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Christian LM, Carroll JE, Porter K, Hall MH. Sleep quality across pregnancy and postpartum: effects of parity and race. Sleep Health 2019; 5:327-334. [PMID: 31122875 DOI: 10.1016/j.sleh.2019.03.005] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/07/2019] [Accepted: 03/19/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Despite high prevalence and clinical implications of disturbed sleep during pregnancy, information on changes in sleep across pregnancy and postpartum is incomplete. Moreover, predictors of differential patterns of sleep quality across the perinatal period are poorly defined. METHODS This study examined subjective sleep quality using the Pittsburgh Sleep Quality Index during each trimester of pregnancy and at 4-11 weeks postpartum among 133 women inclusive of nulliparous and multiparous African Americans and Whites. RESULTS At any given assessment, 53%-71% of women reported poor overall sleep quality (Pittsburgh Sleep Quality Index total score > 5). Moreover, 92% reported poor overall sleep quality during at least 1 assessment, including 88% at some time during gestation. Compared to nulliparous women, multiparous women reported poorer overall sleep quality, shorter sleep duration, and poorer sleep efficiency during the first trimester; poorer overall sleep quality and longer sleep latency in the second trimester; and more frequent sleep disturbances (eg, night time and early morning awakenings) during the third trimester. Among nulliparous as well as multiparous women, specific aspects of sleep (eg, subjective sleep quality, sleep disturbances, sleep efficiency) were poorer in African American compared to White women at different time points during pregnancy. No effects of race or parity were observed on sleep parameters at postpartum. CONCLUSIONS Poor sleep quality during pregnancy as well as early postpartum is highly prevalent among both African American and White women. Both multiparous status and African American race are associated with more disturbed sleep at some time points during pregnancy. These individual differences should be considered in future research and clinical efforts to promote perinatal sleep health.
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Affiliation(s)
- Lisa M Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
| | - Judith E Carroll
- Department of Psychiatry & Biobehavioral Sciences, the Semel Institute for Neuroscience and Human Behavior, and the Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Kyle Porter
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Martica H Hall
- Psychiatry, Psychology, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
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Chan KKS, Fung WTW. The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong. Qual Life Res 2019; 28:2171-2182. [DOI: 10.1007/s11136-019-02181-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 01/12/2023]
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Alcántara C, Gallo LC, Wen J, Dudley KA, Wallace DM, Mossavar-Rahmani Y, Sotres-Alvarez D, Zee PC, Ramos AR, Petrov ME, Casement MD, Hall MH, Redline S, Patel SR. Employment status and the association of sociocultural stress with sleep in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Sleep 2019; 42:zsz002. [PMID: 30649533 PMCID: PMC6448284 DOI: 10.1093/sleep/zsz002] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/15/2018] [Indexed: 01/09/2023] Open
Abstract
STUDY OBJECTIVES We examined the association of sociocultural stress severity (i.e. acculturation stress, ethnic discrimination) and chronic stress burden with multiple dimensions of sleep in a population-based sample of US Hispanics/Latinos. We also explored whether employment status modified stress-sleep associations. METHODS We conducted survey linear regressions to test the cross-sectional association of sociocultural stress severity and stress burden with sleep dimensions using data collected between 2010 and 2013 from individuals who participated in both the Hispanic Community Health Study/Study of Latinos Sueño and Sociocultural Ancillary studies (N = 1192). RESULTS Greater acculturation stress (B = 0.75, standard error [SE] = 0.26, p < .01) and chronic psychosocial stress burden (B = 1.04, SE = 0.18, p < .001) were associated with greater insomnia symptoms but were not associated with actigraphic measures of sleep. Ethnic discrimination was not associated with any of the sleep dimensions. The association of acculturation stress with insomnia severity was greater in unemployed (B = 2.06, SE = 0.34) compared to employed (B = 1.01, SE = 0.31) participants (p-interaction = .08). CONCLUSIONS Acculturation stress severity and chronic stress burden are important and consistent correlates of insomnia, but not actigraphically measured sleep dimensions. If replicated, future research should test whether interventions targeting the resolution of sociocultural stress improve sleep quality in Hispanics/Latinos.
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Affiliation(s)
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Jia Wen
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Katherine A Dudley
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Douglas M Wallace
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | | | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill-Gillins School of Global Public Health, Chapel Hill, NC
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Alberto R Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL
| | - Megan E Petrov
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | | | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Susan Redline
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
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Ikeda A, Charvat H, Shigemura J, Kales SN, Tanigawa T. Longitudinal trends in disaster-related insomnia among Fukushima nuclear plant workers: the Fukushima Nuclear Energy Workers’ Support Project study. Sleep 2019; 42:5374591. [DOI: 10.1093/sleep/zsz043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/29/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ai Ikeda
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hadrien Charvat
- Prevention Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Jun Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
- Occupational Medicine, Cambridge Health Alliance, Cambridge, MA
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan
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55
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Hisler GC, Brenner RE. Does sleep partially mediate the effect of everyday discrimination on future mental and physical health? Soc Sci Med 2019; 221:115-123. [DOI: 10.1016/j.socscimed.2018.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 09/27/2018] [Accepted: 12/02/2018] [Indexed: 01/17/2023]
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56
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Occupational Health and Sleep Issues in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Beatty Moody DL, Taylor AD, Leibel DK, Al-Najjar E, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Kouo T, Erus G, Rosenberger WF, Evans MK, Zonderman AB, Waldstein SR. Lifetime discrimination burden, racial discrimination, and subclinical cerebrovascular disease among African Americans. Health Psychol 2018; 38:63-74. [PMID: 30474995 DOI: 10.1037/hea0000638] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Explore interactive relations of lifetime discrimination burden and racial discrimination-chronic stressors among African Americans (AAs)-and age with MRI-assessed white matter lesion volume (WMLV), a prognostic indicator of poor clinical brain health outcomes. METHOD AAs (N = 71; 60.6% female, mean age = 50) participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) SCAN study underwent quantitative magnetic resonance imaging coded for WMLV. Participants self-reported lifetime discrimination burden and racial discrimination approximately 5 years earlier. Multivariable regression models assessed interactions of linear and quadratic effects of discrimination and age with WMLV adjusted for sex and socioeconomic status. RESULTS Findings revealed significant interactive relations of age and (a) quadratic, lifetime discrimination burden, B = .05, p = .014, ηpartial2 = .092, and (b) quadratic, racial discrimination, B = .03, p = .001, ηpartial2 = .155, with WMLV. Among older AA, increases in lifetime discrimination burden and racial discrimination were associated with increases in WMLV (ps < .03); in younger AA, decreasing levels of racial discrimination were related to increases in WMLV (p = .006). CONCLUSIONS Among older AA, as lifetime discrimination burden and racial discrimination increased, so did WMLV. However, in younger AA, decreases in racial discrimination were associated with increased WMLV. Elucidation of complex mechanistic underpinnings, including potentially differential impacts of the acknowledgment versus suppression or underreporting of discriminatory experiences, among AA of different age cohorts, is critical to understanding the present pattern of findings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
| | - Antione D Taylor
- Department of Psychology, University of Maryland, Baltimore County
| | - Daniel K Leibel
- Department of Psychology, University of Maryland, Baltimore County
| | - Elias Al-Najjar
- Department of Mathematics and Statistics, University of Maryland, Baltimore County
| | - Leslie I Katzel
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine
| | | | - Rao P Gullapalli
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine
| | - Stephen L Seliger
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine
| | - Theresa Kouo
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine
| | - Guray Erus
- Department of Radiology, University of Pennsylvania
| | | | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging
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Covassin N, Greene EL, Singh P, Somers VK. Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep. Curr Hypertens Rep 2018; 20:57. [PMID: 29884924 DOI: 10.1007/s11906-018-0855-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Sleep deficiency has been proposed as a potential contributor to racial disparities in cardiovascular health. We present contemporary evidence on the unequal burden of insufficient sleep in Blacks/African-Americans and the repercussions for disparate risk of hypertension. RECENT FINDINGS The prevalence of insufficient sleep is high and rising and has been recognized as an important cardiovascular risk factor. Presumably due to a constellation of environmental, psychosocial, and individual determinants, these risks appear exacerbated in Blacks/African-Americans, who are more likely to experience short sleep than other ethnic/racial groups. Population-based data suggest that the risk of hypertension associated with sleep deficiency is greater in those of African ancestry. However, there is a paucity of experimental evidence linking short sleep duration to blood pressure levels in African-Americans. Blacks/African-Americans may be more vulnerable to sleep deficiency and to its hypertensive effects. Future research is needed to unequivocally establish causality and determine the mechanism underlying the postulated racial inequalities in sleep adequacy and consequent cardiovascular risk.
