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Hackett RA, Ronaldson A, Bhui K, Steptoe A, Jackson SE. Racial discrimination and health: a prospective study of ethnic minorities in the United Kingdom. BMC Public Health 2020; 20:1652. [PMID: 33203386 PMCID: PMC7672934 DOI: 10.1186/s12889-020-09792-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/29/2020] [Indexed: 12/28/2022] Open
Abstract
Background Racism has been linked with poor health in studies in the United States. Little is known about prospective associations between racial discrimination and health outcomes in the United Kingdom (UK). Methods Data were from 4883 ethnic minority (i.e. non-white) participants in the UK Household Longitudinal Study. Perceived discrimination in the last 12 months on the basis of ethnicity or nationality was reported in 2009/10. Psychological distress, mental functioning, life satisfaction, self-rated health, physical functioning and reports of limiting longstanding illness were assessed in 2009/10 and 2011/12. Linear and logistic regression analyses adjusted for age, sex, income, education and ethnicity. Prospective analyses also adjusted for baseline status on the outcome being evaluated. Results Racial discrimination was reported by 998 (20.4%) of the sample. Cross-sectionally, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (odds ratio (OR) = 1.78, 95% confidence interval (CI) 1.49; 2.13) and fair/poor self-rated health (OR = 1.50; 95% CI 1.24; 1.82) than those who did not report racial discrimination. Racial discrimination was associated with greater psychological distress (B = 1.11, 95% CI 0.88; 1.34), poorer mental functioning (B = − 3.61; 95% CI -4.29; − 2.93), poorer physical functioning (B = − 0.86; 95% CI -1.50; − 0.27), and lower life satisfaction (B = − 0.40, 95% CI -0.52; − 0.27). Prospectively, those who reported racial discrimination had a greater likelihood on average of limiting longstanding illness (OR = 1.31, 95% CI 1.01; 1.69) and fair/poor self-rated health (OR = 1.30; 95% CI 1.00; 1.69), than those who did not report racial discrimination. Racial discrimination was associated increased psychological distress (B = 0.52, 95% CI 0.20; 0.85) and poorer mental functioning (B = − 1.77; 95% CI -2.70; − 0.83) over two-year follow-up, adjusting for baseline scores. Conclusions UK adults belonging to ethnic minority groups who perceive racial discrimination experience poorer mental and physical health than those who do not. These results highlight the need for effective interventions to combat racial discrimination in order to reduce inequalities in health. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-020-09792-1.
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Affiliation(s)
- Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. .,Department of Behavioural Science and Health, University College London, London, UK.
| | - Amy Ronaldson
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kamaldeep Bhui
- Centre for Department of Psychiatry & Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
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152
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Zghal A, El-Masri M, McMurphy S, Pfaff K. Exploring the Impact of Health Care Provider Cultural Competence on New Immigrant Health-Related Quality of Life: A Cross-Sectional Study of Canadian Newcomers. J Transcult Nurs 2020; 32:508-517. [PMID: 33095098 PMCID: PMC8404719 DOI: 10.1177/1043659620967441] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: New immigrants underutilize health care because of multiple barriers. Although culturally competent health care improves access, it is typically assessed by providers, not newcomers whose perceptions matter most. Methodology: Surveys that included measures of cultural competence and health-related quality of life (QOL) were completed by 117 new immigrants in Windsor, Ontario, Canada. A series of stepwise linear regression analyses were conducted to identify independent predictors of QOL and its four domains: physical health, psychological, social relationships, and environment. Results: Our adjusted results suggest that experiences of discrimination was negatively associated with overall QOL (β = −.313; p < .001) and its psychological (β = −.318; p < .001), social (β = −.177; p = .048), and environmental (β = −.408; p < .001) domains. Discussion: Discrimination negatively influences new immigrant QOL. Provider cultural competency training should emphasize the influence of provider discrimination on immigrant health and explore learners’ values and biases.
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Affiliation(s)
- Afef Zghal
- University of Windsor, Windsor, Ontario, Canada
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153
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Scott J, Silva S, Simmons LA. Social Adversity, Sleep Characteristics, and Elevated Blood Pressure Among Young Adult Black Females. Health Equity 2020; 4:421-429. [PMID: 33111027 PMCID: PMC7585615 DOI: 10.1089/heq.2020.0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose: We examined whether sleep characteristics and adverse social exposures were associated with elevated blood pressure (BP) in young adult black women. Methods: This is a cross-sectional analysis of existing data from 581 black females who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health). Adverse social exposures included child abuse, discrimination, perceived stress, social isolation, and subjective social status. Self-reported sleep characteristics were measures of duration, latency, continuity, and snoring. Logistic regression was used to evaluate the influence of social exposures and sleep characteristics on BP. Results: Among the women (mean age=29.1 years), 32.4% had elevated BP (≥130 systolic or ≥80 diastolic). In adjusted analysis, poor sleep continuity (adjusted odds ratio [aOR]=1.70, 95% confidence interval [CI]=1.07–2.70) and discrimination (aOR=1.61, 95% CI=1.00–2.58) were associated with higher odds of elevated BP, while more social isolation (aOR=0.69, 95% CI=0.48–0.99) was associated with lower odds of elevated BP. Conclusion: Poor sleep continuity and experiencing discrimination may represent key risk factors for hypertension in young black females. Unexpectedly, being more isolated was associated with lower BP. Future research should examine how to adapt current paradigms and measures of social connectedness, isolation, and stress to better elucidate the impact of these factors on the long-term health of young black females.
