Race/Ethnic and Educational Disparities in the Association between Pathogen Burden and a Laboratory-Based Cumulative Deficits Index

Citation

Noppert, Grace A.; Aiello, Allison E.; O'Rand, Angela M.; & Cohen, Harvey Jay (2020). Race/Ethnic and Educational Disparities in the Association between Pathogen Burden and a Laboratory-Based Cumulative Deficits Index. Journal of Racial and Ethnic Health Disparities, 7(1), 99-108. PMCID: PMC6980710

Abstract

BACKGROUND: Disparities in adult morbidity and mortality may be rooted in patterns of biological dysfunction in early life. We sought to examine the association between pathogen burden and a cumulative deficits index (CDI), conceptualized as a pre-clinical marker of an unhealthy biomarker profile, specifically focusing on patterns across levels of social disadvantage.
METHODS: Using the data from the National Health and Nutrition Examination Survey 2003-2004 wave (aged 20-49 years), we examined the association of pathogen burden, composed of seven pathogens, with the CDI. The CDI comprised 28 biomarkers corresponding to available clinical laboratory measures. Models were stratified by race/ethnicity and education level.
RESULTS: The CDI ranged from 0.04 to 0.78. Nearly half of Blacks were classified in the high burden pathogen class compared with 8% of Whites. Among both Mexican Americans and other Hispanic groups, the largest proportion of individuals were classified in the common pathogens class. Among educational classes, 19% of those with less than a high school education were classified in the high burden class compared with 7% of those with at least a college education. Blacks in the high burden pathogen class had a CDI 0.05 greater than those in the low burden class (P < 0.05). Whites in the high burden class had a CDI only 0.03 greater than those in the low burden class (P < 0.01).
DISCUSSION: Our findings suggest there are significant social disparities in the distribution of pathogen burden across race/ethnic groups, and the effects of pathogen burden may be more significant for socially disadvantaged individuals.

URL

http://dx.doi.org/10.1007/s40615-019-00638-0

Reference Type

Journal Article

Year Published

2020

Journal Title

Journal of Racial and Ethnic Health Disparities

Author(s)

Noppert, Grace A.
Aiello, Allison E.
O'Rand, Angela M.
Cohen, Harvey Jay

Article Type

Regular

PMCID

PMC6980710

Data Set/Study

National Health and Nutrition Examination Survey (NHANES)

Continent/Country

United States of America

State

Nonspecific

Race/Ethnicity

Black
White
Mexican American
Hispanic/Latinx

ORCiD

Aiello - 0000-0001-7029-2537
Noppert - 0000-0002-2040-960x