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Comparative Study
. 2019 Jan 28;9(1):796.
doi: 10.1038/s41598-018-37440-7.

A Comparative Analysis of the Status Anxiety Hypothesis of Socio-economic Inequalities in Health Based on 18,349 individuals in Four Countries and Five Cohort Studies

Richard Layte  1 , Cathal McCrory  2 , Cliona Ni Cheallaigh  3 , Nollaig Bourke  3 , Mika Kivimaki  4 , Ana Isabel Ribeiro  5 , Silvia Stringhini  6 , Paolo Vineis  7
Affiliations
Comparative Study

A Comparative Analysis of the Status Anxiety Hypothesis of Socio-economic Inequalities in Health Based on 18,349 individuals in Four Countries and Five Cohort Studies

Richard Layte et al. Sci Rep. .

Abstract

The status anxiety hypothesis proposes that systematic inflammation as a consequence of chronic psycho-social stress is a possible pathway linking socio-economic position (SEP) to premature ageing and is a possible explanation for cross-national variation in patterns of health and well-being. Harmonised data from the LIFEPATH consortium on 18,349 individuals aged 50 to 75 and 30,632 observations are used to measure variation in the association between inflammation measured as C-reactive protein and SEP across four countries (Britain, Ireland, Portugal and Switzerland) and five studies (ELSA, Whitehall II, TILDA, EPIPorto and SKIPOGH). Adjusting for population composition, mean concentrations of CRP are highest in Portugal, the country with the highest income inequality and lowest in Switzerland, a lower income inequality country. Across all of the studies, lower SEP groups have higher mean concentrations of CRP and, as predicted by the theory, absolute differentials between SEP groups reflect the pattern of societal income inequality. Adjustment for lifestyle indicators reduces SEP differentials by between 45% and 52% but cannot account for country variation in mean inflammation.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
GINI Coefficient (Income Inequality) by Year and Country.
Figure 2
Figure 2
Predicted Overall CRP Concentrations by Country and Age Trajectory, (mg/L).
Figure 3
Figure 3
(a) Predicted Absolute Differentials (Low SEP – High SEP) in CRP Concentration (mg/L) by Country and Age. (b) Predicted Absolute Differentials (Middle SEP – High SEP) in CRP Concentration (mg/L) by Country and Age.
Figure 4
Figure 4
(a) Predicted CRP Concentration by Class and Age Trajectory, (mg/L) Portugal. (b) Predicted CRP Concentration by Class and Age Trajectory, (mg/L) GB (Whitehall II). (c) Predicted CRP Concentration by Class and Age Trajectory, (mg/L) Switzerland. (d) Predicted CRP Concentration by Class and Age Trajectory, (mg/L) Ireland. (e) Predicted CRP Concentration by Class and Age Trajectory, (mg/L) GB (ELSA).
Figure 5
Figure 5
(a) Predicted Relative Differentials (Low SEP - High SEP) in CRP Concentration (mg/L) by Country and Age. (b) Predicted Relative Differentials (Middle SEP - High SEP) in CRP Concentration (mg/L) by Country and Age.
Figure 6
Figure 6
Predicted Reduction in Low/High SEP Differential by Adjustment of Lifestyle Factors by Country.
See this image and copyright information in PMC

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