title: Elevated inflammatory biomarkers during unemployment: modification by age and country in the UK.
abstract: BACKGROUND
  There is raised risk of mortality following unemployment, and reviews have consistently found worse psychological health among the unemployed. Inflammation is increasingly implicated as a mediating factor relating stress to physical disease and is strongly linked to depression. Inflammation may, therefore, be implicated in processes associated with excess mortality and morbidity during unemployment. This study examined associations of unemployment with inflammatory markers among working-age men and women from England and Scotland.
  
  
  METHODS
  Cross-sectional analyses using data from the Health Survey for England and the Scottish Health Survey collected between 1998 and 2010. Systemic inflammation was indexed by serum concentrations of C reactive protein (CRP) and fibrinogen, and compared between participants currently employed/self-employed, currently unemployed and other groups.
  
  
  RESULTS
  CRP, fibrinogen and odds of CRP >3 mg/L were all significantly raised for the unemployed, as compared to the employed participants (eg, OR for CRP >3 mg/L=1.43, CI 1.15 to 1.78 N=23 025), following adjustment for age, gender, occupational social class, housing tenure, smoking, alcohol consumption, body mass index, long-term illness and depressive/anxiety symptoms. Strengths of associations varied considerably by both age and country/region, with effects mainly driven by participants aged ≥48 and participants from Scotland, which had comparatively high unemployment during this time.
  
  
  CONCLUSIONS
  Current unemployment is associated with elevated inflammatory markers using data from two large-scale, nationally representative UK studies. Effect modification by age suggests inflammation may be particularly involved in processes leading to ill-health among the older unemployed. Country/regional effects may suggest the relationship of unemployment with inflammation is strongly influenced by contextual factors, and/or reflect life course accumulation processes.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hughes
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: McMunn
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Mel
authors.initials: M
authors.lastname: Bartley
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK Institute for Social and Economic Research, University of Essex, Colchester, UK.
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000523:psychology; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009790:Occupations / Q000145:classification; D012606:Scotland / Q000453:epidemiology; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D012923:Social Class; D013315:Stress, Psychological / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D014478:Unemployment / Q000523:psychology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: Molecular Epidemiology; Social and life-course epidemiology; UNEMPLOYMENT