Subjective Social Status and Longitudinal Changes in Systemic Inflammation

Abstract 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.