Allostatic load in an environmental riskscape: the role of stressors and gender

ALLOSTATIC LOAD AND SOCIOECONOMIC STATUS IN POLISH ADULT MEN

This study considers the relationship between a cumulative index of biological dysregulation (allostatic load) and several dimensions of socioeconomic status (SES) and lifestyle in adult Polish males. The extent to which lifestyle variables can explain SES variation in allostatic load was also evaluated. Participants were 3887 occupationally active men aged 25–60 years living in cities and villages in the Silesia region of Poland. The allostatic load indicator included eleven markers: % fat (adverse nutritional intake), systolic and diastolic blood pressures (cardiovascular activity), FEV1 (lung function), erythrocyte sedimentation rate (inflammatory processes), glucose and total cholesterol (cardiovascular disease risk), total plasma protein (stress-haemoconcentration), bilirubin, creatinine clearance and alkaline phosphatase activity (hepatic and renal functions). A higher level of completed education, being married and residing in an urban area were associated with lower physiological dysregulation. The association between indicators of SES and allostatic load was not eliminated or attenuated when unhealthy lifestyle variables were included in the model. Smoking status and alcohol consumption played minimal roles in explaining the association between SES and allostatic load; physical activity, however, had a generally protective effect on allostatic load.

Switching Dynamics and the Stress Process

This paper shows how maintaining social relationships can be a daily hassle that has implications for the stress process, depending on how often individuals transition, or "switch," between their various social roles and social settings throughout the day. I use nationally representative time diary data on 7,662 respondents from the 2010 American Time Use Survey to measure individual rates of this switching behavior and to examine how this relates to perceived stress. Regression analysis shows that, net of how many social roles they play and settings they visit on a given day, individuals who switch more frequently between these elements report higher levels of stress. This finding holds for women but not men, suggesting that switching dynamics are disproportionately stressful for women. I close by discussing the implications of the findings for research on gender and health.

The influence of urban natural and built environments on physiological and psychological measures of stress--a pilot study

Environments shape health and well-being, yet little research has investigated how different real-world environmental settings influence the well-known determinant of health known as stress. Using a cross-over experimental design; this pilot study investigated the effect of four urban environments on physiological and psychological stress measures. Participants (N = 15) were exposed on separate days to one of the four settings for 20 min. These settings were designated as Very Natural; Mostly Natural; Mostly Built and Very Built. Visitation order to the four settings was individually randomized. Salivary cortisol and alpha-amylase; as well as self-report measures of stress; were collected before and after exposure to each setting. Gender was included as a variable in analysis; and additional data about environmental self-identity, pre-existing stress, and perceived restorativeness of settings were collected as measures of covariance. Differences between environmental settings showed greater benefit from exposure to natural settings relative to built settings; as measured by pre-to-post changes in salivary amylase and self-reported stress; differences were more significant for females than for males. Inclusion of covariates in a regression analysis demonstrated significant predictive value of perceived restorativeness on these stress measures, suggesting some potential level of mediation. These data suggest that exposure to natural environments may warrant further investigation as a health promotion method for reducing stress.

Segregation and cardiovascular illness: the role of individual and metropolitan socioeconomic status

Demographic and epidemiologic research suggest that cardiovascular illness is negatively linked to socioeconomic status and positively related to racial residential segregation. Relying on 2005 data from the Behavior Risk Factor Surveillance Survey and the American Community Survey, this study examines how segregation and SES (individual and metropolitan) impact hypertension for a sample of 200,102 individuals. Multilevel analyses indicate that both segregation and hypersegregation are associated with hypertension, net of individual and spatial SES. While individual and metropolitan SES have independent effects on hypertension, these effects also differ across segregation type. In segregated and hypersegregated environments, highly educated and high-earning individuals seem to be protected against hypertension. In extremely hypersegregated areas, areas where there is very little interaction with non-black residents, SES does not have any protective benefit. These findings reveal that SES has differential effects across segregation types and that hypertension in disadvantaged (extremely hypersegregated) areas may be a function of structural constraints rather than socioeconomic position.

A Systematic Review of Allostatic Load, Health, and Health Disparities

The theoretical constructs of allostasis and allostatic load (AL) have contributed to our understanding of how constantly changing social and environmental factors impact physiological functioning and shape health and aging disparities, particularly along socioeconomic, gendered, racial, and ethnic lines. AL represents the cumulative dysregulation of biological systems with prolonged or poorly regulated allostatic responses. Nearly two decades of empirical research has focused on operationalizing the AL construct for examining the antecedents and health outcomes accompanying multisystem biological dysregulation. The purpose of this systematic review is to examine the empirical literature that quantifies the AL construct; the review also evaluates the social, environmental, and genetic antecedents of AL as well as its predictive utility for a variety of health outcomes. A total of 58 articles published between 1997 and 2012 were retrieved, analyzed, and synthesized. The results revealed considerable heterogeneity in the operationalization of AL and the measurement of AL biomarkers, making interpretations and comparisons across studies challenging. There is, however, empirical substantiation for the relationships between AL and socioeconomic status, social relationships, workplace, lifestyle, race/ethnicity, gender, stress exposure, and genetic factors. The literature also demonstrated associations between AL and physical and mental health and all-cause mortality. Targeting the antecedents of AL during key developmental periods is essential for improving public health. Priorities for future research include conducting prospective longitudinal studies, examining a broad range of antecedent allostatic challenges, and collecting reliable measures of multisystem dysregulation explicitly designed to assess AL, at multiple time points, in population-representative samples.

Update and review of racial disparities in sepsis

BACKGROUND

Sepsis is an excessive systemic inflammatory response activated by invasive infection. There has been substantial epidemiologic literature addressing perceived disparities in sepsis by demographic factors such as gender and race. There also have been multiple examinations of the disparities of sepsis with regard to environmental and socioeconomic factors. This paper reviews the current epidemiologic literature evaluating the association of race with the development of sepsis and its associated outcomes.

METHODS

Review of pertinent English-language literature.

RESULTS

Race is a marker of poverty, preexisting conditions, increased allostatic loads, and decreased access to health systems. Racial disparities and the incidence of sepsis likely are explained by a multiplicity of environmental factors that are not captured by administrative data.

CONCLUSION

Race is a surrogate for many intangible factors that lead to the development of sepsis and inferior outcomes.

The socio-spatial neighborhood estimation method: an approach to operationalizing the neighborhood concept

The literature on neighborhoods and health highlights the difficulty of operationalizing "neighborhood" in a conceptually and empirically valid manner. Most studies, however, continue to define neighborhoods using less theoretically relevant boundaries, risking erroneous inferences from poor measurement. We review an innovative methodology to address this problem, called the socio-spatial neighborhood estimation method (SNEM). To estimate neighborhood boundaries, researchers used a theoretically informed combination of qualitative GIS and on-the-ground observations in Texas City, Texas. Using data from a large sample, we assessed the SNEM-generated neighborhood units by comparing intra-class correlation coefficients (ICCs) and multi-level model parameter estimates of SNEM-based measures against those for census block groups and regular grid cells. ICCs and criterion-related validity evidence using SF-36 outcome measures indicate that the SNEM approach to operationalization could improve inferences based on neighborhoods and health research.