Social Status and Susceptibility to Respiratory Infections

Adults and children of lower socioeconomic status (SES) are at higher risk for a wide range of communicable infectious diseases, especially respiratory infections. Greater risk for infectious illness among people with lower SES is thought to be attributable to increased exposure to infectious agents and decreased host resistance to infection. We summarize three studies that examine the prospective association of several markers of social status (unemployment, perceived and observed social status) with host resistance to upper respiratory infections. Unemployment was associated with increased susceptibility to infection in adult humans. Lower social status in male monkeys was also associated with increased susceptibility, as was lower perceived social status in humans. The association of social status and susceptibility was accounted for primarily by increased risk in the lowest social status groups. However, further increases in social status were associated with further decreases in susceptibility in both monkeys and humans.