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Affiliation(s)
- Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Eddie L Greene
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prachi Singh
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA
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Datu JAD. Everyday discrimination, negative emotions, and academic achievement in Filipino secondary school students: Cross-sectional and cross-lagged panel investigations. J Sch Psychol 2018; 68:195-205. [PMID: 29861029 DOI: 10.1016/j.jsp.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/18/2017] [Accepted: 04/11/2018] [Indexed: 10/17/2022]
Abstract
Different forms of overt discrimination have been consistently linked to maladaptive psychological, physical health, and educational outcomes. However, limited research has been carried out to assess the link of subtle forms of discrimination like everyday discrimination on academic functioning in the school context. The current study addressed this research gap through examining the association of everyday discrimination with negative emotions and academic achievement among Filipino high school students. A cross-sectional study (Study 1) showed that everyday discrimination was positively associated with negative emotions and negatively linked to perceived academic achievement. Furthermore, everyday discrimination had indirect effects on academic achievement through the intermediate variable negative emotions. Then, a two-wave cross-lagged panel investigation (Study 2) demonstrated that Time 1 everyday discrimination was linked to higher Time 2 negative emotions. Reciprocal associations were also found among the constructs because Time 1 academic achievement was linked to lower levels Time 2 negative emotions and Time 2 everyday discrimination. The theoretical and practical implications of the research are elucidated.
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Affiliation(s)
- Jesus Alfonso D Datu
- Department of Special Education and Counselling, Hong Kong, SAR China; Integrated Centre for Well-Being (I-WELL), The Education University of Hong Kong, Hong Kong, SAR China.
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Chronic discrimination and bodily pain in a multiethnic cohort of midlife women in the Study of Women's Health Across the Nation. Pain 2018; 158:1656-1665. [PMID: 28753588 DOI: 10.1097/j.pain.0000000000000957] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A growing literature links discrimination to key markers of biobehavioral health. While racial or ethnic differences in pain are seen in experimental and clinical studies, the authors were interested in how chronic discrimination contributes to pain within multiple racial or ethnic groups over time. Participants were 3056 African American, Caucasian, Chinese, Hispanic, and Japanese women from the Study of Women's Health Across the Nation. The Everyday Discrimination Scale was assessed from baseline through 13 follow-up examinations. The bodily pain subscale of the MOS 36-Item Short-Form Health Survey (SF-36) was assessed annually. There were large racial or ethnic differences in reports of discrimination and pain. Discrimination attributions also varied by race or ethnicity. In linear mixed model analyses, initially adjusted for age, education, and pain medications, chronic everyday discrimination was associated with more bodily pain in all ethnic groups (beta = -5.84; P < 0.002 for Japanese; beta = -6.17; P < 0.001 for African American; beta = -8.74; P < 0.001 for Chinese; beta = -10.54; P < 0.001 for Caucasians; beta = -12.82; P < 0.001 for Hispanic). Associations remained significant in all ethnic groups after adjusting for additional covariates in subsequent models until adding depressive symptoms as covariate; in the final fully-adjusted models, discrimination remained a significant predictor of pain for African American (beta = -4.50; P < 0.001), Chinese (beta = -6.62; P < 0.001), and Caucasian (beta = -7.86; P < 0.001) women. In this longitudinal study, experiences of everyday discrimination were strongly linked to reports of bodily pain for the majority of women. Further research is needed to determine if addressing psychosocial stressors, such as discrimination, with patients can enhance clinical management of pain symptoms.
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61
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Lewis TT, Van Dyke ME. Discrimination and the Health of African Americans: The Potential Importance of Intersectionalities. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2018; 27:176-182. [PMID: 30655654 DOI: 10.1177/0963721418770442] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Research examining associations between self-reported experiences of discrimination overall (e.g. potentially due to race, gender, socioeconomic status, age, etc…) and health -particularly among African-Americans - has grown rapidly over the past two decades. Yet recent findings suggest that self-reported experiences of racism alone may be less impactful for the health of African-Americans than previously hypothesized. Thus, an approach that captures a broader range of complexities in the study of discrimination and health among African-Americans may be warranted. This article presents an argument for the importance of examining intersectionalities in studies of discrimination and physical health in African-Americans, and provides an overview of research in this area.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Miriam E Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University
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Hoyt LT, Deardorff J, Marceau K, Laurent CA, Windham GC, Greenspan LC, Pinney SM, Teitelbaum S, Grimm KJ, Hagan MJ, Biro FM, Wolff MS, Kushi LH, Hiatt RA. Girls' Sleep Trajectories Across the Pubertal Transition: Emerging Racial/Ethnic Differences. J Adolesc Health 2018; 62:496-503. [PMID: 29396081 PMCID: PMC5866777 DOI: 10.1016/j.jadohealth.2017.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 10/19/2017] [Accepted: 10/30/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE This study aims to examine the longitudinal association between puberty and sleep in a diverse sample of girls and explore racial/ethnic differences in this association. METHODS Using latent growth curve modeling, the present study measured pubertal development (timing and rate) and sleep (wake time and bedtime) in 1,239 socioeconomically and ethnically diverse girls starting when they were 6-8 years old and followed longitudinally for up to 8 years. Pubertal assessment was conducted annually in clinic by physical examination, classified by sexual maturation stage for breast and pubic hair development by trained raters. RESULTS In line with previous research, black girls had the earliest pubertal development, followed by Hispanic, white, and Asian girls. Black girls, on average, reported significantly shorter sleep duration than Hispanic (β = -.20, p < .001), Asian (β = -.29, p = .002), and white (β = -.35, p < .001) girls. In a series of dual-process models, we found that early pubertal timing predicted shorter sleep duration for early-maturing black girls (breast development: β = .13, p = .005; pubic hair development: β = .14, p = .012). There was no evidence of any association between pubertal rate and sleep. All models controlled for family socioeconomic status and body mass index. CONCLUSION Sleep is essential for many aspects of youth development, including emotional, cognitive, and physical functioning. Developmental changes associated with puberty may put some early maturing girls at risk of shorter sleep duration in adolescence and exacerbate racial/ethnic disparities in health and well-being.
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Affiliation(s)
| | | | - Kristine Marceau
- Department of Human Development & Family Studies, Purdue University, West Lafayette, Indiana
| | - Cecile A Laurent
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Gayle C Windham
- California Department of Public Health, Richmond, California
| | | | - Susan M Pinney
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kevin J Grimm
- Department of Psychology, Arizona State University, Tempe, Arizona
| | - Melissa J Hagan
- Department of Psychology, San Francisco State University, San Francisco, California
| | - Frank M Biro
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary S Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Robert A Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
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Goosby BJ, Cheadle JE, Strong-Bak W, Roth TC, Nelson TD. Perceived Discrimination and Adolescent Sleep in a Community Sample. THE RUSSELL SAGE FOUNDATION JOURNAL OF THE SOCIAL SCIENCES : RSF 2018; 4:43-61. [PMID: 38707763 PMCID: PMC11068330 DOI: 10.7758/rsf.2018.4.4.03] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Sleep is a key restorative process, and poor sleep is linked to disease and mortality risk. The adolescent population requires more sleep on average than adults but are most likely to be sleep deprived. Adolescence is a time of rapid social upheaval and sensitivity to social stressors including discrimination. This study uses two weeks of daily e-diary measures documenting discrimination exposure and concurrent objective sleep indicators measured using actigraphy. We assess associations between daily discrimination and contemporaneous sleep with a diverse sample of adolescents. This novel study shows youth with higher average discrimination reports have worse average sleep relative to their counterparts. Interestingly, youth reporting daily discrimination have better sleep the day of the report than youth who do not.
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Affiliation(s)
- Bridget J Goosby
- Sociology and co-directors of the LifeHD: Life in Frequencies Health Disparities Research Lab at the University of Nebraska-Lincoln
| | - Jacob E Cheadle
- Sociology and co-directors of the LifeHD: Life in Frequencies Health Disparities Research Lab at the University of Nebraska-Lincoln
| | - Whitney Strong-Bak
- doctoral candidate and graduate research assistant in the School Psychology Program
| | - Taylor C Roth
- doctoral student and graduate research assistant in the department of psychology at the University of Nebraska-Lincoln
| | - Timothy D Nelson
- psychology and director of the Pediatric Health Lab at the University of Nebraska-Lincoln
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Hoggard LS, Hill LK. Examining How Racial Discrimination Impacts Sleep Quality in African Americans: Is Perseveration the Answer? Behav Sleep Med 2018; 16:471-481. [PMID: 27690630 PMCID: PMC5378656 DOI: 10.1080/15402002.2016.1228648] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND African Americans experience more problematic and disordered sleep than White Americans. Racial discrimination has been implicated in this disparity. However, the mechanisms by which discrimination disrupts sleep are unclear. It has been theorized that Perseverative Cognition (PC), characterized by recurrent patterns of reflective (i.e., rumination) and anticipatory (i.e., worry) negative thinking about personally relevant stressors, may reflect the functional mechanism linking discrimination to sleep. The present study is the first to empirically examine the dual components of PC as a candidate functional mechanism in the association between racial discrimination and subjective sleep quality. PARTICIPANTS Sixty-eight self-identified African American college students (55.9% female; Mage = 20.18, SD = 2.93) were recruited at a large predominantly white public university in the Midwest. METHODS The participants completed the Perceived Ethnic Discrimination Questionnaire (PEDQ), Pittsburgh Sleep Quality Index (PSQI), Penn State Worry Questionnaire (PSWQ), and Ruminative Responses Scale (RRS). RESULTS After adjusting for age, gender, and social class, results revealed a significant indirect effect of racial discrimination (RD) on subjective sleep quality through rumination, 95% CI [.008, .125], but not worry. RD was positively associated with rumination, b =.50, SE =.16, p = .003, and rumination, in turn, was positively associated with poorer sleep quality, b = .09, SE = .04, p = .012. CONCLUSIONS As both RD and poor sleep quality have been directly linked to heart disease, diabetes, depression, and a number of other maladies, our findings suggest that RD, sleep, and coping strategies (e.g., rumination) employed to manage RD experiences may be important targets for addressing racial disparities in health.
