Population mixing and childhood diabetes

Parslow, R. C., McKinney, P. A., Law, G. R. and Bodansky, H. J. (2001) Population mixing and childhood diabetes. International Journal of Epidemiology, 30 (3). pp. 533-538. ISSN 0300-5771

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Item Type:Article
Item Status:Live Archive


Background: Exposure to infections, particularly in early life, may modify the risk of developing childhood diabetes. Population mixing, based on the number and diversity of incoming migrants to an area can be used as a proxy measure for exposure to infections. We tested the hypothesis that incidence of childhood Type I diabetes is higher in areas of low population mixing. Methods: Children (<15 years) diagnosed with diabetes between 1986-1994 in Yorkshire, UK (n = 994) were analysed with demographic data and denominator populations from the 1991 UK Census. Population mixing was estimated separately for 'any age' (>1 year) and children (1-15 years) for each area, using the proportion of migrants and an index of diversity based on numbers and origins of migrants. Regression models calculated the effect of 'any age' and childhood population mixing on the incidence of diabetes, controlling for population density, ethnicity and proportion of migrants. Results: Areas with low levels of population mixing of children (bottom decile), were significantly associated with higher incidence of childhood diabetes for 0-14 years (incidence rate ratio IRR = 1.46, 95% CI : 1.01-2.11). When stratified by age different effects were observed for childhood population mixing with raised IRR for ages 5-9 (2.23, 95% CI: 1.20-4.11) and 10-14 (1.47, 95% CI: 0.89-2.42), and decreased IRR for 0-4-year-olds (0.56, 95% CI: 0.17-1.82). Conclusion: The incidence of childhood diabetes is highest in areas where limited childhood population mixing occurs and the diversity of origins of incoming children is low; those over 4 years are at greatest risk. This is consistent with an infectious hypothesis where absence of stimulation to the developing immune system increases vulnerability to late infectious exposure, which may precipitate diabetes.

Keywords:child health, diabetes, medical geography, mixing, population migration, adolescent, age, article, calculation, child, controlled study, demography, ethnology, exposure, high risk population, human, hypothesis, immune system, incidence, infant, infection, insulin dependent diabetes mellitus, juvenile diabetes mellitus, major clinical study, migration, newborn, population, population density, priority journal, regression analysis, United Kingdom, Adolescent, Chi-Square Distribution, Child, Preschool, Diabetes Mellitus, Type 1, Female, Great Britain, Humans, Infant, Newborn, Male, Risk Factors, Socioeconomic Factors, Transients and Migrants, United Kingdom
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
L Social studies > L510 Health & Welfare
Divisions:College of Social Science > School of Health & Social Care
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ID Code:26554
Deposited On:09 Mar 2017 13:45

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