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Affiliation(s)
- Jewel Scott
- Duke University School of Nursing, Durham, North Carolina, USA
| | - Susan Silva
- Duke University School of Nursing, Durham, North Carolina, USA
| | - Leigh Ann Simmons
- Department of Human Ecology, University of California, Davis, Davis, California, USA
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154
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Cano M. English use/proficiency, ethnic discrimination, and alcohol use disorder in Hispanic immigrants. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1345-1354. [PMID: 32055891 DOI: 10.1007/s00127-020-01837-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/03/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Acculturation-related measures, often based on language, have traditionally been identified as predictors of drinking outcomes for US Hispanics. However, a sole focus on acculturation may obscure the role of societal factors such as discrimination. The present study evaluated ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder in US Hispanic immigrants. METHODS The study examined data from the 2222 self-identified Hispanic immigrant adults in the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported alcohol use within the past year. The study utilized multivariable binomial logistic regression analyses to test relationships between English use/proficiency and perceived ethnic discrimination; English use/proficiency and DSM-5 alcohol use disorder; ethnic discrimination and DSM-5 alcohol use disorder. Statistical mediation examined ethnic discrimination as a mediator in the relationship between English use/proficiency and alcohol use disorder. RESULTS Perceived ethnic discrimination was significantly associated with alcohol use disorder in men (adjusted odds ratio [AOR] 1.99; 95% CI [confidence interval], 1.40-2.83), yet not women (AOR 1.32; 95% CI, 0.71-2.44), in a regression model that also included English use/proficiency. Perceived ethnic discrimination also acted as a partial mediator between English use/proficiency and DSM-5 alcohol use disorder for male, yet not female, Hispanic immigrants. CONCLUSION Findings show some support for the notion that experiences of ethnic discrimination, which may accompany the process of acculturation, partially explain deteriorating drinking outcomes in Hispanic immigrant men adapting to life in the US.
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Affiliation(s)
- Manuel Cano
- Department of Social Work, University of Texas at San Antonio, 501 W. César E. Chávez Blvd., San Antonio, TX, 78207, USA.
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155
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Cheng P, Cuellar R, Johnson DA, Kalmbach DA, Joseph CL, Cuamatzi Castelan A, Sagong C, Casement MD, Drake CL. Racial discrimination as a mediator of racial disparities in insomnia disorder. Sleep Health 2020; 6:543-549. [PMID: 32928711 PMCID: PMC7485499 DOI: 10.1016/j.sleh.2020.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES Racial and ethnic minorities are more likely to suffer from insomnia that is more severe; however, few studies have examined mechanisms by which racial disparities in severity of insomnia disorder may arise. One potential mechanism for disparities in insomnia severity is perceived discrimination. This study tested discrimination as a mediator in the relationship between race and insomnia. METHODS Participants were recruited from communities in the Detroit metropolitan area and were diagnosed with insomnia disorder using the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). The final sample included 1,458 individuals. Insomnia symptom severity was assessed via the Insomnia Severity Index and self-reported racial discrimination was evaluated using a single item. Racial discrimination was tested as a mediator in the relationship between race and insomnia symptom severity. Individuals were categroized as either White or a racial minority (i.e., non White individuals), with sensitivity analyses examining Black individuals and non-Black racial minority groups. RESULTS Consistent with our hypothesis, racial discrimination was a significant mediator accounting for 57.3% of the relationship between race and insomnia symptom severity. Sensitivity analyses indicated that the indirect effect of racial discrimination was stronger in the non-Black racial minority group compared to Black individuals. CONCLUSIONS These results provide support that racial discrimination is likely an important mechanism by which racial and ethnic sleep disparities exist. Implications for prevention, intervention, and treatment of insomnia in racial minorities to reduce health disparities are discussed.
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Affiliation(s)
- Philip Cheng
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI USA.
| | - Ruby Cuellar
- Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - David A Kalmbach
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI USA
| | - Christine Lm Joseph
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI USA
| | | | - Chaewon Sagong
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI USA
| | | | - Christopher L Drake
- Thomas Roth Sleep Disorders and Research Center, Henry Ford Health System, Novi, MI USA
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156
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Billings ME, Cohen RT, Baldwin CM, Johnson DA, Palen BN, Parthasarathy S, Patel SR, Russell M, Tapia IE, Williamson AA, Sharma S. Disparities in Sleep Health and Potential Intervention Models: A Focused Review. Chest 2020; 159:1232-1240. [PMID: 33007324 PMCID: PMC7525655 DOI: 10.1016/j.chest.2020.09.249] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 08/25/2020] [Accepted: 09/24/2020] [Indexed: 12/14/2022] Open
Abstract
Disparities in sleep health are important but underrecognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socioeconomic status, racism, discrimination, neighborhood segregation, geography, social patterns, and access to health care as well as by cultural beliefs, necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating, and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.
