Impact of psychosocial stressors on type 2 diabetes among migrants and non-migrants in The Netherlands: The HELIUS study

Background

Migrant populations in Europe have a type 2 diabetes (T2D) burden two to five times that of non-migrants. However, the role of psychosocial stressors—whose experiences can uniquely vary across population groups—remains underexplored. We examined associations between work stress, home stress, and adverse life events with T2D across major ethnic groups in The Netherlands.

Methods

We used baseline data from HELIUS cohort (2011–2015), including 21,501 adults of Dutch, Moroccan, Turkish, South-Asian Surinamese, African Surinamese, and Ghanaian origin. Psychosocial stress was assessed using validated measures in preceding 12 months. T2D was defined by World Health Organization criteria. Robust Poisson regression estimated prevalence ratios (PRs), adjusting for age, sex, and education. Mediation and moderation analyses explored behavioural pathways and role of social support.

Results

Occasional work stress was inversely associated with T2D in total population (aPR 0.82; 95 % CI 0.75–0.93) and among Moroccan-origin participants [0.76 (0.63–0.97)]. Regular home stress was positively associated with T2D in total population [1.15 (1.03–1.28)], but not across ethnic groups. Adverse life events were linked to higher T2D risk overall [1.22 (1.03–1.41)], and among Dutch [1.48 (1.21–1.76)] and African Surinamese [1.43 (1.09–1.89)] origin populations. BMI and alcohol use partially mediated these associations. Social support buffered work and home stress.

Conclusion

Work stress, home stress, and adverse life events differentially influence T2D risk in diverse populations, with effects pronounced in Dutch, Moroccan and African Surinamese origin groups. Interventions targeting psychosocial stress may help reduce T2D in diverse populations.