Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, Essex CO4 3SQ, UK.
Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK.
Brain Behav Immun. 2017 Aug;64:91-102. doi: 10.1016/j.bbi.2017.03.012. Epub 2017 Mar 30.
Unemployment represents for many affected individuals a substantial source of psychosocial stress, and is linked to both increased risk of morbidity and mortality and adverse health-related behaviours. Few studies have examined the association of unemployment with systemic inflammation, a plausible mediator of the associations of psychosocial stress and health, and results are mixed and context dependent. This study examines the association of unemployment with C-reactive protein (CRP) and fibrinogen, two markers of systemic inflammation.
A random-effects meta-analysis was performed using a multilevel modelling approach, including 12 national UK surveys of working-age participants in which CRP and fibrinogen were measured between 1998 and 2012 (N=30,037 economically active participants). The moderating impact of participant age and UK country was explored.
CRP and fibrinogen were elevated in unemployed compared to employed participants; jobseekers were also more likely (Odds Ratio: 1.39, p<0.001) to have CRP levels corresponding to high cardiovascular risk (>3mg/L), after adjustment for age, gender, education, long-term illness, smoking, and body mass index. Associations were not explained by mental health. Associations peaked in middle-age, and were stronger in Scotland and Wales than in England.
Our study demonstrates that systemic inflammation is associated with an important but little-studied aspect of the social environment, as it is elevated in unemployed compared to employed survey participants. Modifications suggest the association of unemployment and inflammation is substantially influenced by contextual factors, and may be especially strong in Wales, where further investigation of this relationship is needed.
失业对许多受影响的个人来说是一个巨大的社会心理压力源，与发病率和死亡率的增加以及与健康相关的不良行为有关。很少有研究探讨失业与全身炎症之间的关系，全身炎症是心理社会压力与健康之间关联的一个合理的中介因素，结果是混杂的，并且取决于具体情况。本研究探讨了失业与 C 反应蛋白（CRP）和纤维蛋白原这两种全身炎症标志物之间的关系。
使用多层次建模方法进行随机效应荟萃分析，纳入了 1998 年至 2012 年间对英国工作年龄参与者进行的 12 项全国性调查，这些调查测量了 CRP 和纤维蛋白原（N=30037 名经济活跃参与者）。探讨了参与者年龄和英国国家的调节作用。
与就业参与者相比，失业者的 CRP 和纤维蛋白原水平升高；调整年龄、性别、教育程度、长期疾病、吸烟和体重指数后，求职者发生 CRP 水平对应高心血管风险（>3mg/L）的可能性也更高（优势比：1.39，p<0.001）。这些关联不能用心理健康来解释。关联在中年时达到峰值，在苏格兰和威尔士比在英格兰更强。
我们的研究表明，全身炎症与社会环境的一个重要但研究较少的方面有关，因为与就业调查参与者相比，失业者的全身炎症水平升高。这些修饰表明，失业与炎症之间的关联受到环境因素的显著影响，在威尔士可能尤其强烈，需要进一步研究这种关系。