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Affiliation(s)
- Martha E Billings
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA
| | - Robyn T Cohen
- Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA
| | - Carol M Baldwin
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ
| | - Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Brian N Palen
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington School of Medicine, Seattle, WA; Veterans Affairs Puget Sound Health Care System, Seattle, WA
| | | | - Sanjay R Patel
- Center for Sleep and Cardiovascular Outcomes Research, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Maureen Russell
- Northern Arizona University, Institute for Human Development, Flagstaff, AZ
| | - Ignacio E Tapia
- Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Ariel A Williamson
- Sleep Center, Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sunil Sharma
- Division of Pulmonary, Critical Care, and Sleep Medicine, West Virginia University, WV.
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157
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Liang T, Munro HM, Hargreaves MK, Steinwandel MD, Blot WJ, Buchowski MS. Patterns and correlates of sleep duration in the Southern cohort community study. Sleep Med 2020; 75:459-467. [PMID: 32998092 DOI: 10.1016/j.sleep.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate whether race (African American (AA) and white) is associated with sleep duration among adults from low socioeconomic (SES) strata and whether SES status, lifestyle behaviors, or health conditions are associated with sleep duration within race-sex groups. METHODS This cross-sectional study includes 78,549 participants from the Southern Community Cohort Study (SCCS). Averaged daily sleep duration was assessed by weighted averages of self-reported sleep duration on weekdays and weekends. Adjusted odds ratios (ORs) of very short (<5 h/day), short (5-6 h/day), and long sleep (≥9 h/day) associated with pre-selected risk factors in each race-sex group were determined by multinomial logistic models. RESULTS The prevalence of very short and short sleep was similar among AAs (6.2% and 29.1%) and whites (6.5% and 29.1%). Long sleep was considerably more prevalent among AAs (19.3%) than whites (13.0%). Very short sleep was associated with lower education and family income, with stronger associations among whites. Higher physical activity levels significantly decreased odds for both very short (OR = 0.80) and long sleep (OR = 0.78). Smoking, alcohol use, and dietary intake were not associated with sleep duration. Regardless of race or sex, very short, short, and long sleep were significantly associated with self-reported health conditions, especially depression (ORs were 2.06, 1.33, and 1.38, respectively). CONCLUSIONS Sleep duration patterns differed between AAs and whites from the underrepresented SCCS population with low SES. Sleep duration was associated with several socioeconomic, health behaviors, and health conditions depending on race and sex.
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Affiliation(s)
- Tao Liang
- Division of Gastroenterology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Heather M Munro
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Mark D Steinwandel
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William J Blot
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maciej S Buchowski
- Division of Gastroenterology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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158
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Moore KR, Williams DR, Baird DD. Disparities by Skin Color Among Young African-American Women. J Racial Ethn Health Disparities 2020; 8:1002-1011. [PMID: 32888171 DOI: 10.1007/s40615-020-00856-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/18/2020] [Accepted: 08/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Light-skin disadvantage (hypothesized to result from resentment by darker-skinned individuals) has been described in majority African-American populations but is less studied than dark-skin disadvantage. We investigated both light- and dark-skin disadvantage in a contemporary African-American study population. METHODS We used skin reflectance and questionnaire data from 1693, young African-American women in Detroit, Michigan, and dichotomized outcomes as advantaged/disadvantaged. We compared outcomes for women with light vs. medium skin color with prevalence differences (PDs) and 95% confidence intervals (CIs), and dark-skin disadvantage with prevalence ratios (PRs) and 95% CIs for a 10-unit increase in skin color. RESULTS There was little evidence for light-skin disadvantage, but darker skin was associated with disadvantage across socioeconomic, health, and psychosocial domains. The strongest associations were for SES, but even controlling for SES, other associations included higher body mass index (PR 1.14 95% CI 1.08-1.20) and more stressful events (PR 1.10 95% CI 1.01-1.20). CONCLUSIONS Dark-skin disadvantage was the predominant form of colorism. Skin color metrics in public health research can capture more information than simple racial/ethnic categories, and such research could bring awareness to the deep-rooted colorism in society.
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Affiliation(s)
- Kristen R Moore
- Epidemiology Branch A3-05, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, 27709, USA.
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Donna D Baird
- Epidemiology Branch A3-05, National Institute of Environmental Health Sciences, Research Triangle Park, Durham, NC, 27709, USA
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159
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Mirpuri S, Ocampo A, Narang B, Roberts N, Gany F. Discrimination as a social determinant of stress and health among New York City taxi drivers. J Health Psychol 2020; 25:1384-1395. [PMID: 29409354 PMCID: PMC8482413 DOI: 10.1177/1359105318755543] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Discrimination is associated with poorer mental and physical health outcomes. Taxi drivers have a higher risk of exposure to discrimination and higher rates of chronic conditions. A cross-sectional needs assessment was conducted with a multilingual group of 535 male taxi drivers in New York City. Drivers reporting higher discrimination were more likely to have higher perceived stress and were more likely to have anxiety/depression and chronic pain, adjusting for confounders. Workplace-based interventions designed to help drivers cope with discrimination, stress, and chronic health conditions, interventions to educate the taxi-riding public, and greater attention to these issues from administrative agencies are warranted.
