previous studies based on single measurement of risk factors.
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