Background: Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status.
Purpose: We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex.
Methods: Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race.
Results: Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex.
Conclusions: Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.
Keywords: C-reactive protein; Inflammation; Interleukin-6; Socioeconomic status; Subjective social status.
Subjective social status (SSS) refers to how people perceive their social rank compared with others and has been linked to meaningful differences in physical health. Increases in inflammation may contribute to associations between lower SSS and poorer physical health. In a sample of healthy adults, we examined whether SSS was associated with prospective, multiyear changes in markers of systemic inflammation and if this differed by sex or race. We found that adults who perceived their social status as lower than peers in their community exhibited an accelerated increase in interleukin-6, a marker of systemic inflammation, over a 3-year period. When participants were asked to compare themselves to people in the broader USA, the pattern was similar but less robust. Results were independent of individual differences in sociodemographic characteristics including family-adjusted income and education. Findings did not differ by sex or race and were not explained by differences in adiposity and symptoms of depression and hopelessness. Effects for C-reactive protein, a second marker of inflammation, were generally nonsignificant. Although preliminary, findings suggest an immune pathway by which perceived social status may relate to chronic diseases of aging.
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