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Affiliation(s)
- Sheena Mirpuri
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole Roberts
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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160
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Jackson CL, Walker JR, Brown MK, Das R, Jones NL. A workshop report on the causes and consequences of sleep health disparities. Sleep 2020; 43:zsaa037. [PMID: 32154560 PMCID: PMC7420527 DOI: 10.1093/sleep/zsaa037] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Indexed: 01/10/2023] Open
Abstract
Sleep deficiencies, which include insufficient or long sleep duration, poor sleep quality, and irregular timing of sleep, are disproportionately distributed among populations that experience health disparities in the United States. Sleep deficiencies are associated with a wide range of suboptimal health outcomes, high-risk health behaviors, and poorer overall functioning and well-being. This report focuses on sleep health disparities (SHDs), which is a term defined as differences in one or more dimensions of sleep health on a consistent basis that adversely affect designated disadvantaged populations. SHDs appear to share many of the same determinants and causal pathways observed for health outcomes with well-known disparities. There also appears to be common behavioral and biological mechanisms that connect sleep with poorer health outcomes, suggesting a link between SHDs and other health disparities observed within these designated populations. In 2018, the National Institute on Minority Health and Health Disparities, the National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research convened a workshop with experts in sleep, circadian rhythms, and health disparities to identify research gaps, challenges, and opportunities to better understand and advance research to address SHDs. The major strategy to address SHDs is to promote integration between health disparity causal pathways and sleep and circadian-related mechanisms in research approaches and study designs. Additional strategies include developing a comprehensive, integrative conceptual model, building transdisciplinary training and research infrastructure, and designing as well as testing multilevel, multifactorial interventions to address SHDs.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Jenelle R Walker
- Center for Translation Research and Implementation Science, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Marishka K Brown
- Division of Lung Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Rina Das
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Nancy L Jones
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
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161
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Yip T, Cheon YM. Sleep, psychopathology and cultural diversity. Curr Opin Psychol 2020; 34:123-127. [PMID: 32203913 PMCID: PMC7308190 DOI: 10.1016/j.copsyc.2020.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 02/10/2020] [Accepted: 02/11/2020] [Indexed: 11/30/2022]
Abstract
Research on ethnic/racial disparities in sleep in the United States finds minorities to have shorter self-reported and actigraphy-recorded sleep duration and poorer sleep quality. Disparities in mental health mirror disparities in sleep with ethnic/racial minorities reporting higher prevalence and more severe struggles. This review focuses on recent research in sleep and mental health disparities and considers ethnic/racial discrimination as an important third variable that may link these two domains of disparities research. For example, research has found discrimination to mediate ethnic/racial disparities in sleep; at the same time, sleep has been observed to mediate the link between discrimination and mental health. The review concludes with the importance of considering ethnicity/race and accompanying sociodemographic, environmental, and behavioral influences on sleep and mental health research.
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162
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Springfield S, Qin F, Hedlin H, Eaton CB, Rosal MC, Taylor H, Staudinger UM, Stefanick ML. Resilience and CVD-protective Health Behaviors in Older Women: Examining Racial and Ethnic Differences in a Cross-Sectional Analysis of the Women's Health Initiative. Nutrients 2020; 12:E2107. [PMID: 32708626 PMCID: PMC7400950 DOI: 10.3390/nu12072107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022] Open
Abstract
Little is known about the relationship between self-reported psychological resilience (resilience) and health behaviors shown to reduce the risk of cardiovascular disease (CVD). This study examines the associations between resilience and CVD-related risk factors, such as diet, smoking, physical activity, sleep, and alcohol consumption among older American women from diverse backgrounds. METHODS A cross-sectional secondary analysis was conducted on 77,395 women (mean age 77 years, Black (N = 4475, 5.8%), non-Hispanic white (N = 69,448, 89.7%), Latina (N = 1891, 2.4%), and Asian or Pacific Islander (N = 1581, 2.0%)) enrolled in the Women's Health Initiative Extension Study II. Resilience was measured using an abbreviated version of the brief resilience scale. Multivariable logistic regression models were used to evaluate the association between resilience and health behaviors associated with risk for CVD, while adjusting for stressful life events and sociodemographic information. To test whether these associations varied among racial/ethnic groups, an interaction term was added to the fully adjusted models between resilience and race/ethnicity. RESULTS High levels of resilience were associated with better diet quality (top 2 quintiles of the Healthy Eating Index 2015) (OR = 1.22 (95% Confidence Interval (1.15-1.30)), adhering to recommended physical activity (≥ 150 min per week) (1.56 (1.47, 1.66)), sleeping the recommended hours per night (7-9) (1.36 (1.28-1.44)), and moderate alcohol intake (consuming alcoholic drink(s) 1-7 days per week) (1.28 (1.20-1.37)). The observed association between resilience and sleep is modified by race/ethnicity (p = 0.03). CONCLUSION Irrespective of race/ethnicity, high resilience was associated with CVD-protective health behaviors. This warrants further investigation into whether interventions aimed at improving resilience could increase the effectiveness of lifestyle interventions.
