Elevated C-reactive protein in children from risky neighborhoods: evidence for a stress pathway linking neighborhoods and inflammation in children

Stephanie T Broyles, Amanda E Staiano, Kathryn T Drazba, Alok K Gupta, Melinda Sothern, Peter T Katzmarzyk, Stephanie T Broyles, Amanda E Staiano, Kathryn T Drazba, Alok K Gupta, Melinda Sothern, Peter T Katzmarzyk

Abstract

Background: Childhood 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 results: The 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.

Conclusions: Children 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.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Variation in elevated C-reactive protein…
Figure 1. Variation in elevated C-reactive protein concentrations across neighborhood (census tract) poverty and crime.
Figure 2. Covariate-adjusted elevated C-reactive protein (CRP)…
Figure 2. Covariate-adjusted elevated C-reactive protein (CRP) concentrations across neighborhood (census tract) poverty and crime levels.
(A) Percent of children with elevated CRP in low, medium, and high crime neighborhoods, by low-medium poverty versus high poverty neighborhoods, and (B) percent of children with elevated CRP in low, medium, and high poverty neighborhoods, by low-medium crime versus high crime neighborhoods.

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