Chronic Inflammation at the Intersection of Race and Ethnicity, Gender, and Socioeconomic Status: The Mediating Effects of Proximate Risk Factors as Composite Lifestyles

Aliza D. Richman, West Chester University
Elizabeth H. Baker, University of Alabama at Birmingham

This paper examines proximate risk factors as composite lifestyles in order to understand how common health behavioral patterns mediate the influence of intersecting social disadvantages on C-reactive protein (CRP) concentrations. Latent class analyses enable the identification of composite lifestyles based on obesity, abdominal obesity, insufficient physical activity, alcohol use, and smoking. Lifestyles characterized by obesity, abdominal obesity, insufficient physical activity, and abstaining from alcohol account for poor white, poor black, non-poor black, and non-poor Hispanic women’s elevated inflammation levels compared to non-poor white women. In the case of all male demographic subgroups as well as poor Hispanic women, inflammation disparities persist net of accounting for potentially unhealthy combinations of proximate risk factors. The extent to which latent classes explain elevated inflammation among intersecting demographic traits enables clinicians to understand how proximate risk factors cluster together to affect inflammation and identify which proximate risk factor may be most effective in creating parity in CRP levels among demographic subgroups.