Abstract
BackgroundChildhood socioeconomic status is linked to adult cardiovascular disease and disease risk. One proposed pathway involves inflammation due to exposure to a stress-inducing neighborhood environment. Whether CRP, a marker of systemic inflammation, is associated with stressful neighborhood conditions among children is unknown.Methods and ResultsThe sample included 385 children 5–18 years of age from 255 households and 101 census tracts. Multilevel logistic regression analyses compared children and adolescents with CRP levels >3 mg/L to those with levels ≤3 mg/L across neighborhood environments. Among children living in neighborhoods (census tracts) in the upper tertile of poverty or crime, 18.6% had elevated CRP levels, in contrast to 7.9% of children living in neighborhoods with lower levels of poverty and crime. Children from neighborhoods with the highest levels of either crime or poverty had 2.7 (95% CI: 1.2–6.2) times the odds of having elevated CRP levels when compared to children from other neighborhoods, independent of adiposity, demographic and behavioral differences.ConclusionsChildren living in neighborhoods with high levels of poverty or crime had elevated CRP levels compared to children from other neighborhoods. This result is consistent with a psychosocial pathway favoring early development of cardiovascular risk that involves chronic stress from exposure to socially- and physically-disordered neighborhoods characteristic of poverty.
Highlights
In adults, low socioeconomic status (SES) has been consistently linked to higher cardiovascular disease (CVD) risk. [1,2] growing evidence links low SES to prevalence of the metabolic syndrome (MetS) [3,4,5,6,7] and incidence of Type II diabetes, [8,9,10,11,12] risk factors for CVD
Children living in neighborhoods with high levels of poverty or crime had elevated C-reactive protein (CRP) levels compared to children from other neighborhoods
These behaviors are associated with low childhood SES. [16,17] it is not surprising that low childhood SES has been implicated in the development of adult metabolic syndrome [7], diabetes [10], and CVD [18,19]
Summary
Low socioeconomic status (SES) has been consistently linked to higher cardiovascular disease (CVD) risk. [1,2] growing evidence links low SES to prevalence of the metabolic syndrome (MetS) [3,4,5,6,7] and incidence of Type II diabetes (diabetes), [8,9,10,11,12] risk factors for CVD. Low SES may influence disease risk through behavioral pathways involving poor diet, [13] physical inactivity, [14] and smoking, [15] which often begin in childhood. [20,27,28,29,30] exposure to a stressful neighborhood environment may be an important aspect of poverty’s influence on CVD risk Consistent with this pathway, studies in adults have noted relationships between obesity, [31] diabetes incidence, [32] and heart disease [33,34] with negative aspects of the neighborhood environment (negative perceptions, [32] neighborhood unemployment and crime, [33], and an index of neighborhood psychosocial stress that includes area SES in its measure [31,34]). Whether CRP, a marker of systemic inflammation, is associated with stressful neighborhood conditions among children is unknown
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