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The Biology of Inequality

The Biology of Inequality

This research theme is led by Tony Robertson and investigates the biological mechanisms that link our social and economic circumstances and our health.
Social inequalities in health, with people experiencing progressively worse health with increasing deprivation, are present throughout the world. In Scotland, this inequality in life expectancy by deprivation (20% most deprived vs. 20% least deprived based on the Scottish Index of Multiple Deprivation) stands at 11 and 7.5 years for men and women, respectively. Inequalities in health are not only limited to mortality, with the incidence of physical and mental conditions being higher for individuals with lower socioeconomic position (SEP, measured by factors such as income, occupation, area of residence etc.), including most cancers, heart disease, diabetes, depression and multimorbidity. However, the underlying biological processes, linking poorer SEP and ill health are not well understood. Understanding the causal links between SEP and health throughout the lifecourse can help in the development of disease risk predictors and designing interventions that will be essential if inequalities are to be reduced in Scotland and elsewhere.
Given the wide range of conditions that vary by SEP, it has been proposed that there are some common biological pathways in how SEP can ’€˜get under the skin’€™. Through the exposure to behavioural, material and psychosocial factors that SEP results in, the body is put under demands/exposed to potential damage that it can adapt to/repair in the short-term. However, if these exposures persist, impairment of the normal regulatory mechanisms (referred to as dysregulation) and/or damage to cells, tissues and organs can occur. The ’€˜wear and tear’€™ on the body that will occur over long spells of such dysregulation/damage is typically irreversible, eventually increasing the risks of poor health and functioning.
The potential pathways focused on in this research theme include biological ageing (the rate at which our cells and organs deteriorate and lose function, measured by telomere length) and allostatic load (the cumulative physiological burden that occurs across several key physiological systems, measured by combining several biomarker measures into a single score). Specific projects include investigating the role of allostatic load in predicting morbidity and mortality; contextual effects in the association between SEP and allostatic load (age, sex, place, SEP measure); and the potential mediators acting between SEP and allostatic load (behavioural, material and psychological).


Robertson T, Benzeval M, Whitley E, Popham F. The role of material, psychological and behavioral factors in mediating the association between socioeconomic position and allostatic load. Brain, Behavior & Immunity 2014; e10.005. PDF (£0)
Robertson T, Popham F, Benzeval M. Socioeconomic inequalities in allostatic load across the lifecourse. BMC Public Health 2014; 4(1): 184. PDF (£0)
Robertson T, Benzeval M. Do mismatches between pre- and post-natal conditions influence adult physiological functioning? PLOS ONE. 2014; 9(1): e86953. PDF (£0)
 Gardner M, Robertson T et al (51 authors). Gender and telomere length: Systematic review and meta-analysis. Experimental Gerontology. 2014; 51: 15-27. PDF (£)
 Phillips AC, Robertson T, Carroll D, Der G, Shiels P, McGlynn L, Benzeval M. Symptoms of depression predict telomere length, but only in younger adults: Evidence from the West of Scotland Twenty-07 Study. Psychosomatic Medicine. 2013; 75(3):288-296. PDF (£)
 Robertson T, Batty GD, Der G, Fenton C, Shiels PG, Benzeval M. Is socioeconomic status associated with biological aging, as measured by telomere length? Epidemiologic Reviews 2013; 35(1): 98-111. PDF (£0)
 Der G, Batty GD, Benzeval M, Deary IJ, Green MJ, McGlynn L, McIntyre A, Robertson T, Shiels PG. Is telomere length a biomarker for aging: cross-sectional evidence from the West of Scotland? PLOS ONE 2012; 7:e45166. PDF (£0)
Robertson T, Batty GD, Der G, Green MJ, McGlynn LM, McIntyre A, Shiels PG, Benzeval M. Is telomere length socially patterned? Evidence from the West of Scotland Twenty-07 Study. PLOS ONE 2012; 7:e41805. PDF (£0)



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