Background Disparities in chronic systemic inflammation among black and white women and men are well documented. However, while chronic stress domains such as discrimination and financial strain, as well as socioeconomic factors such as education, have all been linked to inflammation, more research is needed to clarify how these social determinants influence each other and contribute to inflammation. Guided by the Stress Process Model and Intersectionality, this present study assessed the mediating role of both discrimination and financial strain in the relationship between race-gender groups and inflammation (measured as elevated CRP levels). This research also examined if the potential indirect effects of discrimination and financial strain were contingent on the educational level of black and white men and women with the United States.
Methods This secondary analysis focused on an analytic sample (ages 25–74) of black and white men and women (n=775) from the Midlife in the United States (MIDUS) Biomarkers Project (2004–2009). SPSS version 24 and PROCESS macro were used to test all mediation and moderated mediation analyses.
Results Separate mediation analyses revealed that after adjusting for age and when compared to the reference category (white men), both financial strain and daily discrimination mediated the relationship between race-gender (black men, black women, and white women) and inflammation (CRP levels). That is, self-identifying as a black man, white woman, or black woman positively influenced perceptions of both everyday discrimination and financial strain, which in turn contributed to increased levels of CRP. However, when both mediators were included in the mediation model, discrimination was only significant among black men. Results of the first moderated mediation analysis indicated that the indirect effect among black men on inflammation through discrimination was significantly stronger for black men educated beyond high school. Findings from the second moderated mediation analysis findings suggested that education significantly moderated the indirect effect of race-gender on inflammation through financial strain. While this indirect effect was stronger for black men and white women with a high school degree or less; conversely, the effect was stronger for black women with educational levels that exceeded high school.
Conclusion This study contributes to the literature on inflammation by further illuminating the social determinants and social patterning of inflammation among black and white women and men within the United States.
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