Correlations Between Chronic Inflammation and Poverty and Raised Risk of Mortality
Researchers here report on an epidemiological analysis of the effects of relative poverty and chronic inflammation on health and life span. It is well known that socioeconomic status correlates with mortality and life expectancy. There is a great deal of debate over which of the numerous mechanisms potentially involved in this correlation contribute the largest share of the effect size. Separately, chronic inflammation is disruptive to tissue structure and function, increases with age, and is known to increase risk and accelerate progression of all of the common age-related fatal conditions. As one might expect, the poverty and chronic inflammation together correlate with worse outcomes than either separately.
Chronic systemic inflammation and poverty are both linked to an increased mortality risk. The goal of this study was to determine if there is a synergistic effect of the presence of inflammation and poverty on the 15-year risk of all-cause, heart disease and cancer mortality among US adults. We analyzed the nationally representative National Health and Nutrition Examination Survey (NHANES) 1999 to 2002 with linked records to the National Death Index through the date December 31, 2019. Among adults aged 40 and older, 15-year mortality risk associated with inflammation, C-reactive protein (CRP), and poverty was assessed in Cox regressions. All-cause, heart disease, and cancer mortality were the outcomes.
Individuals with elevated CRP at 1.0 mg/dL and poverty were at greater risk of 15-year adjusted, all-cause mortality (hazard ratio [HR] = 2.45) than individuals with low CRP and were above poverty. For individuals with just one at risk characteristic, low inflammation/poverty (HR = 1.58), inflammation/above poverty (HR = 1.59) the mortality risk was essentially the same and substantially lower than the risk for adults with both. Individuals with both elevated inflammation and living in poverty experience a 15-year heart disease mortality risk elevated by 127% and 15-year cancer mortality elevated by 196%.