Inflammation

A raised inflammation test can signal that something needs attention without saying what it is. ESR—the erythrocyte sedimentation rate—measures how far red blood cells settle in a column of blood over one hour. Inflammation can make them settle faster, but so can changes in the red cells themselves. A raised ESR is therefore a prompt to interpret the rest of the panel and the person's symptoms, not a diagnosis on its own (Brigden, Am Fam Physician, 1999).

That distinction matters in this sample. 22.2% of 7,914 ESR results were above the limits used here, roughly one in five. The limits are above 20 mm/hr for women and above 15 mm/hr for men. Women's reports and older reports are flagged more often, and raised ESR also appears more often alongside low haemoglobin in the women’s paired results, and alongside elevated blood sugar in the wider paired sample. Those patterns help explain what needs to be read together; they do not identify the cause of a raised result.

The distribution below shows the ESR readings themselves, using the same bands for everyone. Most were 20 mm/hr or below; 14.6% were above 20 to 40 mm/hr and 4.6% were above 40. These raw-value bands are different from the sex-specific flag used for the 22.2% headline.

All 7,914 reports. These raw-value bands use the same boundaries for everyone. The 22.2% flagged share instead uses above 20 mm/hr for women and above 15 mm/hr for men.

The sample counts laboratory reports from insured employees and covered family, not unique people. Flagged shares cannot be compared with 2025: that edition used above 30 mm/hr for everyone. Survey, claims and laboratory records are not linked person by person. Methodology.

Average ESR is almost exactly where the 2025 edition left it, on nearly four times the sample#

The average sedimentation rate barely moved between the two editions. It is the measure on this page that both editions computed the same way.

Each row compares one sex with its own figure from the previous edition. Both editions report averages for the reports they tested: 2,086 of them in 2025 and 7,914 here, 3.79 times as many.

Women's average is 19.2 mm/hr against 19.3, and men's is 8.5 against 8.8. Both are almost unchanged despite a much larger 2026 sample.

A third of women's results cross their limit, against one in eight men's#

34.0% of women's ESR reports were flagged, compared with 12.9% of men's.

The paired haemoglobin results show a further difference in flag rates. Among the women's reports that carried a haemoglobin result as well as an ESR:

3,402 of the 3,483 women's reports carried both results. The remaining 81 had no paired haemoglobin and are not in this table.

Haemoglobin was below 12 g/dL in 1,180 of the 3,402 paired reports from women (34.7%).

Flagged results were more than twice as common where the haemoglobin sat below the report's threshold for women. Because a reduced haematocrit speeds the fall of red cells on its own, a raised ESR in this group needs haemoglobin context.

Raised blood sugar is more common in reports with a flagged ESR#

Among reports with both test results, elevated blood sugar appeared in 48.2% of those with a flagged ESR, compared with 34.7% of those without. HbA1c reflects average blood glucose over the past three months; NIDDK puts normal below 5.7%, the prediabetes range at 5.7 to 6.4%, and the diabetes range at 6.5% or above, so 5.7% is the lower edge of the raised band. A result in a diagnostic range may need confirmation; these figures count test results, not confirmed diagnoses.

HbA1c is the blood-sugar marker the Blood Sugar page maps in full; across its own base of 7,088 HbA1c reports, 38.7% sit at or above 5.7%. The two groups here fall either side of that figure, the flagged group above and the unflagged group below, and the difference between them is 13.4 points.

Among men alone, on 3,224 paired male reports, the difference is wider rather than narrower: 51.3% against 34.3%, a difference of 17.0 points. The contrast is therefore also present within men, rather than only in the combined group. It does not hold haemoglobin constant within men, and neither comparison is adjusted for age.

The paired triglyceride results show a much smaller difference.

Strictly above 150 mg/dL, on the 6,717 reports carrying both an ESR and a triglyceride result.

The triglyceride shares differ by only 0.3 percentage points on the underlying counts, compared with 13.4 points for HbA1c. The two comparisons use overlapping but different sets of paired reports; the near-equal triglyceride shares do not establish that there is no association in the wider population.

The flagged share runs from one in six in the 20s to four in ten at 60 and above#

These five bands cover 7,840 of the 7,914 reports. A further 73 were under 20 and one carried no age. All shares use the same fixed thresholds, which do not rise with age.

The 20s through the 40s sit inside a narrow band, 16.7% to 21.8%, and the share then steps up at 50–59 and again at 60 and above. Blood sugar in this report moves differently: on its own base of HbA1c reports, the share at 5.7% or above reads 16.7% at 20–29, 33.0% at 30–39 and 52.9% at 40–49. The tested groups overlap but are not identical, and neither comparison follows people from one age band to the next. Side by side, the glucose share is already a third by the 30s while the ESR share is still close to where it started. The Age & Generation page collects the report's age comparisons for the other markers.

How much of the later step is in the rule rather than in the blood is not something this table can settle. This report applies the same limits at every age, above 20 mm/hr for women and above 15 for men. A standard clinical reference table sets exactly those upper limits for adults under 50 and raises them after 50, to 20 mm/hr for men and 30 mm/hr for women (Brigden, Am Fam Physician, 1999, Table 1). An older report here is being judged against the under-50 line. Separately, human aging is characterised by a chronic, low-grade inflammation, the pattern named inflammaging (Franceschi & Campisi, J Gerontol, 2014). The table does not separate the effect of the fixed limits from biological differences between the age groups.

The two sexes reach that late rise from very different levels.

Each sex is counted against its own limit, so the two columns are not a burden comparison. The same five bands as above, covering 7,840 reports.

Both shares rise across the five bands. The gap is widest at 40–49 and narrowest at 60 and above: men's share climbs after 50, from 11.6% in the 40s to 37.8% at 60 and above, while women's share is high from the start.

Delhi NCR leads the five metros at 30.7%, nearly double Pune#

Reports are placed in a metro by pincode. These five metros hold 6,934 of the 7,914 reports, 87.6% of this page's base. The remaining 980 sit outside these five buckets, in other named cities and in broad regional groupings, the largest of them holding 98 reports. None of those is ranked here.

Delhi NCR's flagged share is nearly double Pune's. Inside Delhi, 45.9% of 362 women's reports were flagged and 18.4% of 450 men's. The older groups are higher too: 51.9% of 104 reports at 50–59 and 55.1% of 69 at 60 and above.

This report records no measure of air quality, diet, occupation or access to care, so it cannot say why the metros differ. Exposure to fine particulate matter is associated with cardiovascular mortality and events, and credible biological mechanisms have been described for that association (Brook et al., Circulation, 2010), but that is literature about measured exposure, and exposure is not measured here. The Delhi NCR page carries the city's other markers.

Covered family members are flagged nearly twice as often as employees, and the gap survives the sex split#

"Dependent or other" is every covered relationship that is not the employee. The difference is 15.8 points. It does not run the same way on every marker, and Self vs Dependent sets out where it reverses.

About two thirds of the dependent reports are women, against about a third of the employee reports. Because women's flag rate is higher, this mix matters when reading the combined comparison. The split below shows that the family difference also occurs within each sex.

Inside each sex the family reports are still flagged more often, by 6.3 points among women and 13.7 among men. Neither comparison holds age constant, and a report exists only for someone who had the test, so these figures describe covered family members who were screened and say nothing about those who were not.