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Affiliation(s)
- Sparkle Springfield
- Parkinson School of Health Sciences and Public Health, Department of Public Health, Loyola University Chicago, 2160 S N 1st Ave, Maywood, IL 60153, USA
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University, Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University, Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Charles B. Eaton
- Warren Alpert Medical School, Department of Family Medicine School of Public Health Brown, Providence University, Providence, RI 02912, USA;
| | - Milagros C. Rosal
- Department of Population and Quantitative Health Sciences, Medical School of Massachusetts University, Massachusetts University, Worcester, MA 01605, USA;
| | - Herman Taylor
- Research Wing Room, Morehouse School of Medicine Cardiovascular Research Institute, Atlanta, GA 30310, USA;
| | - Ursula M. Staudinger
- Columbia Aging Center & Department of Socio medical Science, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Stanford University, Alto, CA 94304, USA;
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Gaston SA, Nguyen-Rodriguez S, Aiello AE, McGrath J, Jackson WB, Nápoles A, Pérez-Stable EJ, Jackson CL. Hispanic/Latino heritage group disparities in sleep and the sleep-cardiovascular health relationship by housing tenure status in the United States. Sleep Health 2020; 6:451-462. [PMID: 32622645 DOI: 10.1016/j.sleh.2020.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/13/2019] [Accepted: 01/07/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The objective of this study was to investigate whether the sleep-cardiovascular health (CVH) association varies by Hispanic/Latino heritage group and housing tenure status (i.e., homeownership, unassisted housing, government-assisted housing), which is an important social determinant of health. DESIGN Cross-sectional analysis of pooled National Health Interview Survey (2004-2017) data. SETTING United States. PARTICIPANTS US-born/non-US-born Mexican, Puerto Rican, Cuban, Dominican, Central/South American, and US-born non-Hispanic (NH)-white adults. MEASUREMENTS Within each housing tenure category, Poisson regressions with robust variance estimated the adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) of (1) habitual sleep duration (<6-hours, 6-<7-hours, and >9-hours vs. 7-9 hours) and sleep quality for Hispanic/Latino heritage groups compared with NH-whites and (2) ideal CVH for Hispanic/Latino heritage groups within each sleep duration category, separately, compared with NH-whites who reported 7-9 hours sleep duration. RESULTS Among 283,767 NH-white and Hispanic/Latino adults (mean age=47.0±0.09 years, 50.1% female), 33% rented housing (4% government-assisted; 29% unassisted), and 67% were homeowners. Compared with their NH-white housing tenure counterparts, only Puerto Rican homeowners were more likely to report <6-hours (PR=1.70 [95% CI: 1.44-2.01]) and 6-<7-hours (PR=1.31 [1.19-1.44]) sleep duration. Overall, Hispanic/Latino heritage groups were either less likely or no more likely to report >9-hours sleep duration and poor sleep quality compared with NH-whites. Disparities in CVH were large between Puerto Rican unassisted renters and homeowners who reported >9-hours of habitual sleep compared with their NH-white housing tenure counterparts who reported 7-9 hours. CONCLUSIONS Hispanic/Latino-white disparities in the sleep-CVH relationship may vary by Hispanic/Latino heritage group and housing tenure.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | | | - Allison E Aiello
- Department of Epidemiology and Carolina Population Center, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John McGrath
- Social & Scientific Systems, Inc., Research Triangle Park, NC, USA
| | | | - Anna Nápoles
- Office of the Scientific Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities and the Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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Graham C, Reither EN, Ciciurkaite G, Dev DA, Fargo J. Does context matter? A multilevel analysis of neighborhood disadvantage and children's sleep health. Sleep Health 2020; 6:578-586. [PMID: 32546433 DOI: 10.1016/j.sleh.2020.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 04/28/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine how demographic, socioeconomic, and neighborhood characteristics are associated with bedtimes among US kindergarteners. DESIGN Parents reported bedtimes of their children as well as personal, household, and residential characteristics via interviews in the Early Childhood Longitudinal Study-Kindergarten (ECLS-K) Class of 1998-1999. The ECLS-K links individual households to US Census tracts. SETTING A random selection of 1,280 schools and surrounding communities in the US. PARTICIPANTS A random selection of 16,936 kindergarteners and their parents. MEASUREMENTS The 2 outcomes were regular and latest weekday bedtimes of kindergarteners. Through a series of nested multilevel regression models, these outcomes were regressed on individual- and neighborhood-level variables, including race/ethnicity, sex, family type, household income, mother's educational attainment, neighborhood disorder, and several additional neighborhood characteristics. RESULTS Models showed significant (P < .05) bedtime disparities by race/ethnicity, sex, family income, and mother's educational attainment. Additionally, models tended to indicate that kindergarteners from disadvantaged neighborhoods experienced later bedtimes than children from more advantaged areas. Neighborhood characteristics accounted for a portion of racial/ethnic differences, suggesting that bedtime disparities are partly rooted in disparate environmental conditions. CONCLUSIONS Reducing disparities in childhood sleep may require programs that target not only children and their parents, but also the communities in which they reside.
