Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills

Hidde K. Krijnen; Liza A. Hoveling; Aart C. Liefbroer; Ute Bültmann; Nynke Smidt

doi:10.1016/j.ypmed.2022.107140

Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills

Hidde K. Krijnen
, Liza A. Hoveling^*
, Aart C. Liefbroer
, Ute Bültmann
, Nynke Smidt

^*Corresponding author for this work

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Our aim was to investigate sex differences in the associations between socioeconomic position (SEP) and metabolic syndrome (MetS) development, and to what extent these associations are mediated by health literacy and self-management skills. Methods: A subsample (n = 88,384, 59.5% female) of the adult Lifelines Cohort Study was used. MetS development according to NCEP-ATPIII criteria was assessed on average 3.8 years after baseline. SEP-MetS associations were assessed for moderation by sex, and sex-stratified accordingly. Associations between SEP measures (education, income and occupational prestige), health literacy and self-management skills, and MetS development were investigated using logistic regression analyses. The mediating effects of health literacy and self-management skills on the SEP-MetS associations were investigated using the Karlson-Holm-Breen method. Results: Among males and females, respectively 9.4% and 7.1% developed MetS. For males, education was inversely associated with MetS development; health literacy (7.1%) and self-management skills (1.9%) mediated a proportion of these educational differences. For females, education, income and occupational prestige were inversely associated with MetS development; health literacy (respectively 5.9% and 6.4%) and self-management skills (respectively 4.1% and 3.7%) mediated a proportion of the educational and occupational differences in MetS development. Neither health literacy nor self-management skills mediated female income differences in MetS development. Conclusions: Socioeconomic differences in MetS development differ between males and females. Both for males and females, health literacy and self-management skills mediated a small proportion of socioeconomic differences in MetS development.

Original language	English
Article number	107140
Pages (from-to)	1-7
Number of pages	7
Journal	Preventive Medicine
Volume	161
Early online date	6 Jul 2022
DOIs	https://doi.org/10.1016/j.ypmed.2022.107140
Publication status	Published - Aug 2022

Bibliographical note

Funding Information:
This work was supported by The Netherlands Organization for Health Research and Development (ZonMw) [grant number 531003011 ]. ZonMw had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Funding Information:
We wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers that delivered data to Lifelines, and all study participants. The Lifelines Biobank initiative was made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the northern provinces of the Netherlands.

Publisher Copyright:
© 2022 The Authors

Funding

This work was supported by The Netherlands Organization for Health Research and Development (ZonMw) [grant number 531003011 ]. ZonMw had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. We wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers that delivered data to Lifelines, and all study participants. The Lifelines Biobank initiative was made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the northern provinces of the Netherlands.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 4 Quality Education

Keywords

Health literacy
Longitudinal studies
Mediation
Metabolic syndrome
Self-management skills
Socioeconomic factors

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10.1016/j.ypmed.2022.107140

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Cite this

@article{56fa59f2540340f49228417989292e67,

title = "Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills",

abstract = "Background: Our aim was to investigate sex differences in the associations between socioeconomic position (SEP) and metabolic syndrome (MetS) development, and to what extent these associations are mediated by health literacy and self-management skills. Methods: A subsample (n = 88,384, 59.5\% female) of the adult Lifelines Cohort Study was used. MetS development according to NCEP-ATPIII criteria was assessed on average 3.8 years after baseline. SEP-MetS associations were assessed for moderation by sex, and sex-stratified accordingly. Associations between SEP measures (education, income and occupational prestige), health literacy and self-management skills, and MetS development were investigated using logistic regression analyses. The mediating effects of health literacy and self-management skills on the SEP-MetS associations were investigated using the Karlson-Holm-Breen method. Results: Among males and females, respectively 9.4\% and 7.1\% developed MetS. For males, education was inversely associated with MetS development; health literacy (7.1\%) and self-management skills (1.9\%) mediated a proportion of these educational differences. For females, education, income and occupational prestige were inversely associated with MetS development; health literacy (respectively 5.9\% and 6.4\%) and self-management skills (respectively 4.1\% and 3.7\%) mediated a proportion of the educational and occupational differences in MetS development. Neither health literacy nor self-management skills mediated female income differences in MetS development. Conclusions: Socioeconomic differences in MetS development differ between males and females. Both for males and females, health literacy and self-management skills mediated a small proportion of socioeconomic differences in MetS development.",

keywords = "Health literacy, Longitudinal studies, Mediation, Metabolic syndrome, Self-management skills, Socioeconomic factors",

author = "Krijnen, \{Hidde K.\} and Hoveling, \{Liza A.\} and Liefbroer, \{Aart C.\} and Ute B{\"u}ltmann and Nynke Smidt",

note = "Funding Information: This work was supported by The Netherlands Organization for Health Research and Development (ZonMw) [grant number 531003011 ]. ZonMw had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. Funding Information: We wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers that delivered data to Lifelines, and all study participants. The Lifelines Biobank initiative was made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the northern provinces of the Netherlands. Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = aug,

doi = "10.1016/j.ypmed.2022.107140",

language = "English",

volume = "161",

pages = "1--7",

journal = "Preventive Medicine",

issn = "0091-7435",

publisher = "Elsevier Inc.",

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TY - JOUR

T1 - Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills

AU - Krijnen, Hidde K.

