An Intersectional Perspective on the Relationships Among Social Status, Self-reported Discrimination, and Low-grade C-Reactive Protein in the Health and Retirement Study

TitleAn Intersectional Perspective on the Relationships Among Social Status, Self-reported Discrimination, and Low-grade C-Reactive Protein in the Health and Retirement Study
Publication TypeThesis
Year of Publication2018
AuthorsFarmer, HR
Academic DepartmentBiobehavioral Health
DegreeDoctor of Philosophy
Number of Pages205
Date Published06/2018
UniversityThe Pennsylvania State University
CityState College, PA
KeywordsC-reactive protein, developmental perspective, Gerontology, health, health discrimination, Intersectionality, Lifespan, Racial Disparities, social determinants, social status and health

A broad literature has documented social patterning of health, such that those with lower social status (e.g., racial minorities, women, and people of lower socioeconomic status) bear a disproportionate burden of morbidity and mortality relative to those with higher status. Disparities may be larger for some individuals, particularly those who are socially disadvantaged in more than one status. Variations in stress exposure, like experiences of discrimination, and resulting low-grade inflammation, may explain such disparities. A limited body of literature has examined the social distribution of low-grade inflammation, which is implicated in chronic diseases that are responsible for excess deaths in the United States. Limited work has examined how social statuses might interact to predict inflammatory markers like C-reactive protein (CRP), or tested psychosocial mechanisms responsible for the social distribution of CRP. The present study will examine the relationship between race, gender, and SES; everyday and lifetime discrimination exposure; and CRP. Aim 1 will test whether an interaction of race, gender, and SES are associated with CRP levels. Aim 2 will assess how race, gender, and SES shape exposure to lifetime and everyday discrimination, and whether this discrimination exposure mediates the relationship between race x gender x SES and CRP. Data were drawn from 5,486 respondents in the Health and Retirement Study, a nationally representative sample of midlife and older adults, to analyze the relationships between social status (e.g., race, gender, SES), everyday discrimination, lifetime discrimination, and CRP levels at baseline and after a four-year follow-up. Aim 1 study results demonstrate that race, gender, and SES interact to produce differential CRP levels at baseline and follow-up. The results suggest that there are incremental benefits for each additional level of SES for all race and gender groups except Black women. Significant three-way interactions of race, gender, and SES also indicate that Black women experience higher CRP levels with increases in SES, and that Black men with low SES are have the highest levels of CRP. Aim 2 study results show that everyday and lifetime discrimination exposure varies across social status groups. However, there were no significant interactions among race, gender, and SES on discrimination exposure. Further, results showed that both everyday and lifetime exposure to discrimination were significantly associated with CRP levels at baseline but not with change in CRP over four years. In clarifying the complexity inherent in disparities in low-grade inflammation, as well as potential psychosocial mechanisms responsible for these mechanisms, this work will contribute to a greater understanding of the factors underlying major causes of excess morbidity and mortality in the United States, and may identify potential intervention points for addressing health disparities.

Citation Key10240