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Metabolic disorders
Economic insecurity during the Great Recession and metabolic, inflammatory and liver function biomarkers: analysis of the UK Household Longitudinal Study
  1. Claire L Niedzwiedz1,
  2. Srinivasa Vittal Katikireddi2,
  3. Aaron Reeves3,
  4. Martin McKee4,
  5. David Stuckler5
  1. 1 Department of Sociology, University of Oxford, Oxford, UK
  2. 2 MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  3. 3 International Inequalities Institute, London School of Economics and Political Science, London, UK
  4. 4 Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
  5. 5 Department of Policy Analysis and Public Management, University of Bocconi, Milan, Italy
  1. Correspondence to Dr Claire L Niedzwiedz, Department of Sociology, University of Oxford, Oxford, OX1 3UQ UK; claire.niedzwiedz{at}sociology.ox.ac.uk

Abstract

Background Economic insecurity correlates with adverse health outcomes, but the biological pathways involved are not well understood. We examine how changes in economic insecurity relate to metabolic, inflammatory and liver function biomarkers.

Methods Blood analyte data were taken from 6520 individuals (aged 25–59 years) participating in Understanding Society. Economic insecurity was measured using an indicator of subjective financial strain and by asking participants whether they had missed any bill, council tax, rent or mortgage payments in the past year. We investigated longitudinal changes in economic insecurity (remained secure, increase in economic insecurity, decrease in economic insecurity, remained insecure) and the accumulation of economic insecurity. Linear regression models were calculated for nine (logged) biomarker outcomes related to metabolic, inflammatory, liver and kidney function (as falsification tests), adjusting for potential confounders.

Results Compared with those who remained economically stable, people who experienced consistent economic insecurity (using both measures) had worsened levels of high-density lipoprotein (HDL)-cholesterol, triglycerides, C reactive protein (CRP), fibrinogen and glycated haemoglobin. Increased economic insecurity was associated with adverse levels of HDL-cholesterol (0.955, 95% CI 0.929 to 0.982), triglycerides (1.077, 95% CI 1.018 to 1.139) and CRP (1.114, 95% CI 1.012 to 1.227), using the measure of financial strain. Results for the other measure were generally consistent, apart from the higher levels of gamma-glutamyl transferase observed among those experiencing persistent insecurity (1.200, 95% CI 1.110 to 1.297).

Conclusion Economic insecurity is associated with adverse metabolic and inflammatory biomarkers (particularly HDL-cholesterol, triglycerides and CRP), heightening risk for a range of health conditions.

  • Social Epidemiology
  • Social Inequalities
  • Socio-Economic

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/jech-2017-209105

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    Footnotes

    • Contributors CLN led the conceptualisation, design, analysis and interpretation of results, with assistance from SVK, AR, MM and DS. CLN drafted the manuscript, and all authors commented on the drafts and approved the final version.

    • Funding CLN and DS are funded by a Wellcome Trust Award: 100709/Z/12/Z. DS is also funded by an ERC Grant 313590-HRES. AR is supported by the Joseph Rowntree Foundation. SVK isfunded by an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the UK Medical Research Council (MC_UU_12017/13 and MC_UU_12017/15) and the ScottishGovernment Chief Scientist Office (SPHSU13 and SPHSU15).

    • Competing interests None declared.

    • Ethics approval The Understanding Society study was approved by the University of Essex Ethics Committee and the National Research Ethics Service. No additional ethical approval was necessary for this secondary data analysis.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Understanding Society data are available from the UK Data Service.