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Is Discrimination Related to Markers of Systemic Inflammation? A Systematic Review and Meta-analysis.

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    Discrimination is linked to higher systemic inflammation, a key factor in health inequities. This association varies based on how discrimination and inflammation are measured and study characteristics.

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    Area of Science:

    • Public Health
    • Social Epidemiology
    • Psychoneuroimmunology

    Background:

    • Discrimination is a significant social determinant of health, contributing to health inequities.
    • Understanding the physiological pathways, like systemic inflammation, linking discrimination to adverse health outcomes is crucial.
    • Existing research shows varied associations between discrimination and inflammation, necessitating a synthesis of findings.

    Purpose of the Study:

    • To systematically review and meta-analyze the association between discrimination and systemic inflammation.
    • To investigate how methodological and sample characteristics influence the discrimination-inflammation association.

    Main Methods:

    • A systematic review and meta-analysis of 47 articles, encompassing 161 effect sizes.
    • Meta-regressions using random effects models to estimate overall and subgroup effect sizes.

    Main Results:

    • A significant positive association was found between discrimination and systemic inflammation (r=0.087, P<0.001) in 74,763 participants.
    • The magnitude of the association varied by discrimination type, inflammatory marker (CRP, IL-6), and study methodology.
    • Racial/ethnic discrimination and statistical power were significant factors influencing the observed association.

    Conclusions:

    • Greater discrimination is consistently associated with higher levels of systemic inflammation.
    • Further theoretical and methodological advancements are needed to elucidate the precise mechanisms linking discrimination to physiological changes.