Variation in size of red cell distribution width is linked with socioeconomic factors

It is well known that socioeconomic factors such as poverty and low education play a role in health, but new research released today at the American Public Health Association's 140th Annual Meeting in San Francisco, Calif., shows this association is also seen in biomarkers of the blood.

New research suggests that the variation in size of red blood cells known as "red cell distribution width," (RDW) most recently used as a predictor of hospitalization outcomes and mortality, is now linked back to social causes.

After controlling for a number of factors, including age, gender, body mass index and history of smoking or disease, results show that those with low education are nearly one and a half times more likely to have high RDW. Those living below 100 percent of the federal poverty level are nearly twice as likely to have high RDW. African Americans are at higher risk of high RDW than whites, and people who have never been married are more likely to have high RDW. In addition, with each increase in the amount of social resources people have, there is a corresponding decrease in risk of having high RDW.

"We've known for years that low education and low income affect myriad health outcomes, but now we are seeing this relationship at the cellular level," said Matthew Pantell, MS, at UC Berkeley and UCSF, and presenter at APHA's Annual Meeting. "We're seeing how social disadvantages and influences can get under the skin and impact health unlike we've shown before."

The findings emerge from 1999-2010 data from the National Health and Nutrition Examination Surveys, which included 13,460 adults aged 45 or older. The research was conducted at the National Institutes of Health at the National Institute on Aging.

APHA's 140th Annual Meeting is themed "Prevention and Wellness Across the Lifespan" and will focus on the importance of environmental, social and behavioral issues that impact health at all stages of life.