Background Poor self-rated health (SRH) and elevated inflammation and morbidity and mortality are robustly associated in middle- and older-aged adults. Less is known about SRH-elevated inflammation associations during young adulthood and whether these linkages differ by sex. Methods Data came from the National Longitudinal Study of Adolescent Health. At Wave IV, young adults aged 24–34 reported their SRH, acute and chronic illnesses, and sociodemographic and psychological characteristics relevant to health. Trained fieldworkers assessed medication use, BMI, waist circumference, and also collected bloodspots from which high-sensitivity CRP (hs-CRP) was assayed. The sample size for the present analyses was N=13,236. Results Descriptive and bivariate analyses revealed a graded association between SRH and hs-CRP: Lower ratings of SRH were associated with a higher proportion of participants with hs-CRP > 3 mg/L and higher mean levels of hs-CRP. Associations between SRH and hs-CRP remained significant when acute and chronic illnesses, medication use, and health behaviors were taken into account. When BMI was taken into account, the association between SRH and hs-CRP association fully attenuated in females; a small, but significant association between SRH and hs-CRP remained in males. Conclusion Poor SRH and elevated hs-CRP are associated in young adults, adjusting for other health status measures, medication use, and health behavior. In males, SRH provided information about elevated hs-CRP that was independent of BMI. In females, BMI may be a better surrogate indicator of global health and pro-inflammatory influences compared to SRH.

Background Cases with very high C-reactive protein (CRP > 10 mg/l) are often dropped from analytic samples in research on risk for chronic physical and mental illness, but this convention could inadvertently result in excluding those most at risk. We tested whether young adults with very high CRP scored high on indicators of chronic disease risk. We also tested intergenerational pathways to and sex-differentiated correlates of very high CRP. Methods Data came from Waves I (ages 11–19) and IV (ages 24–34) of the National Longitudinal Study of Adolescent Health (N=13,257). At Wave I, participants’ parents reported their own education and health behaviors/health. At Wave IV, young adults reported their socioeconomic status, psychological characteristics, reproductive/health behaviors and health; trained fieldworkers assessed BMI, waist circumference, blood-pressure, and medication use, and collected bloodspots from which high-sensitivity CRP (hs-CRP) was assayed. Results Logistic regressions revealed that many common indicators of chronic disease risk—including parental health/health behaviors reported 14 years earlier—were associated with very high CRP in young adults. Several of these associations attenuated with the inclusion of BMI. More than 75% of young adults with very high CRP were female. Sex differences in associations of some covariates and very high CRP were observed. Conclusion Especially among females, the exclusion of very high CRP cases could result in an underestimation of “true” associations of CRP with both, chronic disease risk indicators and morbidity/mortality. Very high CRP could represent an extension of the lower CRP range when it comes to chronic disease risk.

Objective In middle-aged and older samples, perceived subjective socioeconomic status (SSS) is a marker of social rank that is associated with elevated inflammation and cardiovascular disease risk independent of objective indicators of socioeconomic status (oSES). Whether SSS is uniquely associated with elevated inflammation during young adulthood and whether these linkages differ by sex has not been studied using a nationally representative sample of young adults. Methods Data came from the National Longitudinal Study of Adolescent to Adult Health. At Wave IV, young adults, aged mostly 24-32 years old, reported their SSS, oSES, and a range of covariates of both SES and elevated inflammation. Trained fieldworkers assessed medication use, body mass index, and waist circumference, and also collected bloodspots from which high-sensitivity C-reactive protein (hs-CRP) was assayed. The sample size for the present analyses was N=13,236. Results Descriptive and bivariate analyses revealed a graded association between SSS and hs-CRP (b=-.072, SE=.011, p< .001): As SSS declined, mean levels of hs-CRP increased. When oSES indicators were taken into account, this association was no longer significant in women (b=-.013, SE=.019 p=.514). In men, a small but significant SSS-hs-CRP association remained after adjusting for oSES indicators and additional potential confounders of this association in the final models (b=-.034, SE=.011 p= .003; p< .001 for the sex x SSS interaction). Conclusion SSS is independently associated with elevated inflammation in young adults. The associations were stronger in men than in women. These data suggest that subjective, global assessments of social rank might play a role in developing adverse health outcomes.