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Affiliation(s)
| | - Eric N Reither
- Department of Sociology, Social Work and Anthropology, Utah State University, Logan, Utah; Utah State University, Logan, Utah.
| | | | - Dipti A Dev
- University of Nebraska-Lincoln, Lincoln, Nebraska
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Yip T, Cham H, Wang Y, El-Sheikh M. Discrimination and Sleep Mediate Ethnic/Racial Identity and Adolescent Adjustment: Uncovering Change Processes With Slope-as-Mediator Mediation. Child Dev 2020; 91:1021-1043. [PMID: 31317537 PMCID: PMC6980173 DOI: 10.1111/cdev.13276] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study employs slope-as-mediator techniques to explore how the daily association between ethnic/racial discrimination and sleep disturbances serves as an intermediary link between ethnic/racial identity (ERI) and psychological adjustment. In a diverse sample of 264 adolescents (Mage = 14.3 years old, 70% female, 76% United States born, 25% African American, 32% Asian American, 43% Latinx), discrimination was associated with sleep disturbance. Furthermore, ERI commitment buffered the impact of discrimination on sleep, whereas ERI exploration exacerbated the impact of discrimination. Finally, the daily level association between discrimination and sleep (i.e., daily slope) mediated the association between ERI and adolescent adjustment. Substantive links between discrimination and sleep are discussed as well as broader applications of slope-as-mediator techniques.
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166
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Yip T, Cheon YM, Wang Y, Cham H, Tryon W, El-Sheikh M. Racial Disparities in Sleep: Associations With Discrimination Among Ethnic/Racial Minority Adolescents. Child Dev 2020; 91:914-931. [PMID: 30942498 PMCID: PMC11174141 DOI: 10.1111/cdev.13234] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This study investigates the same-day associations between discrimination and sleep among 350 adolescents ages 13-15 (M = 14.29, SD = 0.65; Asian = 41%, Black = 22%, Latinx = 37%). Assessing sleep duration, sleep onset latency, and wake minutes after sleep onset using wrist actigraphy, Black adolescents slept 35 min less than Asian and 36 min less than Latinx youth. Black adolescents suffered the most wake minutes after sleep onset, followed by Latinx and Asian youth. Latinx youth reported the highest levels of sleep disturbance, whereas Asian youth reported the highest levels of daytime dysfunction. Daily discrimination was associated with lower levels of same-night sleep onset latency, more sleep disturbance, more next-day daytime dysfunction, and higher next-day daytime sleepiness.
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167
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Powell CA, Rifas-Shiman SL, Oken E, Krieger N, Rich-Edwards JW, Redline S, Taveras EM. Maternal experiences of racial discrimination and offspring sleep in the first 2 years of life: Project Viva cohort, Massachusetts, USA (1999-2002). Sleep Health 2020; 6:463-468. [PMID: 32331867 DOI: 10.1016/j.sleh.2020.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/20/2019] [Accepted: 02/03/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the association of maternal lifetime experiences of racial discrimination with infant sleep duration over the first 2 years of life. DESIGN Prebirth cohort study. SETTING Massachusetts, USA (baseline: 1999-2002). PARTICIPANTS 552 mother-infant dyads in Project Viva, for whom the mother self-identified as being a woman of color. MEASUREMENTS During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in eight domains. The main outcome was a weighted average of their infants' 24-hour sleep duration from 6 months to 2 years. RESULTS 30% reported 0 domains of racial discrimination, 35% 1-2 domains, and 34% ≥3 domains. Any racial discrimination (≥1 vs. 0 domains) was higher among black (80%) versus Hispanic (58%) or Asian (53%) mothers and the United States versus foreign-born mothers (79% vs. 58%) and was associated with higher mean prepregnancy BMI (26.8 vs. 24.5 kg/m2). Children whose mothers reported ≥3 domains versus 0 domains had shorter sleep duration from 6 months to 2 years in unadjusted analysis (β -18.6 min/d; 95% CI -37.3, 0.0), which was attenuated after adjusting for maternal race/ethnicity and nativity (-13.6 min/d; -33.7, 6.5). We found stronger associations of racial discrimination with offspring sleep at 6 months (-49.3 min/d; -85.3, -13.2) than for sleep at 1 year (-13.5 min/d; -47.2, 20.3) or 2 years (4.2 min/d; -21.5, 29.9). CONCLUSIONS Maternal lifetime experiences of racial discrimination was associated with shorter offspring sleep duration at 6 months, but not with infant's sleep at 1 and 2 years of age.
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Affiliation(s)
- Chloé A Powell
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Division of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA.