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Affiliation(s)
- Lori S. Hoggard
- Center for Health Equity Research, Department of Social Medicine and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina,Institute of African American Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - LaBarron K Hill
- c Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , North Carolina.,d Center for Biobehavioral Health Disparities Research , Duke University , Durham , North Carolina.,e Center for the Study of Aging and Human Development , Duke University Medical Center , Durham , North Carolina
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65
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Clark US, Miller ER, Hegde RR. Experiences of Discrimination Are Associated With Greater Resting Amygdala Activity and Functional Connectivity. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 3:367-378. [PMID: 29628069 DOI: 10.1016/j.bpsc.2017.11.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/04/2017] [Accepted: 11/28/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Social discrimination, a type of psychological stressor, is associated with poorer physical and mental health outcomes, yet we have little understanding of how discrimination affects neural functions in marginalized populations. By contrast, the effects of psychological stress on neural functions are well documented, with evidence of significant effects on the amygdala-a neural region that is central to psychosocial functions. Accordingly, we conducted an examination of the relation between self-reported discrimination exposure and amygdala activity in a diverse sample of adults. METHODS Seventy-four adults (43% women; 72% African American; 23% Hispanic; 32% homosexual/bisexual) completed self-report ratings of discrimination exposure. Spontaneous amygdala activity and functional connectivity were assessed during resting-state functional magnetic resonance imaging. RESULTS Greater discrimination exposure was associated with higher levels of spontaneous amygdala activity. Increases in discrimination were also associated with stronger functional connectivity between the amygdala and several neural regions (e.g., anterior insula, putamen, caudate, anterior cingulate, medial frontal gyrus), with the most robust effects observed in the thalamus. These effects were independent of several demographic (e.g., race, ethnicity, sex) and psychological (e.g., current stress, depression, anxiety) factors. CONCLUSIONS Collectively, our findings provide the first evidence that social discrimination is independently associated with elevations in intrinsic amygdala activity and functional connectivity, thus revealing clear parallels between the neural substrates of discrimination and psychological stressors of other origins. Such results should spur future investigations of amygdala-based networks as potential etiological factors linking discrimination exposure to adverse physical and mental health outcomes.
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Affiliation(s)
- Uraina S Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Evan R Miller
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rachal R Hegde
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York
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Alcántara C, Patel SR, Carnethon M, Castañeda S, Isasi CR, Davis S, Ramos A, Arredondo E, Redline S, Zee PC, Gallo LC. Stress and Sleep: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. SSM Popul Health 2017; 3:713-721. [PMID: 29104908 PMCID: PMC5663240 DOI: 10.1016/j.ssmph.2017.08.004] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Hispanics/Latinos face specific sociocultural stressors associated with their marginalized status in the United States. While stress is known to cause poor sleep, the differential effects of the specific stressors faced by Hispanics/Latinos have not been evaluated. Using cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study, we conducted weighted generalized linear models to evaluate the associations of acculturation stress, ethnic discrimination, and chronic moderate/severe stress with self-reported sleep outcomes (insomnia symptoms, daytime sleepiness, sleep duration) in individual and aggregate models adjusted for site, socio-demographics, behavioral, and medical conditions. Participants included 5313 Hispanic/Latino adults; 43.5% ≥ age 45, 54.8% female, and 22.0% US-born. Chronic moderate/severe stress, ethnic discrimination, and acculturation stress were each positively associated with sleep. In the adjusted aggregate model, only chronic moderate/severe stress was associated with insomnia symptoms (exp(b) = 1.07 for each additional stressor, 95% CI = 1.05, 1.09). Both acculturation stress (exp(b) = 1.05 for each additional SD, 95% CI = 1.02, 1.10) and ethnic discrimination (exp(b) = 1.05 for each additional SD, 95% CI = 1.01, 1.08) were associated with daytime sleepiness. Each SD increase in ethnic discrimination related to a 16% and 13% increased prevalence of short (< 7 h) (RRR = 1.16, 95% CI = 1.02, 1.31) and long sleep duration (> 9 h) (RRR = 1.13, 95% CI = 1.00, 1.27), respectively. These associations were consistent across sex. Acculturation stress and ethnic discrimination are associated with poor sleep in Hispanics/Latinos. Future research should explore whether behavioral sleep interventions minimize the impact of sociocultural stressors on sleep. Latina/os face unique stressors associated with their marginalized status in the USA. We explored the association of sociocultural stressors with Latina/o sleep. Acculturation stress and ethnic discrimination were associated with daytime sleepiness. Only chronic psychosocial stress was associated with insomnia symptoms. Ethnic discrimination was associated with both short and long sleep duration.
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Affiliation(s)
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Sheila Castañeda
- School of Public Health, San Diego State University, San Diego, CA
| | | | - Sonia Davis
- Department of Biostatistics, University of North Carolina at Chapel Hill-Gillins School of Global Public Health, Chapel Hill, NC
| | - Alberto Ramos
- University of Miami Miller School of Medicine, Miami, FL
| | - Elva Arredondo
- School of Public Health, San Diego State University, San Diego, CA
| | - Susan Redline
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA
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Gordon AM, Mendes WB, Prather AA. The social side of sleep: Elucidating the links between sleep and social processes. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2017; 26:470-475. [PMID: 29398789 DOI: 10.1177/0963721417712269] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sleep problems have become a public health epidemic with recent data suggesting that over 69% of US adults get less sleep than they need. Despite the important role that sleep plays in our lives, sleep as a variable of interest in interpersonal processes has been historically absent from the psychological literature. Recently, however, researchers have shed some light on the link between sleep and a wide array of social processes. This work illuminates the important role that sleep plays in our social experiences, from basic social perception to complex social interactions. We outline a working model for the bidirectional link between sleep and social processes, including underlying mechanisms, review the recent research that informs this model, and use it to elucidate important next steps to bring together sleep and social psychological research. We also address the pragmatics of measuring sleep for non-sleep researchers.
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Francis B, Klebanoff M, Oza-Frank R. Racial discrimination and perinatal sleep quality. Sleep Health 2017; 3:300-305. [PMID: 28709519 DOI: 10.1016/j.sleh.2017.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 05/06/2017] [Accepted: 05/31/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This research examined the association between perceived everyday racial discrimination, as a psychosocial stressor, and perinatal sleep quality. DESIGN Cross-sectional (N=640) and longitudinal associations (N=133) between everyday experiences of discrimination and sleep quality were examined using a pregnancy and postpartum data registry. PARTICIPANTS We studied a sample of 640 unique women from the Perinatal Research Repository (PRR), a longitudinal study of mothers, fathers, and babies recruited from Nationwide Children's Hospital and The Ohio State University in Columbus, Ohio. MEASUREMENTS Discrimination and sleep quality were assessed using the Experiences of Discrimination Scale and the Pittsburgh Sleep Quality Index, respectively. RESULTS Overall, everyday discrimination was associated with poorer global sleep quality and all but three sleep sub-measures of the PSQI cross-sectionally, but not longitudinally. When stratified, the adverse effects of everyday discrimination varied by race and perinatal time period. Increases in everyday discrimination were independently associated with poorer sleep initiation, poorer sleep maintenance and poorer daytime dysfunction. CONCLUSIONS Findings suggest that the immediate stressors of everyday racial discrimination were independently associated with poorer sleep quality among pregnant women cross-sectionally. Poorer sleep quality has been associated with numerous adverse perinatal outcomes and this association may be important in understanding racial discrimination as a risk factor. Our failure to identify a longitudinal association makes the direction of causation uncertain, however. Further longitudinal studies are necessary to clarify the association, given the potential importance of poor sleep quality in the pathogenesis of pregnancy complications.
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Affiliation(s)
- Brittney Francis
- The Research Institute at Nationwide Children's Hospital; College of Public Health, The Ohio State University; Ohio Perinatal Research Network.
| | - Mark Klebanoff
- The Research Institute at Nationwide Children's Hospital; College of Medicine, The Ohio State University; College of Public Health, The Ohio State University; Ohio Perinatal Research Network
| | - Reena Oza-Frank
- The Research Institute at Nationwide Children's Hospital; College of Medicine, The Ohio State University; Ohio Perinatal Research Network
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69
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Goosby BJ, Straley E, Cheadle JE. Discrimination, Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities. POPULATION RESEARCH AND POLICY REVIEW 2017. [DOI: 10.1007/s11113-017-9439-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Owens SL, Hunte HER, Sterkel A, Johnson DA, Johnson-Lawrence V. Association Between Discrimination and Objective and Subjective Sleep Measures in the Midlife in the United States Study Adult Sample. Psychosom Med 2017; 79:469-478. [PMID: 28114149 PMCID: PMC5413390 DOI: 10.1097/psy.0000000000000428] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Evidence suggests that sleep quality is worse in nonwhite minorities compared with whites. Poor sleep is associated with higher levels of perceived interpersonal discrimination, which is consistently reported among minorities. However, the literature is limited in exploring discrimination with both objective and subjective sleep outcomes in the same sample. We examined the relationship between discrimination and markers of subjective and objective sleep in a racially diverse sample. METHODS The analytic sample included 441 participants of the Midlife in the United States II (MIDUS) study (M [SD] age, 46.6 [1.03]; female, 57.9%; male, 42.1%; nonwhite, 31.7%). Complete data were available for 361 participants. Sleep measures included the Pittsburgh Sleep Quality Index, sleep latency, wake after sleep onset, and sleep efficiency derived from 7-day actigraphy. Discrimination was measured with the Williams Everyday Discrimination Scale. Ordinary least squares and logistic regression models were used to assess the relationship between discrimination and the subjective and objective measures of sleep. RESULTS After adjusting for covariates, respondents with higher discrimination scores were significantly more likely to experience poor sleep efficiency (odds ratio, 1.12; p = .005) and report poorer sleep quality (odds ratio, 1.09; p = .029) on the basis of the Pittsburgh Sleep Quality Index. Higher discrimination scores were also associated with longer wake after sleep onset (b = 0.032, p < .01) and more sleep difficulties (b = 0.049, p = .01). Discrimination attenuated all differences in the sleep measures between whites and nonwhites except for sleep efficiency. CONCLUSIONS The findings support the model that discrimination acts as a stressor that can disrupt subjective and objective sleep. These results suggest that interpersonal discrimination explains some variance in worse sleep among nonwhites compared with whites.
