High Social Risk and Biomarkers of Systemic Inflammation: A Population-Based Study in Middle-Aged and Older Adults Living in Rural Communities.

Abstract

Background: The association between social risk and biomarkers of inflammation remains underexplored in low-resource communities, where social risk and levels of inflammation differ from those in industrialized urban centers. This study aims to assess the association between levels of social risk and biomarkers of inflammation in adults residing in remote rural settings.

Methods: This population-based, cross-sectional study involved 1392 community-dwellers aged ≥40 years. Social risk was assessed using the social determinants of health (SDH) included in Gijon's Social Familial Evaluation Scale (SFES). Biomarkers of inflammation were measured through the Systemic Immune-Inflammation Index (SII) and the C-Reactive Protein (CRP)/albumin ratio. Both unadjusted and multivariate models were fitted to determine the independent association between SDH and biomarkers of inflammation, treated as dependent variables.

Results: The mean (±SD) age of 1392 study participants was 53.8 ± 11.5 years (59% women). The mean Gijon's SFES score was 10.1 ± 2.6 points, the mean SII was 451.6 ± 240.5 × 10⁹ L, and the mean CRP/albumin ratio was 0.13 ± 0.29. Unadjusted generalized linear regression models demonstrated direct significant associations between SDH scores and both dependent variables, including SII (β: 6.12; 95% CI: 1.35-10.89) and the CRP/albumin ratio (β: 0.03; 95% CI: 0.01-0.05). These associations remained significant after adjusting for demographics, level of education, and cardiovascular risk factors for both, the SII (β: 7.24; 95% CI: 2.08-12.41) and the CRP/albumin ratio (β: 0.03; 95% CI: 0.01-0.05).

Conclusions: Social risk is directly associated with biomarkers of inflammation in the study population, suggesting that inflammation may be associated with adverse health outcomes in individuals with high social risk. Study results demonstrate that this association is not only evident in high-income regions but in underserved rural communities as well.