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

## TL;DR

The study finds that psychosocial stressors like work stress and adverse life events are linked to higher type 2 diabetes risk in migrant and non-migrant groups in the Netherlands.

## Contribution

The study reveals differential associations between psychosocial stressors and T2D across ethnic groups, highlighting potential targets for intervention.

## Key findings

- Occasional work stress was inversely associated with T2D in the total population and among Moroccan-origin participants.
- Adverse life events were linked to higher T2D risk overall and specifically in Dutch and African Surinamese origin populations.
- BMI and alcohol use partially mediated the associations between stressors and T2D.

## Abstract

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.

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.

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.

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.