The Causal Impact of Stress on Inflammation Over the Long-Term: Evidence From Exposure to a Natural Disaster

Elizabeth Frankenberg, University of North Carolina at Chapel Hill
Ralph Lawton, Duke University
Teresa E. Seeman, University of California, Los Angeles
Cecep Sumantri, SurveyMETER
Duncan Thomas , Duke University

We determine whether exposure to a large-scale high-stress exogenous shock has long term consequences for health as indicated by elevated levels of C-reactive protein (CRP), an acute-phase marker of inflammation. Using data on 7,000 respondents in the Study of the Tsunami Aftermath and Recovery who were living along coastal Aceh, we contrast CRP of those who were directly exposed to the devastation of the 2004 Indian Ocean earthquake and tsunami with comparable respondents who were not directly exposed. Exposure to the disaster, which is plausibly exogenous, is measured immediately after the tsunami. CRP is measured 13 years later using rigorously validated POCTs. We find that females and older males exposed to the shock are significantly more likely to present with elevated CRP (>3mg/dl) than those not exposed adjusting for age, gender and socio-economic status. Corroborating evidence implicating stress as the central mechanism is provided by parallel differences in adiposity.

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 Presented in Session 34. Biodemography, Health, and Mortality