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Affiliation(s)
- Sherry L Owens
- From the Department of Social and Behavioral Sciences (Owens, Hunte), West Virginia University, Morgantown, West Virginia; Department of Psychiatry and Behavioral Sciences (Sterkel), Stanford University, Stanford, California; Division of Sleep Medicine (Johnson), Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; and Department of Public Health and Health Sciences (Johnson-Lawrence), University of Michigan-Flint, Flint, Michigan
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71
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Abstract
Minority individuals in the United States (US) have an increased prevalence of obstructive sleep apnea (OSA) compared to their white/Caucasian counterparts. In general, adherence to positive airway pressure (PAP) therapy is poor and some studies suggest that PAP use among minority individuals is inferior to that of whites. However, there has not been a review of the evidence that addresses racial-ethnic disparities for PAP adherence in the treatment of OSA, and no review has systematically examined the contributing factors to poor adherence among minority individuals compared to whites. We searched the literature for studies published between January 1990 to July 2016 that included objective PAP use comparisons between adult US minority individuals and whites. Twenty-two studies met the inclusion criteria. All studies compared the PAP adherence of blacks to whites. Seven studies compared the PAP adherence of additional minority groups to that of whites. Sixteen of the 22 studies (73%) showed worse PAP adherence in blacks compared to whites. Four studies found equivalent PAP use in US Hispanics compared to whites. Little is known about the PAP adherence of other US minority groups. We present a framework and research agenda for understanding PAP use barriers among US minority individuals.
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72
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Fuller-Rowell TE, Curtis DS, El-Sheikh M, Duke AM, Ryff CD, Zgierska AE. Racial discrimination mediates race differences in sleep problems: A longitudinal analysis. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:165-173. [PMID: 27429065 PMCID: PMC5243865 DOI: 10.1037/cdp0000104] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To examine changes in sleep problems over a 1.5-year period among Black or African American (AA) and White or European American (EA) college students and to consider the role of racial discrimination as a mediator of race differences in sleep problems over time. METHOD Students attending a large, predominantly White university (N = 133, 41% AA, 57% female, mean age = 18.8, SD = .90) reported on habitual sleep characteristics and experiences of racial discrimination at baseline and follow-up assessments. A latent variable for sleep problems was assessed from reports of sleep latency, duration, efficiency, and quality. Longitudinal models were used to examine race differences in sleep problems over time and the mediating role of perceived discrimination. Covariates included age, gender, parent education, parent income, body mass index, self-rated physical health, and depressive symptoms. Each of the individual sleep measures was also examined separately, and sensitivity analyses were conducted using alternative formulations of the sleep problems measure. RESULTS AAs had greater increases in sleep problems than EAs. Perceived discrimination was also associated with increases in sleep problems over time and mediated racial disparities in sleep. This pattern of findings was similar when each of the sleep indicators was considered separately and held with alternative sleep problems measures. CONCLUSIONS The findings highlight the importance of racial disparities in sleep across the college years and suggest that experiences of discrimination contribute to group disparities. (PsycINFO Database Record
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Affiliation(s)
| | - David S. Curtis
- Department of Human Development and Family Studies, Auburn University, AL
| | - Mona El-Sheikh
- Department of Human Development and Family Studies, Auburn University, AL
| | - Adrienne M. Duke
- Department of Human Development and Family Studies, Auburn University, AL
| | - Carol D. Ryff
- Department of Psychology, University of Wisconsin—Madison, WI
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73
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Abstract
Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention.
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74
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Ong AD, Williams DR, Nwizu U, Gruenewald TL. Everyday unfair treatment and multisystem biological dysregulation in African American adults. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:27-35. [PMID: 28045308 PMCID: PMC5443680 DOI: 10.1037/cdp0000087] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Increasing evidence suggests that chronic exposure to unfair treatment or day-to-day discrimination increases risk for poor health, but data on biological stress mechanisms are limited. This study examined chronic experiences of unfair treatment in relation to allostatic load (AL), a multisystem index of biological dysregulation. METHOD Data are from a sample of 233 African-American adults (37-85 years; 64% women). Perceptions of everyday unfair treatment were measured by questionnaire. An AL index was computed as the sum of 7 separate physiological system risk indices (cardiovascular regulation, lipid, glucose, inflammation, sympathetic nervous system, parasympathetic nervous system, hypothalamic pituitary adrenal axis). RESULTS Adjusting for sociodemographics, medication use, smoking status, alcohol consumption, depressive symptoms, lifetime discrimination, and global perceived stress, everyday mistreatment was associated with higher AL. CONCLUSIONS The results add to a growing literature on the effects of chronic bias and discrimination by demonstrating how such experiences are instantiated in downstream physiological systems. (PsycINFO Database Record
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Affiliation(s)
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Harvard University
| | - Ujuonu Nwizu
- Africana Studies and Research Center, Cornell University
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75
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Kiat JE, Straley E, Cheadle JE. Why won't they sit with me? An exploratory investigation of stereotyped cues, social exclusion, and the P3b. Soc Neurosci 2016; 12:612-625. [PMID: 27557430 DOI: 10.1080/17470919.2016.1223167] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The importance of understanding how we anticipate and prepare for being socially excluded is underscored by the numerous adverse mental and physical consequences of social rejection. In this study, we adapted a social exclusion paradigm, the Lunchroom task, to investigate the use of social context cues in the formation of social outcome expectations as indexed by the P3b, an ERP component associated with attention orientation and context updating. In this task, Black and White participants were presented with either neutral or stereotyped cues prior to being exposed to simulated inclusion versus exclusion outcome scenarios. Black participants showed evidence of (1) a significantly reduced P3b response to exclusions preceded by stereotyped cues relative to neutral cue-related exclusions and (2) a marginally significant increase in the P3b response to inclusions relative to exclusions when both were preceded by stereotyped cues. Both of these findings suggest a key role for the use of social cues in the formation of outcome expectations. In line with our hypothesis that the random intermixing of inclusion and exclusion outcomes would prevent formation of outcome expectations when coupled with the absence of self-relevant cues, no overall P3b modulations were observed among a comparison group of White participants.
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Affiliation(s)
- John E Kiat
- a Department of Psychology , The University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Elizabeth Straley
- b Department of Sociology , The University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Jacob E Cheadle
- b Department of Sociology , The University of Nebraska-Lincoln , Lincoln , NE , USA
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76
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Taylor RJ, Miller R, Mouzon D, Keith VM, Chatters LM. Everyday Discrimination among African American Men: The Impact of Criminal Justice Contact. RACE AND JUSTICE 2016; 8:154-177. [PMID: 29552376 PMCID: PMC5849240 DOI: 10.1177/2153368716661849] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study examined the impact of criminal justice contact on experiences of everyday discrimination among a national sample of African American men. African American men have a high likelihood of being targets of major discrimination, as well as experiencing disproportionate contact with the criminal justice system. Few studies, however, examine everyday discrimination (e.g., commonplace social encounters of unfair treatment) among this group. Using data from the National Survey of American Life, we provide a descriptive assessment of different types of everyday discrimination among African American men. Specifically, we examined differences in everyday discrimination among men who have never been arrested, those who have been arrested but not incarcerated, and men who have a previous history of criminal justice intervention categorized by type of incarceration experienced (i.e., reform school, detention, jail, or prison). Study findings indicated overall high levels of reported everyday discrimination, with increased likelihood and a greater number of experiences associated with more serious forms of criminal justice contact. However, in many instances, there were no or few differences in reported everyday discrimination for African American men with and without criminal justice contact, indicating comparable levels of exposure to experiences with unfair treatment.