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Susan Redline
- Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, and Beth Israel Deaconess Medical School, Boston, MA
| | - Elsie M Taveras
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA
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Abstract
The concept of sleep health provides a positive holistic framing of multiple sleep characteristics, including sleep duration, continuity, timing, alertness, and satisfaction. Sleep health promotion is an underrecognized public health opportunity with implications for a wide range of critical health outcomes, including cardiovascular disease, obesity, mental health, and neurodegenerative disease. Using a socioecological framework, we describe interacting domains of individual, social, and contextual influences on sleep health. To the extent that these determinants of sleep health are modifiable, sleep and public health researchers may benefit from taking a multilevel approach for addressing disparities in sleep health. For example, in addition to providing individual-level sleep behavioral recommendations, health promotion interventions need to occur at multiple contextual levels (e.g., family, schools, workplaces, media, and policy). Because sleep health, a key indicator of overall health, is unevenly distributed across the population, we consider improving sleep health a necessary step toward achieving health equity.
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Affiliation(s)
- Lauren Hale
- Program in Public Health; and Department of Family, Population, and Preventive Medicine; Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794-8338, USA;
| | - Wendy Troxel
- Division of Behavior and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania 15213, USA;
| | - Daniel J Buysse
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA;
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169
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Gaston SA, Feinstein L, Slopen N, Sandler DP, Williams DR, Jackson CL. Everyday and major experiences of racial/ethnic discrimination and sleep health in a multiethnic population of U.S. women: findings from the Sister Study. Sleep Med 2020; 71:97-105. [PMID: 32505024 DOI: 10.1016/j.sleep.2020.03.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/12/2020] [Accepted: 03/10/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Perceived racial/ethnic discrimination and poor sleep occur across all races/ethnicities in the U.S., although both are most common among racial/ethnic minorities. Few studies have investigated associations between perceived racial/ethnic discrimination and various sleep dimensions in a multiethnic population. METHODS We analyzed cross-sectional associations among 40,038 eligible Sister Study participants (enrollment: 2003-2009) who reported ever/never experiencing specific types of everyday (eg, treated unfairly at a store or restaurant) or major (eg, unfairly stopped, threatened, or searched by police) discrimination attributed to their race/ethnicity during a follow-up survey in 2008-2012. Participants also reported short sleep duration (<7 h), sleep debt (≥2-h difference between longest and shortest sleep duration), frequent napping (≥3 times/week), and insomnia. Poisson regression with robust variance estimation, adjusted for sociodemographic and health characteristics, estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between each type of racial/ethnic discrimination and each sleep dimension, overall and by race/ethnicity. RESULTS Mean age was 55 ± 8.9 years, 89% were Non-Hispanic (NH)-white, 8% NH-black, and 3% Hispanic/Latina. NH-black participants were the most likely to report everyday (76% vs. 4% [NH-whites] and 36% [Hispanics/Latinas]) and major racial/ethnic discrimination (52% vs. 2% [NH-whites] and 18% [Hispanics/Latinas]). Participants who experienced both types versus neither were more likely to report short sleep duration (PR = 1.17 [95% CI: 1.09-1.25]) and insomnia symptoms (PR = 1.10 [1.01-1.20]) but not other poor sleep dimensions. CONCLUSIONS Racial/ethnic minority women were most likely to experience racial/ethnic discrimination, which was associated with certain poor sleep dimensions among women of all races/ethnicities.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - Lydia Feinstein
- Social & Scientific Systems, Inc., Durham, NC, USA; Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Natalie Slopen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.
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170
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Sladek MR, Doane LD, Park H. Latino adolescents' daily bicultural stress and sleep: Gender and school context moderation. Health Psychol 2020; 39:179-189. [PMID: 31789557 PMCID: PMC7323583 DOI: 10.1037/hea0000824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Bicultural stress (i.e., challenge arising from navigating 2 cultural contexts) has significant consequences for Latino youth's health, but researchers have yet to examine the implications of bicultural stress for adolescents' sleep. The goals of this study were to examine whether individual and day-to-day (within-person) differences in bicultural stress were associated with Latino adolescents' sleep onset latency (i.e., time to fall asleep), sleep midpoint (i.e., sleep schedule), sleep duration (i.e., time asleep), and subjective sleep quality. METHOD Participants were 209 Latino late adolescents (Mage = 18.10 years; 64.4% female) attending over 90 different high schools who completed 7 daily diary surveys while wearing actigraph wristwatches (N = 1,320 daily observations). Participants also reported sleep problems in a standard survey. Statistical interactions were tested to assess moderation by gender and coethnic school composition. RESULTS On average, more bicultural stressors across the week were associated with lower average sleep duration and more sleep problems for male (compared to female) adolescents and youth attending schools with higher (compared to lower) Latino student enrollment. Regarding day-to-day differences, more daily bicultural stressors than usual predicted longer sleep onset latency that night for male adolescents, earlier sleep midpoint that night, and less sleep duration that night for youth attending higher Latino-enrollment schools. CONCLUSIONS Latino adolescents' everyday experiences of bicultural stress relate to differences in sleep duration, timing, and quality, with important variation by gender and school context. Results advance existing theory regarding social position factors that differentiate the health implications of bicultural stress for Latino youth. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | - Leah D Doane
- Department of Psychology, Arizona State University
