Socioeconomic status, psychosocial stress, and cellular ageing

Lead Research Organisation: University College London
Department Name: Epidemiology and Public Health

Abstract

Health varies with social class, and people in affluent sectors of society generally live longer and remain healthier than less privileged groups. Socioeconomic inequalities in health have become a major concern to health professionals and the public at large. There is an urgent need to understand how social factors are translated into disease risk. Psychosocial factors such as job stress, financial strain, social isolation and depression also contribute to risk of physical illness, and are more common in adults of lower socioeconomics status. It is possible that lower social status and exposure to chronic life stress stimulate faster ageing, and that this is one reason why they contribute to disease risk. Our project will test the hypothesis that lower socioeconomic position and chronic life stress lead to more rapid biological ageing by measuring the telomeres in the nuclei of cells. This is an interdisciplinary collaboration involving epidemiology, psychology and cell biology. The study will involve middle aged and older men and women who are part of the Whitehall II epidemiological cohort, a sample of British Civil servants who have been monitored for the part 20 years by Professor Marmot and his research group. They will have their telomeres measured, and assessments will be made of their cardiovascular and inflammatory responses to stress, subclinical cardiovascular disease, and oxidative stress. We expect that lower socioeconomic position and life stress will be related to a level of cellular ageing characteristic of an older person, and that these effects will be related to greater inflammatory stress responses. The study will deepen our understanding of the biological pathways through which life experience influences physical health, while pointing to new preventive and therapeutic avenues that might be explored in order to reduce socioeconomic health inequalities in the future.

Technical Summary

Lower socioeconomic status (SES) and chronic psychosocial stress are associated with a range of adverse health outcomes, including coronary heart disease, type 2 diabetes and onset of disability. One reason may be that lower SES and chronic stress accelerate biological ageing. Telomerase activity and telomere length are markers of cellular ageing. This study will test the hypothesis that lower SES and psychosocial adversity (chronic stress and low social resources) are associated with reduced telomerase activity and shorter telomeres independently of chronological age. Our study will also investigate mediating mechanisms, predicting that lower SES and psychosocial adversity are related to oxidative stress and to heightened inflammatory responses to stress.

These hypotheses will be tested in a study currently in progress involving 660 men and women aged 58-72 years recruited from the Whitehall II epidemiological cohort. Participants are being systematically sampled by SES to compare higher, intermediate and lower status groups. Each person undergoes laboratory psychophysiological testing in which biological responses to standardised challenges are assessed. Blood pressure, heart rate variability, cortisol, lipids, C-reactive protein, interleukin (IL) 6 and IL-1a, and fibrinogen stress responsivity are recorded. Measures of chronic stress exposure (e.g. financial strain, marital conflict, family stress), social relationships (social support, networks, neighbourhood cohesion), psychological factors (e.g. depression, hostility, optimism) and lifestyle are being obtained. All participants undergo electron beam computed tomography (EBCT) for the assessment of coronary artery calcification as a marker of subclinical coronary disease.

This application is for funding to add the collection and analysis of peripheral blood mononuclear cells to the protocol so as to assess telomerase activity and telomere length, together with measures of oxidative stress and chemokines (MCP-1 and RANTES). These variables will allow us to discover whether SES differences in cellular ageing are present, and whether differences are associated with heightened oxidative stress and inflammatory stress responses, with subclinical coronary disease and with psychosocial adversity. The addition of these assessments to an existing study will permit these issues to be investigated at relatively low cost. Involvement of the Whitehall II cohort will ensure that participants are well characterised in terms of clinical, psychosocial and biological risk, and that disease incidence will be tracked into the future. The results will deepen our understanding of the impact of social and psychological factors on physiological function and physical disease risk, opening new avenues for prevention.

Publications

10 25 50

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Allen J (2014) Social determinants of mental health. in International review of psychiatry (Abingdon, England)

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Baum F (2014) Evaluation of Health in All Policies: concept, theory and application. in Health promotion international

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Boseley S (2008) Michael Marmot: leader in the social determinants of health. in Lancet (London, England)

 
Title Telomeres 
Description Measures of telomere length and telomerase activity in a subset of the Whitehall II epidemiological cohort 
Type Of Material Database/Collection of Data/Biological Samples 
Year Produced 2010 
Provided To Others? Yes  
Impact The material is being used by researchers in teh core Whitehall II research group to carry out further analyses 
 
Description Psychosocial factors and telomere length 
Organisation University of California, San Francisco
Department Department of Biochemistry and Biophysics
Country United States 
Sector Academic/University 
PI Contribution Bringing together our group working on biology and stress with Professor Elizabeth Blackburn (Nobel laureate in 2009) and her group on telomere length and telomerase activity
Collaborator Contribution Intellectual collaboraion of great value
Impact Two papers so far, as detailed in publications
Start Year 2008
 
Description Andrew Steptoe - CCACE 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited presentation: Psychobiology of health and disease. Centre for Cognitive Aging and Cognitive Epidemiology, University of Edinburgh.

N/A
Year(s) Of Engagement Activity 2014
 
Description Andrew Steptoe - ESRC 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact ESRC International Centre for Life Course Studies in Society and Health. Social-biological transitions.

Not applicable.
Year(s) Of Engagement Activity 2012
 
Description Andrew Steptoe - Economics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Department of Economics, Peking University, Beijing, China. Psychological wellbeing and health in the ageing population.

Not applicable.
Year(s) Of Engagement Activity 2012
 
Description Andrew Steptoe - Happiness 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Workshop on Happiness, Earth Institute, Columbia University. Psychological wellbeing and Health.

Not applicable.
Year(s) Of Engagement Activity 2012
 
Description Andrew Steptoe - IZA 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact IZA Workshop: Sources of welfare and wellbeing. Wellbeing and health: an epidemiological perspective.

Not applicable.
Year(s) Of Engagement Activity 2011
 
Description Andrew Steptoe - Singapore 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact National University of Singapore. Stress and the ageing process.

Not applicable.
Year(s) Of Engagement Activity 2012
 
Description Steptoe - Behav Med 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Academy of Behavioural Medicine Research, Monterey, CA. Invited presentation. ELSA.

N/A
Year(s) Of Engagement Activity 2013
 
Description Steptoe - Keio 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Keio University, Tokyo. Invited presentation. Social factors in health and ageing.

N/A
Year(s) Of Engagement Activity 2013
 
Description Steptoe - SIPNEI 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact SIPNEI, Orvieto, Italy. Keynote presentation. Stress and psychosocial determinants of health.

N/A
Year(s) Of Engagement Activity 2013