Unemployment and inflammatory markers in England, Wales and Scotland, 1998-2012: Meta-analysis of results from 12 studies

- Inflammatory markers were elevated for jobseekers in UK studies between 1998 and 2012.
- Elevations were net of education, health conditions and health behaviours.
- Associations were stronger in Wales and Scotland than in England.
- Associations were strongest for jobseekers aged 45-54.

IntroductionUnemployment 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.MethodsA 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.ResultsCRP 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 (>3 mg/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.ConclusionsOur 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.