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Socioeconomic status and inflammation: a meta-analysis

Molecular Psychiatry volume 25, pages 2189–2199 (2020)Cite this article

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Abstract

Socioeconomic status (SES), often conceptualized as income, education, or occupation, is associated with risk for disease morbidity and psychopathology. Recent research has focused on the potential biological mechanisms linking lower SES and poor outcomes; much of this work has examined the relationship between SES and markers of systemic inflammation. The strength of the estimated association between SES and inflammatory markers varies widely across individual studies. Thus, we used meta-analytic techniques to quantify the magnitude of this relationship. To accomplish this, PubMed and PsycINFO were searched for papers that reported on SES and two commonly measured systemic inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6). Peer-reviewed, empirical papers conducted in non-patient populations were included. Data from 43 papers (N = 111,156) reporting a total of 63 relevant effect sizes were included in analyses. SES, broadly defined, was significantly associated with both levels of CRP (Z = 0.12; 95% CI, 0.09–0.16) and IL-6 (Z = 0.15; 95% CI, 0.12–0.18); individuals with lower SES showed higher levels of systemic inflammation. Subanalyses demonstrated that studies operationalizing SES as either levels of income or educational attainment also found significant associations with both CRP and IL-6. Moderator analyses revealed that effect sizes varied based on sample characteristics and analysis approaches. Lower SES is associated with significantly elevated levels of inflammatory markers of disease risk. Thus, pro-inflammatory pathways are likely an important mechanism translating socioeconomic inequalities into mental and physical health disparities.

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Acknowledgements

K.L.H. is funded by the National Institutes of Health (F32 MH107129), the Brain and Behavior Research Foundation (Young Investigator Award 23819), Klingenstein Third Generation Foundation, and a Jacobs Foundation Early Career Research Fellowship. The authors thank Lillian Dillard for her assistance with literature searches and coding; and Allison Appleton, Jennifer Morozink Boylan, Ben Chapman, Edith Chen, Yvette Cozier, Ari Elliot, Andrew Fuligni, Neha John-Henderon, Annemarie Koster, Thomas McDade, Gregory Miller, Markus Schafer, Kammi Schmeer, and Hannah Schreier for providing relevant data and information from their published papers on SES and inflammation.

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  1. Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Keely A. Muscatell & Samantha N. Brosso

  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Keely A. Muscatell

  3. Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA

    Kathryn L. Humphreys

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Dr. Humphreys received financial support from NIH, the Brain and Behavior Research Foundation, the Klingenstein Third Generation Foundation, and the Jacobs Foundation. Dr. Muscatell and Ms. Brosso declare that they have no conflict of interest.

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Muscatell, K.A., Brosso, S.N. & Humphreys, K.L. Socioeconomic status and inflammation: a meta-analysis. Mol Psychiatry 25, 2189–2199 (2020). https://doi.org/10.1038/s41380-018-0259-2

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