Abstract
Objectives: Chronic inflammation is a potentially important mechanism through which social inequalities may contribute to health inequalities over the life course. Excess body fat contributes to chronic inflammation, and younger adults in the US have come of age during a pronounced secular increase in body mass index (BMI). We aim to document levels of chronic inflammation in a nationally representative sample of 33-to-44 year-old adults in the US, and to describe associations with BMI, race/ethnicity, and education. Methods: High sensitivity C-reactive protein (CRP) was measured in Wave V (2016–18) of the National Longitudinal Study of Adolescent to Adult Health, with complete data available for 4349 participants. Sex-stratified weighted regression models were implemented to investigate CRP in association with education, race/ethnicity, and BMI. Results: Geometric mean CRP was 1.9 mg/L, and 35.4% of the sample had CRP >3 mg/L. Females had significantly higher CRP than males. Body mass index was a strong positive predictor of CRP, and education level was negatively associated with CRP. Associations between education and CRP were substantially attenuated after adjusting for BMI. High risk CRP increased linearly with BMI even among the obese: 87.0 percent of females and 74.1 percent of males with class 3 obesity (BMI ≥40) were predicted to have high risk CRP > 3 mg/L. Conclusions: The obesity epidemic is producing an epidemic of chronic inflammation in early mid-adulthood in the US. Strong associations between BMI and chronic inflammation portend high risk for future disease—and inequitable distribution of disease—as the cohort ages.
Original language | English (US) |
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Article number | 114059 |
Journal | Social Science and Medicine |
Volume | 281 |
DOIs | |
State | Published - Jul 2021 |
Funding
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under Award Numbers R21HD101757 and F32HD102152 as well as T32HD091058 and P2CHD050924 . The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill , and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development , with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website ( https://dev-addhealth.cpc.unc.edu/ ). No direct support was received from grant P01-HD31921 for this analysis.
Keywords
- C-reactive protein
- Education
- Health disparities
- Obesity
- Overweight
ASJC Scopus subject areas
- Health(social science)
- History and Philosophy of Science