Socioeconomic status discrimination and C-reactive protein in African American and White adults

Objectives: We examined the association between socioeconomic status (SES) discrimination and C-reactive protein (CRP) in a biracial cohort of middle-aged adults using an intersectionality framework. Methods: Participants were 401 African-American and White adults from a population-based cohort in the Southeastern United States. SES discrimination was self-reported with a modified Experiences of Discrimination Scale, and CRP levels were assayed from blood samples. Linear regression analyses were used to examine the associations among SES discrimination, race, education, and CRP after controlling for age, gender, racial and gender discrimination, financial and general stress, body mass index, smoking, sleep quality, and depressive symptoms. Intersectional effects were tested using race x SES discrimination, education x SES discrimination and race x education x SES discrimination interactions. Results: Adjusting for sociodemographics, racial discrimination, gender discrimination, and all relevant two-way interaction terms, we observed a significant race x education x SES discrimination interaction (p = 0.019). In adjusted models stratified by race and education, SES discrimination was associated with elevated CRP among higher educated African-Americans (beta = 0.29, p = 0.018), but not lower educated African-Americans (beta = -0.13, p = 0.32); or lower educated (beta = -0.02, p = 0.92) or higher educated (beta = - 0.01, p = 0.90) Whites. Conclusions: Findings support the relevance of SES discrimination as an important discriminatory stressor for CRP specifically among higher educated African-Americans.