Plasma C reactive protein concentration indicates a direct relation between systemic inflammation and social deprivation

Social deprivation is a major factor in health inequality. In the UK residence in a socially deprived area is associated with an increase in mortality from coronary heart disease (CHD).1 A positive association between the incidence of CHD and residence in a socially deprived neighbourhood has also been observed in the USA.2 Inflammation is important in the development of atherosclerosis, plaque rupture, and thrombosis leading to myocardial infarction. An increase in the plasma concentration of C reactive protein (CRP), within the reference range for the population but below the threshold that indicates clinically significant inflammation, is an independent risk factor for CHD.3 It is also a predictor for the development of diabetes mellitus4—a major cause of vascular disease. We have investigated the relation between the plasma CRP concentration and social deprivation in two large study populations. CRP was measured by an enzyme linked immunoassay, with a lower limit of the working range of 0.1 mg/l, calibrated with the international reference standard (CRM 470-CAP/IFCC; lot 91/0619) and thus yielded results comparable with other major studies.3 CRP measurements were available for 5245 men aged 45–64 years on recruitment in 1989–91 to the WOSCOPS (West of Scotland coronary prevention study).4 The second population were men (n  =  941) and women (n  =  …