Poverty shapes the transcriptome of immune cells

Social determinants of health influence health outcomes and life expectancy. Specifically, individuals living in poverty often have adverse health outcomes related to chronic inflammation that affect the cardiovascular, renal, and pulmonary systems. However, the underlying mechanisms by which poverty increases the risk of disease and health disparities are still not fully understood. To bridge the gap in our understanding of the link between living in poverty and adverse health outcomes, we performed RNA sequencing of blood immune cells from 204 participants of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study in Baltimore City, Maryland. This study cohort included men and women self-identified as African American and White. We identified 581 genes differentially expressed in association with poverty. A larger number of differentially expressed genes were detected in women, compared to men, and 64 genes had distinct sex-by-poverty interaction effects. Genes differentially expressed in women living in poverty were enriched in wound healing and coagulation processes, while in men were mostly related to immunoglobulin production and humoral immune response. Of the genes differentially expressed in individuals living in poverty, 275 are also associated with complex diseases in transcriptome-wide association studies. Our results suggest that living in poverty influences inflammation and the risk for chronic disease through gene expression changes in immune cells, and that some of the effects of living in poverty are different in women and men.