Residing in Poverty and Enduring Chronic Inflammation Significantly Ups Heart Disease and Cancer Death Risk

Study Suggests Screening for Chronic Inflammation in Socially Disadvantaged Individuals

A new study led by Dr. Arch Mainous, a professor at the University of Florida, has suggested that clinicians might consider screening socially disadvantaged people for chronic inflammation, a known risk factor for disease and mortality.

The study, published in Frontiers in Medicine, analysed data from adults aged 40 and older, enrolled between 1999 and 2002 in the National Health and Nutrition Examination Survey (NHANES). The researchers classified participants into four groups based on the presence or absence of chronic inflammation and poverty.

Chronic inflammation was deduced from participants' plasma concentration of high sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation. Poverty was determined by calculating the "poverty index ratio", which is obtained by dividing participants' household income by the official poverty threshold.

The study considered a more stringent threshold of 1.0 mg/dl hs-CRP for chronic systemic inflammation. The results showed that participants with either inflammation or poverty alone had about a 50% increased risk in all-cause mortality. However, the combined effect of inflammation and poverty on mortality was synergistic, as the observed increases in mortality were much greater than what would be expected from the additive effects.

Individuals with both inflammation and poverty had a 127% increased heart disease mortality risk and a 196% increased cancer mortality risk.

Dr. Mainous concluded that guidelines panels should take up the issue to help clinicians integrate inflammation screening into their standard of care for patients at risk for chronic inflammation, including those living in poverty.

Poverty negatively affects physical and mental health, increasing the risk of mental illness, heart disease, hypertension, and stroke, and lowering life expectancy. In 2022, approximately 37.9 million people in the US, or 11.4% of the population, lived below the poverty line.

However, long-term use of anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids comes with risks, so more research will be needed before they are routinely prescribed to decrease systemic inflammation.

The NHANES, conducted since 1971 by the National Center for Health Statistics, tracks the health and nutritional status of US adults and children. The study by Dr. Mainous and colleagues is a significant step towards understanding the complex interplay between poverty and chronic inflammation and their impact on health and mortality.

Residing in Poverty and Enduring Chronic Inflammation Significantly Ups Heart Disease and Cancer Death Risk