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Affiliation(s)
| | - Reuben Miller
- School of Social Work, Institute for Social Research, University of Michigan
| | - Dawne Mouzon
- Edward J. Bloustein School of Planning & Public Policy, Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University of New Jersey
| | - Verna M Keith
- Department of Sociology, Race and Ethnic Studies Institute, Texas A & M University
| | - Linda M Chatters
- School of Public Health, School of Social Work, Institute for Social Research, University of Michigan
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77
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Perceived Discrimination and Mexican-Origin Young Adults' Sleep Duration and Variability: The Moderating Role of Cultural Orientations. J Youth Adolesc 2016; 46:1851-1861. [PMID: 27447706 DOI: 10.1007/s10964-016-0544-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
Perceived ethnic discrimination is central to the experiences of Latino young adults, yet we know little about the ways in which and the conditions under which ethnic discrimination relates to Latino young adults' sleep patterns. Using a sample of 246 Mexican-origin young adults (M age = 21.11, SD = 1.54; 50 % female), the current study investigated the longitudinal links between perceived ethnic discrimination and both sleep duration and night-to-night variability in duration, while also examining the moderating roles of Anglo and Mexican orientations in the associations. The results revealed that perceived discrimination predicted greater sleep variability, and this link was not moderated by cultural orientations. The relation between perceived discrimination and hours of sleep, however, was moderated by Anglo and Mexican orientations. Individuals with high Anglo and Mexican orientations (bicultural) and those with only high Mexican orientations (enculturated), showed no association between discrimination and hours of sleep. Individuals with low Anglo and Mexican orientations (marginalized) displayed a positive association, whereas those with high Anglo and low Mexican orientations (acculturated) displayed a negative association. The results suggest that discrimination has long term effects on sleep variability of Mexican-origin young adults, regardless of cultural orientations; however, for sleep duration, bicultural and enculturated orientations are protective.
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78
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Fazeli Dehkordy S, Hall KS, Dalton VK, Carlos RC. The Link Between Everyday Discrimination, Healthcare Utilization, and Health Status Among a National Sample of Women. J Womens Health (Larchmt) 2016; 25:1044-1051. [PMID: 27429363 DOI: 10.1089/jwh.2015.5522] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research has not adequately examined the potential negative effects of perceiving routine discrimination on general healthcare utilization or health status, especially among reproductive-aged women. We sought to evaluate the association between everyday discrimination, health service use, and perceived health among a national sample of women in the United States. MATERIALS AND METHODS Data were drawn from the Women's Healthcare Experiences and Preferences survey, a randomly selected, national probability sample of 1078 U.S. women aged 18-55 years. We examined associations between everyday discrimination (via a standardized scale) on frequency of health service utilization and perceived general health status using chi-square and multivariable logistic regression modeling. RESULTS Compared with women who reported healthcare visits every 3 years or less (reference group), each one-point increase in discrimination score was associated with higher odds of having healthcare visits annually or more often (odds ratio [OR] = 1.36, confidence interval [95% CI] = 1.01-1.83). Additionally, each one-point increase in discrimination score was significantly associated with lower odds of having excellent/very good perceived health (OR = 0.65; 95% CI = 0.54-0.80). CONCLUSION Perceived discrimination was associated with increased exposure to the healthcare setting among this national sample of women. Perceived discrimination was also inversely associated with excellent/very good perceived health status.
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Affiliation(s)
- Soudabeh Fazeli Dehkordy
- 1 Department of Radiology, University of Michigan School of Medicine , Ann Arbor, Michigan.,2 Department of Graduate Medical Education, St. John Providence Hospital , Southfield, Michigan
| | - Kelli S Hall
- 3 Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University , Atlanta, Georgia
| | - Vanessa K Dalton
- 4 Department of Obstetrics and Gynecology, University of Michigan School of Medicine , Ann Arbor, Michigan.,5 University of Michigan Institute for Healthcare Policy and Innovation , Ann Arbor, Michigan
| | - Ruth C Carlos
- 1 Department of Radiology, University of Michigan School of Medicine , Ann Arbor, Michigan.,5 University of Michigan Institute for Healthcare Policy and Innovation , Ann Arbor, Michigan.,6 University of Michigan Program for Imaging Comparative Effectiveness and Health Services Research , Ann Arbor, Michigan
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79
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Wallace S, Nazroo J, Bécares L. Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom. Am J Public Health 2016; 106:1294-300. [PMID: 27077347 DOI: 10.2105/ajph.2016.303121] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine the longitudinal association between cumulative exposure to racial discrimination and changes in the mental health of ethnic minority people. METHODS We used data from 4 waves (2009-2013) of the UK Household Longitudinal Study, a longitudinal household panel survey of approximately 40 000 households, including an ethnic minority boost sample of approximately 4000 households. RESULTS Ethnic minority people who reported exposure to racial discrimination at 1 time point had 12-Item Short Form Health Survey (SF-12) mental component scores 1.93 (95% confidence interval [CI] = -3.31, -0.56) points lower than did those who reported no exposure to racial discrimination, whereas those who had been exposed to 2 or more domains of racial discrimination, at 2 different time points, had SF-12 mental component scores 8.26 (95% CI = -13.33, -3.18) points lower than did those who reported no experiences of racial discrimination. Controlling for racial discrimination and other socioeconomic factors reduced ethnic inequalities in mental health. CONCLUSIONS Cumulative exposure to racial discrimination has incremental negative long-term effects on the mental health of ethnic minority people in the United Kingdom. Studies that examine exposure to racial discrimination at 1 point in time may underestimate the contribution of racism to poor health.
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Affiliation(s)
- Stephanie Wallace
- All of the authors are with Centre on Dynamics of Ethnicity, University of Manchester, Manchester, Lancashire, UK
| | - James Nazroo
- All of the authors are with Centre on Dynamics of Ethnicity, University of Manchester, Manchester, Lancashire, UK
| | - Laia Bécares
- All of the authors are with Centre on Dynamics of Ethnicity, University of Manchester, Manchester, Lancashire, UK
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80
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Discrimination and sleep quality among older US adults: the mediating role of psychological distress. Sleep Health 2016; 2:100-108. [PMID: 28923251 DOI: 10.1016/j.sleh.2016.02.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To examine the association between everyday discrimination and sleep quality and identify mediating pathways between discrimination and sleep quality. DESIGN Longitudinal. SETTING Health and Retirement Study (HRS). PARTICIPANTS Participants (N = 9223, mean age 66.7 years, 12.8 years of education; 85% White, 12% African American, and 3% another race or ethnicity) who participated in 2006, 2008, 2010, and 2012. MEASUREMENTS At each assessment, participants completed measures of everyday discrimination, lifetime discrimination, attributions of discrimination, depressive symptoms, anxiety symptoms, sleep quality, and non-restfulness. RESULTS More experiences with everyday discrimination were associated with worse sleep quality (β = 0.048, SE = 0.009, P < .01). When psychological distress was added to this model, the direct effect was lower in both magnitude and significance (β = 0.029, SE = 0.011, P < .05), which indicated partial mediation. Psychological distress also fully mediated the relation between everyday discrimination and non-restfulness (direct effect: β = -0.003, SE = 0.010, ns). Individuals who experienced physical disability-based discrimination had worse sleep quality than those who did not experience this form of discrimination (β = 0.114, SE = 0.029, P < .01); psychological distress fully mediated this relation (direct effect: β = -0.025, SE = 0.031, ns). Among individuals with obesity, psychological distress fully mediated the relation between weight discrimination and sleep quality (direct effect: β = 0.036, SE = 0.025, ns), and partially mediated the relation between weight discrimination and non-restfulness (direct effect: β = 0.049, SE = 0.025, P < .05). CONCLUSIONS Everyday discrimination and discrimination based specifically on weight or a physical disability were associated with worse sleep quality. The findings suggest that psychological distress may be one pathway through which these experiences are associated with worse sleep.
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81
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Alcántara C, Biggs ML, Davidson KW, Delaney JA, Jackson CL, Zee PC, Shea SJC, Redline S. Sleep Disturbances and Depression in the Multi-Ethnic Study of Atherosclerosis. Sleep 2016; 39:915-25. [PMID: 26715223 DOI: 10.5665/sleep.5654] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 11/20/2015] [Indexed: 12/18/2022] Open
Abstract
STUDY OBJECTIVES We examined the association of objectively and subjectively measured sleep disturbances with depression, and explored if race/ethnicity, socioeconomic status, and sex modified these associations. METHODS We used data from the cross-sectional Multi-Ethnic Study of Atherosclerosis Sleep Study. Participants included 1,784 adults (ages 54-93 y), 36.8% non-Hispanic Whites, 28.0% African Americans, 23.7% Hispanics, 11.5% Chinese, and 46.0% males. Sleep was assessed with actigraphy, polysomnography, and self-report. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. We used relative risk regression to evaluate the association of sleep measures and depression (CES-D score ≥ 16) adjusting for site, sociodemographics, and behavioral and medical risk factors. RESULTS Overall, 14.5% had depression, 29.3% had insomnia symptoms, 14.1% had excessive daytime sleepiness (EDS), 15.1% had apnea-hypopnea index (AHI) ≥ 30, and 30.4% experienced short sleep (< 6 h). Depression was associated with short sleep duration (adjusted prevalence ratio [PR] = 1.47, 95% confidence interval [CI] = 1.11, 1.94), < 10% rapid eye movement [REM] sleep (PR = 1.57, 95% CI = 1.08, 2.27), ≥ 25% REM sleep (PR = 1.42, 95% CI = 1.03, 1.95), insomnia (PR = 1.83, 95% CI = 1.39, 2.40), excessive daytime sleepiness (EDS) (PR = 1.61, 95% CI = 1.19, 2.18), and AHI > 15 + EDS (PR = 1.55, 95% CI = 1.01, 2.39). Short sleep duration was associated with depression among those with high school education or beyond, but not among those with less education. Insomnia was more strongly associated with depression among men than women. CONCLUSIONS Sleep disturbances are associated with depression among middle-aged and older adults; these associations may be modified by education and sex. Future research should further test these hypotheses, evaluate whether early detection or treatment of sleep disturbances ameliorate depression, and explore subpopulation differences.
