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date: 11 November 2019

Abstract and Keywords

Socioeconomic status (SES) is a major determinant of health and well-being in childhood, adult life, and old age, with people of lower SES, as defined by education, occupation, income, and neighborhood deprivation being at higher risk for a range of communicable and noncommunicable diseases. Psychoneuroimmunological processes may contribute to links between SES and health outcomes. There is extensive population evidence that SES is inversely associated with chronic inflammation indexed by markers such as C-reactive protein, interleukin-6, and fibrinogen. Both childhood and adult SES contribute to this pattern. Evidence for SES differences in acquired immunity is more sparse, but it also implicates lower SES in the dysregulation of immune responses. There is limited experimental data from humans showing that lower SES is associated with heightened inflammation following acute stress. There is an inverse correlation between SES and seropositivity for common infections acquired early in the life course that may in turn contribute to low-grade inflammation in adult life. SES differences in immunity and inflammation are also mediated in part by variations in health-related behaviors such as smoking and energy balance, and by direct stress-related processes. Research linking SES, psychosocial adversity, immune function, and health outcomes longitudinally is needed, together with intervention studies that explore the impact of modifying links in the causal chain.

Keywords: heightened inflammation, impaired immune function, low socioeconomic status

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