AU - Hoveling, Liza A.

AU - Liefbroer, Aart C.

AU - Bültmann, Ute

AU - Smidt, Nynke

N1 - Funding Information: This work was supported by The Netherlands Organization for Health Research and Development (ZonMw) [grant number 531003011 ]. ZonMw had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. Funding Information: We wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers that delivered data to Lifelines, and all study participants. The Lifelines Biobank initiative was made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG the Netherlands), University Groningen and the northern provinces of the Netherlands. Publisher Copyright: © 2022 The Authors

PY - 2022/8

Y1 - 2022/8

N2 - Background: Our aim was to investigate sex differences in the associations between socioeconomic position (SEP) and metabolic syndrome (MetS) development, and to what extent these associations are mediated by health literacy and self-management skills. Methods: A subsample (n = 88,384, 59.5% female) of the adult Lifelines Cohort Study was used. MetS development according to NCEP-ATPIII criteria was assessed on average 3.8 years after baseline. SEP-MetS associations were assessed for moderation by sex, and sex-stratified accordingly. Associations between SEP measures (education, income and occupational prestige), health literacy and self-management skills, and MetS development were investigated using logistic regression analyses. The mediating effects of health literacy and self-management skills on the SEP-MetS associations were investigated using the Karlson-Holm-Breen method. Results: Among males and females, respectively 9.4% and 7.1% developed MetS. For males, education was inversely associated with MetS development; health literacy (7.1%) and self-management skills (1.9%) mediated a proportion of these educational differences. For females, education, income and occupational prestige were inversely associated with MetS development; health literacy (respectively 5.9% and 6.4%) and self-management skills (respectively 4.1% and 3.7%) mediated a proportion of the educational and occupational differences in MetS development. Neither health literacy nor self-management skills mediated female income differences in MetS development. Conclusions: Socioeconomic differences in MetS development differ between males and females. Both for males and females, health literacy and self-management skills mediated a small proportion of socioeconomic differences in MetS development.

AB - Background: Our aim was to investigate sex differences in the associations between socioeconomic position (SEP) and metabolic syndrome (MetS) development, and to what extent these associations are mediated by health literacy and self-management skills. Methods: A subsample (n = 88,384, 59.5% female) of the adult Lifelines Cohort Study was used. MetS development according to NCEP-ATPIII criteria was assessed on average 3.8 years after baseline. SEP-MetS associations were assessed for moderation by sex, and sex-stratified accordingly. Associations between SEP measures (education, income and occupational prestige), health literacy and self-management skills, and MetS development were investigated using logistic regression analyses. The mediating effects of health literacy and self-management skills on the SEP-MetS associations were investigated using the Karlson-Holm-Breen method. Results: Among males and females, respectively 9.4% and 7.1% developed MetS. For males, education was inversely associated with MetS development; health literacy (7.1%) and self-management skills (1.9%) mediated a proportion of these educational differences. For females, education, income and occupational prestige were inversely associated with MetS development; health literacy (respectively 5.9% and 6.4%) and self-management skills (respectively 4.1% and 3.7%) mediated a proportion of the educational and occupational differences in MetS development. Neither health literacy nor self-management skills mediated female income differences in MetS development. Conclusions: Socioeconomic differences in MetS development differ between males and females. Both for males and females, health literacy and self-management skills mediated a small proportion of socioeconomic differences in MetS development.

KW - Health literacy

KW - Longitudinal studies

KW - Mediation

KW - Metabolic syndrome

KW - Self-management skills

KW - Socioeconomic factors

UR - https://www.scopus.com/pages/publications/85134179781

UR - https://www.scopus.com/pages/publications/85134179781#tab=citedBy

U2 - 10.1016/j.ypmed.2022.107140

DO - 10.1016/j.ypmed.2022.107140

M3 - Article

C2 - 35803357

AN - SCOPUS:85134179781

SN - 0091-7435

VL - 161

SP - 1

EP - 7

JO - Preventive Medicine

JF - Preventive Medicine

M1 - 107140

ER -

Socioeconomic differences in metabolic syndrome development among males and females, and the mediating role of health literacy and self-management skills

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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