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Affiliation(s)
- Carmela Alcántara
- Department of Medicine, Columbia University Medical Center, New York, NY.,Social Work, Columbia University School of Social Work, New York, NY
| | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Karina W Davidson
- Department of Medicine, Columbia University Medical Center, New York, NY.,New York Presbyterian Hospital, New York, NY
| | - Joseph A Delaney
- Department of Epidemiology, University of Washington, Seattle, WA
| | | | - Phyllis C Zee
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Steven J C Shea
- Department of Medicine, Columbia University Medical Center, New York, NY.,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Susan Redline
- Department of Medicine,Harvard Medical School; Brigham and Women's Hospital and Beth Israel Deaconess Medical School, Boston, MA
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Reid AE, Rosenthal L, Earnshaw VA, Lewis TT, Lewis JB, Stasko EC, Tobin JN, Ickovics JR. Discrimination and excessive weight gain during pregnancy among Black and Latina young women. Soc Sci Med 2016; 156:134-41. [PMID: 27038321 DOI: 10.1016/j.socscimed.2016.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 02/26/2016] [Accepted: 03/10/2016] [Indexed: 10/22/2022]
Abstract
RATIONALE Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. OBJECTIVE We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. METHOD Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. RESULTS Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. CONCLUSION Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women.
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Affiliation(s)
- Allecia E Reid
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States; Colby College, Psychology Department, United States.
| | - Lisa Rosenthal
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States; Pace University, Psychology Department, United States
| | - Valerie A Earnshaw
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States; Harvard Medical School, Department of Pediatrics, United States; Boston Children's Hospital, Department of Medicine, United States
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, United States
| | - Jessica B Lewis
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States
| | - Emily C Stasko
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States
| | | | - Jeannette R Ickovics
- Yale University, Center for Interdisciplinary Research on AIDS, School of Public Health, United States
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83
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Van Dyke ME, Vaccarino V, Quyyumi AA, Lewis TT. Socioeconomic status discrimination is associated with poor sleep in African-Americans, but not Whites. Soc Sci Med 2016; 153:141-7. [PMID: 26896878 DOI: 10.1016/j.socscimed.2016.02.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 01/18/2016] [Accepted: 02/08/2016] [Indexed: 01/05/2023]
Abstract
RATIONALE Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. OBJECTIVE We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. METHODS We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. RESULTS In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR = 2.39 95%, CI = 1.35, 4.24), but not Whites (OR = 1.03, 95% CI = 0.57, 1.87), and the race × SES discrimination interaction was significant at p = 0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. CONCLUSION Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race.
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Affiliation(s)
- Miriam E Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA.
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA.
| | - Arshed A Quyyumi
- Division of Cardiology, School of Medicine, Emory University, 1462 Clifton Road, NE, Suite 507, Atlanta, GA 30322, USA.
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, NE, Atlanta, GA 30322, USA.
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84
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Petrov ME, Lichstein KL. Differences in sleep between black and white adults: an update and future directions. Sleep Med 2016; 18:74-81. [DOI: 10.1016/j.sleep.2015.01.011] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 01/05/2015] [Accepted: 01/16/2015] [Indexed: 12/13/2022]
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85
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Paine SJ, Harris R, Cormack D, Stanley J. Racial Discrimination and Ethnic Disparities in Sleep Disturbance: the 2002/03 New Zealand Health Survey. Sleep 2016; 39:477-85. [PMID: 26446108 DOI: 10.5665/sleep.5468] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 09/05/2015] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Research on the relationship between racial discrimination and sleep is limited. The aims of this study were to: (1) examine the independent relationship between ethnicity, sex, age, socioeconomic position, experience of racial discrimination and self-reported sleep disturbances, and (2) determine the statistical contribution of experience of racial discrimination to ethnic disparities in sleep disturbances. METHODS The study used data from the 2002/03 New Zealand Health Survey, a nationally-representative, population-based survey of New Zealand adults (≥ 15 years). The sample included 4,108 self-identified Māori (indigenous New Zealanders) and 6,261 European adults. Outcome variables were difficulty falling asleep, frequent nocturnal awakenings, and early morning awakenings. Experiences of racial discrimination across five domains were used to assess overall racial discrimination "ever" and the level of exposure to racial discrimination. Socioeconomic position was measured using neighborhood deprivation, education, and equivalized household income. RESULTS Māori had a higher prevalence of each sleep disturbance item than Europeans. Reported experiences of racial discrimination were independently associated with each sleep disturbance item, adjusted for ethnicity, sex, age group, and socioeconomic position. Sequential logistic regression models showed that racial discrimination and socioeconomic position explained most of the disparity in difficulty falling asleep and frequent nocturnal awakening between Māori and Europeans; however, ethnic differences in early morning awakenings remained. CONCLUSIONS Racial discrimination may play an important role in ethnic disparities in sleep disturbances in New Zealand. Activities to improve the sleep health of non-dominant ethnic groups should consider the potentially multifarious ways in which racial discrimination can disturb sleep.
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Affiliation(s)
| | - Ricci Harris
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Donna Cormack
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - James Stanley
- Dean's Department, University of Otago, Wellington, New Zealand
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86
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Jackson CL, Redline S, Emmons KM. Sleep as a potential fundamental contributor to disparities in cardiovascular health. Annu Rev Public Health 2016; 36:417-40. [PMID: 25785893 DOI: 10.1146/annurev-publhealth-031914-122838] [Citation(s) in RCA: 240] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD). This review examines the relationship between sleep and disparities in CVD. We describe the public health importance of sleep and the role of sleep duration, as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We use a multilevel model focused on population health and health disparities, which is based on the notion that individual behaviors, such as sleep, are influenced by complex and dynamic interrelations among individuals and their physical and social environments. We also describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g., neighborhoods, schools, workplaces) that can address social structures that contribute to disparities, and recommend areas for future research. Integrating sleep into public health research will identify novel approaches for closing gaps in health disparities.
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Affiliation(s)
- Chandra L Jackson
- Clinical and Translational Science Center, Harvard Catalyst, Harvard Medical School, Boston, Massachusetts 02115;
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87
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Halder I, Matthews KA, Buysse DJ, Strollo PJ, Causer V, Reis SE, Hall MH. African Genetic Ancestry is Associated with Sleep Depth in Older African Americans. Sleep 2015; 38:1185-93. [PMID: 25845688 DOI: 10.5665/sleep.4888] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 01/31/2015] [Indexed: 02/05/2023] Open
Abstract
STUDY OBJECTIVES The mechanisms that underlie differences in sleep characteristics between European Americans (EA) and African Americans (AA) are not fully known. Although social and psychological processes that differ by race are possible mediators, the substantial heritability of sleep characteristics also suggests genetic underpinnings of race differences. We hypothesized that racial differences in sleep phenotypes would show an association with objectively measured individual genetic ancestry in AAs. DESIGN Cross sectional. SETTING Community-based study. PARTICIPANTS Seventy AA adults (mean age 59.5 ± 6.7 y; 62% female) and 101 EAs (mean age 60.5 ± 7 y, 39% female). MEASUREMENTS AND RESULTS Multivariate tests were used to compare the Pittsburgh Sleep Quality Index (PSQI) and in-home polysomnographic measures of sleep duration, sleep efficiency, apnea-hypopnea index (AHI), and indices of sleep depth including percent visually scored slow wave sleep (SWS) and delta EEG power of EAs and AAs. Sleep duration, efficiency, and sleep depth differed significantly by race. Individual % African ancestry (%AF) was measured in AA subjects using a panel of 1698 ancestry informative genetic markers and ranged from 10% to 88% (mean 67%). Hierarchical linear regression showed that higher %AF was associated with lower percent SWS in AAs (β (standard error) = -4.6 (1.5); P = 0.002), and explained 11% of the variation in SWS after covariate adjustment. A similar association was observed for delta power. No association was observed for sleep duration and efficiency. CONCLUSION African genetic ancestry is associated with indices of sleep depth in African Americans. Such an association suggests that part of the racial differences in slow-wave sleep may have genetic underpinnings.
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Affiliation(s)
- Indrani Halder
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Victoria Causer
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Steven E Reis
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
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88
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Everson-Rose SA, Lutsey PL, Roetker NS, Lewis TT, Kershaw KN, Alonso A, Diez Roux AV. Perceived Discrimination and Incident Cardiovascular Events: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2015; 182:225-34. [PMID: 26085044 DOI: 10.1093/aje/kwv035] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 01/29/2015] [Indexed: 11/14/2022] Open
Abstract
Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in ≥2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.
