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Socioeconomic Position, Race/Ethnicity, and Inflammation in the Multi-Ethnic Study of Atherosclerosis
Abstract
BACKGROUND: Low socioeconomic position is known to be associated with cardiovascular events and atherosclerosis. Reasons for these associations remain a topic of research. Inflammation could be an important mediating mechanism linking socioeconomic position to cardiovascular risk. METHODS AND RESULTS: This cross-sectional study used data from the baseline examination of the Multi-Ethnic Study of Atherosclerosis (MESA), a study of 6814 men and women 45 to 84 years of age. Race- and ethnicity-stratified regression analyses were used to estimate associations of household income and education with C-reactive protein and interleukin-6 before and after adjustment for infection and medication use, psychosocial factors, behaviors, adiposity, and diabetes mellitus. Low income was associated with higher concentrations of interleukin-6 in all race/ethnic groups. Percent differences associated with 1-SD-lower income were 9% (95% confidence interval [CI], 7 to 11), 6% (95% CI, 1 to 10), 8% (95% CI, 4 to 11), and 8% (95% CI, 3 to 13) for whites, Chinese, blacks, and Hispanics. Low levels of education were associated with higher levels of interleukin-6 only among whites and blacks (percent difference in interleukin-6 associated with 1-SD-lower education: 9% [95% CI, 6 to 12] among Whites, and 7% [95% CI, 3 to 10] among blacks). Similar patterns were observed for C-reactive protein. Adiposity was the single most important factor explaining socioeconomic position associations, especially among blacks and whites. A smaller effect was seen for psychosocial factors and behaviors in all race groups. CONCLUSIONS: Both household income and education are associated with inflammation, but associations vary across race/ethnic groups. Associations likely result from socioeconomic position patterning of adiposity and other factors.
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“Persistent economic difficulties predict increased sickness absence, highlighting the broad impact of financial stress on health [117,118].”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [118]
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“Economic difficulties also contribute to stress, with a low income being associated with higher concentrations of interleukin-6 across all racial and ethnic groups.”
From Comprehensive review of chronic stress pathways and the efficacy of behavioral stress reduction programs (BSRPs) in managing diseases. (2024) · cites this paper as [118]
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Health disparities across the lifespan: Meaning, methods, and mechanisms
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“Although studies have also demonstrated that various psychological and social factors of interest in health disparities research relate to markers of inflammation and immune functioning (McDade et al. 2006, Ranjit et al. 2007), little research has explored psychosocial pathways in relation to SES.”
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“Whereas chronic stress can suppress several aspects of adaptive immune function, it also appears to induce a chronic and systemic state of mild inflammation (Kiecolt-Glaser et al. 2003, Miller et al. 2008, Ranjit et al. 2007a).”
BackgroundDisentangling the Links Between Psychosocial Stress and Cardiovascular Disease
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Ethnic Differences in C-Reactive Protein Concentrations
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“The impact of ethnicity and SESonCRPconcentrationswasalsoexaminedinthe MESA cohort ( 35 ), where educational level was found to be a strong predictor of CRP.”
Background
Metadata
- Authors
- Ranjit, N., Diez-Roux, A. V., Shea, S., Cushman, M., Ni, H., & Seeman, T.
- Affiliations
- University of Vermont (US)
- From the Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor (N.R., A.V.D.-R.); Departments of Medicine and Epidemiology, Columbia University, New York, NY (S.S.); Department of Medicine, University of Vermont, Burlington (M.C.); Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md (H.N.); and Division of Geriatrics, School of Medicine, University of California at Los Angeles (T...
- Venue
- Circulation
- Published
- 2007-11-20
- Volume
- 116
- Issue
- 21
- Pages
- 2383-2390
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2113254280
- Cited by
- 168
- References
- 32
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 6 · 2020: 6 · 2019: 14 · 2018: 7 · 2017: 10 · 2016: 10 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 13
- FWCI
- 13.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Vermont
- Universidad CES
- National Institutes of Health (n01hc95164-17-0-1, n01hc95165-34-0-1, n01hc95161-24-0-1, n01hc095169-003, n01hc95162-31-0-1, n01hc95160-18-0-1, n01hc95163-22-0-1, n01hc95159-40-0-1)
- National Heart, Lung, and Blood Institute (N01 HC-95159, N01-HC-95160, (N01-HC-95163, N01 HC-95161, N01 HC95165, N01HC95164, R01HL076831, N01 HC-95162, N01 HC95169)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD047861)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- socioeconomic position, household income, educational attainment, inflammation, C-reactive protein, interleukin-6, race and ethnicity, atherosclerosis, adiposity, cardiovascular risk, Multi-Ethnic Study of Atherosclerosis
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Ethnicity, Female, Humans, Inflammation, Longitudinal Studies, Male, Middle Aged, Risk Factors, Socioeconomic Factors, Biomarkers, Racial Groups, Atherosclerosis
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