Educational inequalities in diabetes mortality across Europe in the 2000s: the interaction with gender
Abstract
For type 2 diabetes mellitus, there is an inverse gradient between SEP and both diabetes incidence and prevalence. Some research reports a rise in the magnitude of SEP inequalities in recent decades.
Mounting evidence indicates that gender and SEP, as well as other social positions often interact with each other. These interactive processes vary within and between societies and over time.
To determine educational inequalities in diabetes mortality, age-standardised mortality rates, mortality rate ratios, and slope and relative indices of inequality were calculated. To assess whether the association between education and diabetes mortality differs between genders, diabetes mortality was regressed on gender, educational rank and 'gender x educational rank.
An inverse association between education and diabetes mortality exists in both genders across Europe. Absolute educational inequalities are generally larger among men than women; relative inequalities are generally more pronounced among women, the relative index of inequality being 2.8 (95 % CI 2.0-3.9) in men versus 4.8 (95 % CI 3.2-7.2) in women.
Gender inequalities in diabetes mortality are more marked in the highest than the lowest educated. Education and diabetes mortality are inversely related in Europe in the 2000s.
This association differs by gender, indicating the need to take the socioeconomic and gender dimension into account when developing public health policies.