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89
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Rosenthal L, Earnshaw VA, Lewis TT, Reid AE, Lewis JB, Stasko EC, Tobin JN, Ickovics JR. Changes in experiences with discrimination across pregnancy and postpartum: age differences and consequences for mental health. Am J Public Health 2015; 105:686-93. [PMID: 24922166 PMCID: PMC4264991 DOI: 10.2105/ajph.2014.301906] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We aimed to contribute to growing research and theory suggesting the importance of examining patterns of change over time and critical life periods to fully understand the effects of discrimination on health, with a focus on the period of pregnancy and postpartum and mental health outcomes. METHODS We used hierarchical linear modeling to examine changes across pregnancy and postpartum in everyday discrimination and the resulting consequences for mental health among predominantly Black and Latina, socioeconomically disadvantaged young women who were receiving prenatal care in New York City. RESULTS Patterns of change in experiences with discrimination varied according to age. Among the youngest participants, discrimination increased from the second to third trimesters and then decreased to lower than the baseline level by 1 year postpartum; among the oldest participants, discrimination decreased from the second trimester to 6 months postpartum and then returned to the baseline level by 1 year postpartum. Within-subjects changes in discrimination over time predicted changes in depressive and anxiety symptoms at subsequent points. Discrimination more strongly predicted anxiety symptoms among participants reporting food insecurity. CONCLUSIONS Our results support a life course approach to understanding the impact of experiences with discrimination on health and when to intervene.
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Affiliation(s)
- Lisa Rosenthal
- Lisa Rosenthal is with the Psychology Department, Pace University, New York, NY. Valerie A. Earnshaw, Jessica B. Lewis, and Jeannette R. Ickovics are with the Yale School of Public Health and the Yale Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT. Tené T. Lewis is with the Rollins School of Public Health, Emory University, Atlanta, GA. Allecia E. Reid is with the Psychology Department, Colby College, Waterville, ME. Emily C. Stasko is with the Department of Psychology, Drexel University, Philadelphia, PA. Jonathan N. Tobin is with the Clinical Directors Network, New York, NY
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90
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Yip T. The effects of ethnic/racial discrimination and sleep quality on depressive symptoms and self-esteem trajectories among diverse adolescents. J Youth Adolesc 2015; 44:419-30. [PMID: 24682960 PMCID: PMC4574503 DOI: 10.1007/s10964-014-0123-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/17/2014] [Indexed: 11/25/2022]
Abstract
Ethnic/racial discrimination has persistent negative implications for both physical and mental health. The current study employs a risk and resilience framework to explore the joint effects of ethnic/racial discrimination and sleep disturbance on psychosocial outcomes among adolescents. In a sample of 146 minority and White adolescents (70% female), changes in depressive symptoms, anxiety, and self-esteem over 3 years are explored using growth curve models. Regardless of ethnic background, adolescents reporting high levels of ethnic/racial discrimination and poor sleep also reported a corresponding increase in depressive symptoms and lower levels of self-esteem over time. Adolescents reporting all other combinations of sleep quality and ethnic/racial discrimination reported more positive adjustment over time. The joint effects of sleep and ethnic/racial discrimination on adolescent psychosocial development are discussed.
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Affiliation(s)
- Tiffany Yip
- Department of Psychology, Fordham University, 226 Dealy Hall, Bronx, NY, USA,
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91
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Slopen N, Lewis TT, Williams DR. Discrimination and sleep: a systematic review. Sleep Med 2015; 18:88-95. [PMID: 25770043 DOI: 10.1016/j.sleep.2015.01.012] [Citation(s) in RCA: 230] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 11/26/2014] [Accepted: 01/20/2015] [Indexed: 01/19/2023]
Abstract
An increasing body of literature indicates that discrimination has a negative impact on health; poor sleep may be an underlying mechanism. The primary objective of this review was to examine existing studies on the relationship between discrimination and sleep to clarify (a) the potential role of discrimination in shaping population patterns of sleep and sleep disparities, and (b) the research needed to develop interventions at individual and institutional levels. We identified articles from English-language publications in PubMed and EBSCO databases from inception through July 2014. We employed a broad definition of discrimination to include any form of unfair treatment and all self-reported and objectively assessed sleep outcomes, including duration, difficulties, and sleep architecture. Seventeen studies were identified: four prospective, 12 cross-sectional, and one that utilized a daily-diary design. Fifteen of the 17 studies evaluated interpersonal discrimination as the exposure and the majority of studies included self-reported sleep as the outcome. Only four studies incorporated objective sleep assessments. All 17 studies identified at least one association between discrimination and a measure of poorer sleep, although studies with more detailed consideration of either discrimination or sleep architecture revealed some inconsistencies. Taken together, existing studies demonstrate consistent evidence that discrimination is associated with poorer sleep outcomes. This evidence base can be strengthened with additional prospective studies that incorporate objectively measured aspects of sleep. We outline important extensions for this field of inquiry that can inform the development of interventions to improve sleep outcomes, and consequently promote well-being and reduce health inequities across the life course.
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Affiliation(s)
- Natalie Slopen
- Department of Epidemiology and Biostatistics, University of Maryland College Park, School of Public Health, College Park, MD, USA.
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA, USA; Department of African and American Studies and Sociology, Harvard University, Cambridge, MA, USA
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92
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Lewis TT, Cogburn CD, Williams DR. Self-reported experiences of discrimination and health: scientific advances, ongoing controversies, and emerging issues. Annu Rev Clin Psychol 2015; 11:407-40. [PMID: 25581238 DOI: 10.1146/annurev-clinpsy-032814-112728] [Citation(s) in RCA: 556] [Impact Index Per Article: 61.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Over the past two decades, research examining the impact of self-reported experiences of discrimination on mental and physical health has increased dramatically. Studies have found consistent associations between exposure to discrimination and a wide range of Diagnostic and Statistical Manual of Mental Disorders (DSM)-diagnosed mental disorders as well as objective physical health outcomes. Associations are seen in cross-sectional as well as longitudinal studies and persist even after adjustment for confounding variables, including personality characteristics and other threats to validity. However, controversies remain, particularly around the best approach to measuring experiences of discrimination, the significance of racial/ethnic discrimination versus overall mistreatment, the need to account for "intersectionalities," and the importance of comprehensive assessments. These issues are discussed in detail, along with emerging areas of emphasis including cyber discrimination, anticipatory stress or vigilance around discrimination, and interventions with potential to reduce the negative effects of discrimination on health. We also discuss priorities for future research and implications for interventions and policy.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322;
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93
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Jackson CL, Hu FB, Redline S, Williams DR, Mattei J, Kawachi I. Racial/ethnic disparities in short sleep duration by occupation: the contribution of immigrant status. Soc Sci Med 2014; 118:71-9. [PMID: 25108693 DOI: 10.1016/j.socscimed.2014.07.059] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 07/08/2014] [Accepted: 07/28/2014] [Indexed: 12/14/2022]
Abstract
Sleep duration, associated with increased morbidity/mortality, has been shown to vary by race and occupation. Few studies have examined the additional influence of immigrant status. Using a nationally-representative sample of 175,244 US adults from the National Health Interview Survey from 2004 to 2011, we estimated prevalence ratios (PRs) for short sleep duration (<7 h/per day) among US- and non-US born Blacks and Latinos by occupation compared to their White counterparts using adjusted Poisson regression models with robust variance. Non-US born participants' mean age was 46 years, 55% were men, 58% were Latino, and 65% lived in the US ≥ 15 years. Short sleep prevalence was highest among US- and non-US born Blacks in all occupations, and the prevalence generally increased with increasing professional/management roles in Blacks and Latinos while it decreased among Whites. Adjusted short sleep was more prevalent in US-born Blacks compared to Whites in professional/management (PR = 1.52 [95% confidence interval (CI): 1.42-1.63]), support services (PR = 1.31 [95% CI: 1.26-1.37]), and laborers (PR = 1.11 [95% CI: 1.06-1.16]). The Black-White comparison was even higher for non-US born Black laborers (PR = 1.50 [95% CI: 1.24-1.80]). Similar for non-US born Latinos, Latinos born in the US had a higher short sleep prevalence in professional/management (PR = 1.14 [95% CI: 1.04-1.24]) and support services (PR = 1.06 [95% CI: 1.01-1.11]), but a lower prevalence among laborers (PR = 0.77 [95% CI: 0.74-0.81]) compared to Whites. Short sleep varied within and between immigrant status for some ethnicities in particular occupations, further illuminating the need for tailored interventions to address sleep disparities among US workers.
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Affiliation(s)
- Chandra L Jackson
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA.
| | - Frank B Hu
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA
| | - Susan Redline
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA
| | - David R Williams
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA
| | - Josiemer Mattei
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA
| | - Ichiro Kawachi
- 655 Huntington Avenue, Building II, Room 302, Boston, MA 02215, USA
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94
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Abstract
Despite its pervasiveness in primary care, deficient sleep often is underappreciated as a cue to other health risks. Accordingly, this review discusses contemporary evidence-based perspectives on impaired sleep and its associations with other lifestyle medicine concerns, including obesity, cardiovascular conditions, psychological problems, and health-compromising habits. The potential clinical benefits of promoting sleep health also will be considered.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City, Kansas City, Missouri
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95
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Abstract
Researchers have long speculated that exposure to discrimination may increase cardiovascular disease (CVD) risk but compared to other psychosocial risk factors, large-scale epidemiologic and community based studies examining associations between reports of discrimination and CVD risk have only emerged fairly recently. This review summarizes findings from studies of self-reported experiences of discrimination and CVD risk published between 2011-2013. We document the innovative advances in recent work, the notable heterogeneity in these studies, and the considerable need for additional work with objective clinical endpoints other than blood pressure. Implications for the study of racial disparities in CVD and clinical practice are also discussed.
