Insulin dependent diabetes in childhood and material deprivation in northern England, 1977-86.

Abstract

1945-65 cohort then most of the women in the 1980-4 cohort will die from causes other than breast cancer.We conclude that breast carcinomas diagnosed in the 1980s have a smaller primary tumour size, fewer axillary metastases, and more favourable histological features and are associated with better prognosis than cancers diagnosed a few decades ago. Improved survival with breast cancer can at least partially be explained by detection of increased numbers of small carcinomas with favourable histological characteristics. Denmark, 1943-1982. Int3 Cancer 198841:46-51. 3 Pollack ES, Horm JW. Trends in cancer incidence and mortality in the United States, 1969-76. 7 Natl Cancer Inst 198064:1091-103. 4 Adami H-O, Sparen P, Bergstrom R, Holmberg L, Krusemo UB, Ponten J.Increasing survival trend after cancer diagnosis in Sweden: 1960Sweden: -1984 J Natl Cancer Inst 1989;81:1640-7. 5 Toikkanen S, Joensuu H. Prognostic factors and long-term survival in breast cancer. APMIS 1990;98:1005-14. 6 Toikkanen S, Joensuu H, Klemi P. BMJ 1991;303:158-60 Insulin dependent diabetes in childhood and material deprivation in northern England, 1977-86Abstract Objective-To determine the incidence of insulin dependent diabetes in the Northern region of England in children less than 16 years old in the period 1977 to 1986 and to relate the incidence data to an index of deprivation.Design-Retrospective analysis of hospital case records identified from the regional health authority's computer; validation of the primary source with hospital clinic registers and community paediatric registers.Setting-Northern region, excluding South Cumbria District Health Authority (659 300 children under 16 in 1981).Patients-All children diagnosed with insulin dependent diabetes before the age of 16 and resident in the region at time of diagnosis.Main outcome measures-Incidence rates for the 10 year period and analysis of incidence rates within categories of deprivation.Results-919 incident cases were identified. The validation procedure covered 54% of all cases identified and gave 95% completeness of ascertainment. The average annual incidence over the 10 year period was 14-8/100 000 for girls and 13-4/100 000 for boys. The annual incidence for the most and least deprived areas of the region was 18-7/100 000 (95% confidence interval 16-2 to 21-5) for boys and 7/100000 (5.6 to 8.8) for girls. There was a highly significant trend (p<0-001) of decreasing incidence with decreasing level of deprivation.Conclusions-In the north of England the incidence of childhood diabetes is related to material deprivation.

Socioeconomic conditions and type 1 diabetes in childhood in North Rhine–Westphalia, Germany

“…Several studies have indicated an association between lower socioeconomic status and a higher incidence of type 1 diabetes [18][19][20][21][22][23][24][25], in accordance with our prevailing results. One of these studies included a small-area analysis, and several case-control studies have indicated an inverse correlation between socioeconomic status and type 1 diabetes at the individual level [20,22,25].…”

“…Further, regional socioeconomic conditions were assessed from a broad spectrum of socioeconomic indicators taken from annually updated official statistics for the total population or from a standardised, continuous household sample survey (the German Microcensus). Thus, in contrast to many other ecological studies based on census data covering only a short period [9,10,12,17,19,21,26,27], our socioeconomic data covered a reasonable time span.…”

“…In Germany, as in other European countries, the growing social inequality among children is a serious problem [6]. Epidemiological studies on the association between social status and type 1 diabetes in children have reported conflicting results, finding positive [7][8][9][10][11][12][13][14][15][16][17], inverse [18][19][20][21][22][23][24][25] or no associations [26][27][28]. Likewise, the results of studies on the relation with population density and with urban versus rural areas are contradictory [10,13,14,17,19,29,30].…”

Epidemiologicheskie issledovaniya sakharnogo diabeta tipa 1 v detskom vozraste v Evrope

“…Ранее была обнаружена связь СД типа 1 с мате риальным благосостоянием семьи в трех из четырех малых по объему исследованиях в Великобритании [15][16][17][18], где была зафиксирована низкая заболевае мость СД типа 1 в малообеспеченных семьях.…”

Inequidades sociales y diabetes en adolescentes

“…Un claro ejemplo de esta situación en adultos es la diabetes. Numerosos estudios [8][9][10][11][12][13][14][15][16][17] documentan la disminución del riesgo de presentar diabetes en adultos de condición socioeconó-mica favorable, sin embargo, los estudios disponibles sobre la posible relación entre la posición socioeconómica y la ocurrencia de diabetes en niños y adolescentes es escasa y sus resultados son controversiales [18][19][20][21][22] . Parte de esto puede deberse al uso de indicadores socioeconó-micos inapropiados 18,19 .…”