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96
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Slopen N, Williams DR. Discrimination, other psychosocial stressors, and self-reported sleep duration and difficulties. Sleep 2014; 37:147-56. [PMID: 24381373 DOI: 10.5665/sleep.3326] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To advance understanding of the relationship between discrimination and sleep duration and difficulties, with consideration of multiple dimensions of discrimination, and attention to concurrent stressors; and to examine the contribution of discrimination and other stressors to racial/ ethnic differences in these outcomes. DESIGN Cross-sectional probability sample. SETTING Chicago, IL. PARTICIPANTS There were 2,983 black, Hispanic, and white adults. MEASUREMENTS AND RESULTS Outcomes included self-reported sleep duration and difficulties. Discrimination, including racial and nonracial everyday and major experiences of discrimination, workplace harassment and incivilities, and other stressors were assessed via questionnaire. In models adjusted for sociodemographic characteristics, greater exposure to racial (β = -0.14)) and nonracial (β = -0.08) everyday discrimination, major experiences of discrimination attributed to race/ethnicity (β = -0.17), and workplace harassment and incivilities (β = -0.14) were associated with shorter sleep (P < 0.05). The association between major experiences of discrimination attributed to race/ethnicity and sleep duration (β = -0.09, P < 0.05) was independent of concurrent stressors (i.e., acute events, childhood adversity, and financial, community, employment, and relationship stressors). Racial (β = 0.04) and non-racial (β = 0.05) everyday discrimination and racial (β = 0.04) and nonracial (β = 0.04) major experiences of discrimination, and workplace harassment and incivilities (β = 0.04) were also associated with more (log) sleep difficulties, and associations between racial and nonracial everyday discrimination and sleep difficulties remained after adjustment for other stressors (P < 0.05). Racial/ethnic differences in sleep duration and difficulties were not significant after adjustment for discrimination (P > 0.05). CONCLUSIONS Discrimination was associated with shorter sleep and more sleep difficulties, independent of socioeconomic status and other stressors, and may account for some of the racial/ethnic differences in sleep.
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Affiliation(s)
- Natalie Slopen
- Center on the Developing Child, Harvard University, Cambridge, MA ; Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Cambridge, MA ; Department of African and African American Studies, Harvard University, Cambridge, MA ; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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97
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Jacobs EA, Rathouz PJ, Karavolos K, Everson-Rose SA, Janssen I, Kravitz HM, Lewis TT, Powell LH. Perceived discrimination is associated with reduced breast and cervical cancer screening: the Study of Women's Health Across the Nation (SWAN). J Womens Health (Larchmt) 2013; 23:138-45. [PMID: 24261647 DOI: 10.1089/jwh.2013.4328] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Racial disparities in breast and cervical cancer screening have been documented in African American, Hispanic, and Asian populations. Perceived discrimination may contribute to this disparity. The aim of this study was to understand the relationship between perceived everyday racial/ethnic and other discrimination and receipt of breast and cervical cancer screening in a multiethnic population of women. METHODS We analyzed data from 3,258 women participating in the Study of Women's Health Across the Nation (SWAN), a multiethnic/racial, longitudinal cohort study of the natural history of the menopausal transition conducted at seven U.S. sites. Participants completed a validated measure of perceived discrimination and reasons for believing that they were treated differently, along with Pap smears, clinical breast exams (CBE), and mammography at each follow-up period. We used multiple logistic regression for the binary outcomes of having a Pap smear, CBE, or mammogram in each of the two follow-up years, using self-reported "race discrimination" and "other discrimination" at baseline as the main predictors. RESULTS African American women reported the highest percentage of racial discrimination (35%), followed by Chinese (20%), Hispanic (12%), Japanese (11%), and non-Hispanic white women (3%). Non-Hispanic white women reported the highest percentage of "other" discrimination (40%), followed by Chinese (33%), African American (24%), Japanese (23%), and Hispanic women (16%). Perceived racial discrimination was not associated with reduced receipt of preventive screening, except in one fully adjusted model. Reported discrimination owing to "other" reasons, such as age or gender, was associated with reduced receipt of Pap smear (odds ratio [OR] 0.85; 95% confidence interval [CI] 0.74-0.99), CBE (OR 0.78; 95% CI 0.67-0.91), and mammography (OR 0.80; 95% CI 0.69-0.92) regardless of patient race. CONCLUSIONS Perceived discrimination is an important issue across racial/ethnic groups and is negatively associated with receipt of breast and cervical cancer screening. This is an important issue that needs to be further explored and addressed in efforts to improve the delivery of healthcare to all groups.
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Affiliation(s)
- Elizabeth A Jacobs
- 1 Departments of Medicine and Population Health Sciences, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin
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98
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Hunte HER, King K, Hicken M, Lee H, Lewis TT. Interpersonal discrimination and depressive symptomatology: examination of several personality-related characteristics as potential confounders in a racial/ethnic heterogeneous adult sample. BMC Public Health 2013; 13:1084. [PMID: 24256578 PMCID: PMC3845526 DOI: 10.1186/1471-2458-13-1084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 11/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research suggests that reports of interpersonal discrimination result in poor mental health. Because personality characteristics may either confound or mediate the link between these reports and mental health, there is a need to disentangle its role in order to better understand the nature of discrimination-mental health association. We examined whether hostility, anger repression and expression, pessimism, optimism, and self-esteem served as confounders in the association between perceived interpersonal discrimination and CESD-based depressive symptoms in a race/ethnic heterogeneous probability-based sample of community-dwelling adults. METHODS We employed a series of ordinary least squares regression analyses to examine the potential confounding effect of hostility, anger repression and expression, pessimism, optimism, and self-esteem between interpersonal discrimination and depressive symptoms. RESULTS Hostility, anger repression, pessimism and self-esteem were significant as possible confounders of the relationship between interpersonal discrimination and depressive symptoms, together accounting for approximately 38% of the total association (beta: 0.1892, p < 0.001). However, interpersonal discrimination remained a positive predictor of depressive symptoms (beta: 0.1176, p < 0.001). CONCLUSION As one of the first empirical attempts to examine the potential confounding role of personality characteristics in the association between reports of interpersonal discrimination and mental health, our results suggest that personality-related characteristics may serve as potential confounders. Nevertheless, our results also suggest that, net of these characteristics, reports of interpersonal discrimination are associated with poor mental health.
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Affiliation(s)
- Haslyn E R Hunte
- School of Public Health, Social & Behavioral Sciences, Robert C, Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV 26506-9190, USA.
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99
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Williams DR, Mohammed SA. Racism and Health I: Pathways and Scientific Evidence. THE AMERICAN BEHAVIORAL SCIENTIST 2013; 57:10.1177/0002764213487340. [PMID: 24347666 PMCID: PMC3863357 DOI: 10.1177/0002764213487340] [Citation(s) in RCA: 680] [Impact Index Per Article: 61.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This article reviews the scientific research that indicates that despite marked declines in public support for negative racial attitudes in the United States, racism, in its multiple forms, remains embedded in American society. The focus of the article is on the review of empirical research that suggests that racism adversely affects the health of non-dominant racial populations in multiple ways. First, institutional racism developed policies and procedures that have reduced access to housing, neighborhood and educational quality, employment opportunities and other desirable resources in society. Second, cultural racism, at the societal and individual level, negatively affects economic status and health by creating a policy environment hostile to egalitarian policies, triggering negative stereotypes and discrimination that are pathogenic and fostering health damaging psychological responses such as stereotype threat and internalized racism. Finally, a large and growing body of evidence indicates that experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioural patterns that increase health risks.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health ; Department of African and African American Studies and of Sociology, Harvard University ; Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - Selina A Mohammed
- Nursing and Health Studies Program, University of Washington Bothell, Bothell, WA
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100
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Hicken MT, Lee H, Ailshire J, Burgard SA, Williams DR. "Every shut eye, ain't sleep": The role of racism-related vigilance in racial/ethnic disparities in sleep difficulty. RACE AND SOCIAL PROBLEMS 2013; 5:100-112. [PMID: 23894254 PMCID: PMC3722054 DOI: 10.1007/s12552-013-9095-9] [Citation(s) in RCA: 201] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress - "racism-related vigilance" - and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.
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Affiliation(s)
- Margaret T. Hicken
- Department of Epidemiology, University of Michigan, 3634 SPH Tower, 1416 Washington Heights, Ann Arbor, MI 48109, 734.615.9205
| | - Hedwig Lee
- Department of Sociology, University of Washington, Savery 234, Box 353340, Seattle, WA 98195-3340, 206.543.4572
| | - Jennifer Ailshire
- Center for Biodemography and Population Health, University of Southern California, 3715 McClintock Avenue, Room 218C, Los Angeles, CA 90089-0191
| | - Sarah A. Burgard
- Department of Sociology, University of Michigan, 500 State Street, Ann Arbor, MI 48109-1382, 734.615.9538
| | - David R. Williams
- Department of Society, Human Development and Health, Harvard University 615, Kresge Building, 677 Huntington Avenue, Boston, MA 02115, 617.432.6807
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