| | - HyeJung Park
- Department of Psychology, Arizona State University
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171
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Brooks BD, Job SA, Clark EA, Todd EA, Williams SL. Concealment as a moderator of anticipated stigma and psychiatric symptoms. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2020. [DOI: 10.1080/19359705.2020.1721037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Byron D. Brooks
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Sarah A. Job
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Emily A. Clark
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Emerson A. Todd
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
| | - Stacey L. Williams
- Social Issues and Relations Lab, Department of Psychology, East Tennessee State University, Johnson City, Tennessee, USA
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172
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Bethea TN, Zhou ES, Schernhammer ES, Castro-Webb N, Cozier YC, Rosenberg L. Perceived racial discrimination and risk of insomnia among middle-aged and elderly Black women. Sleep 2020; 43:zsz208. [PMID: 31555803 PMCID: PMC6955644 DOI: 10.1093/sleep/zsz208] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/26/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVE To assess whether perceived racial discrimination is associated with insomnia among Black women. METHODS Data on everyday and lifetime racism and insomnia symptoms were collected from questionnaires administered in the Black Women's Health Study, an ongoing prospective cohort of Black women recruited in 1995 from across the United States. In 2009, participants completed five questions on the frequency of discriminatory practices in daily life (everyday racism) and six questions on ever experiencing unfair treatment in key institutional contexts (lifetime racism). In 2015, the Insomnia Severity Index was used to assess insomnia symptoms. We estimated odds ratios and 95% confidence intervals for associations of racism with insomnia, using multivariable logistic regression models adjusted for potential confounders. RESULTS The 26 139 participants in the analytic sample were 40-90 years old (median = 57 years, SD = 9.6 years). Higher levels of everyday racism and lifetime racism were positively associated with subthreshold (ptrend < .01) and clinical insomnia (ptrend < .01). Results remained unchanged after further adjustment for sleep duration and shift work. CONCLUSIONS Higher levels of perceived racism were associated with increased odds of insomnia among middle-aged and elderly Black women. Thus, perceived racism may contribute to multiple racial health disparities resulting from insomnia. Helping minority populations cope with their experiences of discrimination may decrease the significant public health impact of sleep disruption and subsequent diagnoses.
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Affiliation(s)
- Traci N Bethea
- Slone Epidemiology Center, Boston University, Boston, MA
- Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Eric S Zhou
- Dana-Farber Cancer Institute, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Eva S Schernhammer
- Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Department of Epidemiology, Medical University of Vienna, Vienna, Austria
| | | | - Yvette C Cozier
- Slone Epidemiology Center, Boston University, Boston, MA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Lynn Rosenberg
- Slone Epidemiology Center, Boston University, Boston, MA
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173
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Goldstein SJ, Gaston SA, McGrath JA, Jackson CL. Sleep Health and Serious Psychological Distress: A Nationally Representative Study of the United States among White, Black, and Hispanic/Latinx Adults. Nat Sci Sleep 2020; 12:1091-1104. [PMID: 33299371 PMCID: PMC7721291 DOI: 10.2147/nss.s268087] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 09/14/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Prior studies investigating the relationship between sleep and serious psychological distress (SPD) have lacked racial/ethnic diversity and generalizability. We investigated associations between sleep and SPD among a large, nationally representative, and racially/ethnically diverse sample of US adults. METHODS We pooled cross-sectional data from the 2004 to 2017 National Health Interview Survey. Participants self-reported sleep duration and sleep disturbances (eg, trouble falling and staying asleep). SPD was defined as a Kessler Psychological Distress Scale (K6) score ≥13. Adjusting for sociodemographic, health behavior, and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of SPD for each sleep characteristic, overall and by race/ethnicity. RESULTS Among 316,840 participants, the mean age ± standard error was 46.9 ± 0.1 years, 52% were women, 75% were non-Hispanic (NH)-White, 16% NH-Black, and 9% Hispanic/Latinx. The prevalence of SPD was 3.4% for NH-Whites, 4.1% for NH-Blacks, and 4.5% for Hispanics/Latinxs. Participants with <7 hours versus 7-9 hours of sleep duration were more likely to have SPD, and the magnitude of the association was strongest among NH-Black participants (PRNH-Blacks=3.50 [95% CI: 2.97-4.13], PR Hispanics/Latinx=2.95 [2.42-3.61], and PRNH-Whites=2.66 [2.44-2.89]). Positive associations between sleep disturbances and SPD were generally stronger among NH-Black and Hispanic/Latinx compared to NH-White adults. CONCLUSION Poor sleep health was positively associated with SPD, and the magnitude of the association was generally stronger among racial/ethnic minorities. Future investigations should prospectively focus on the determinants and health consequences of SPD attributable to objectively measured sleep across racial/ethnic groups.
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Affiliation(s)
- Samuel J Goldstein
- The University of North Carolina at Chapel Hill, Department of Environmental Sciences and Engineering, Chapel Hill, NC, USA
| | - Symielle A Gaston
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | | | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.,Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
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174
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Alcaraz KI, Wiedt TL, Daniels EC, Yabroff KR, Guerra CE, Wender RC. Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA Cancer J Clin 2020; 70:31-46. [PMID: 31661164 DOI: 10.3322/caac.21586] [Citation(s) in RCA: 243] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 09/12/2019] [Accepted: 09/25/2019] [Indexed: 12/21/2022] Open
Abstract
Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially preventable cancer deaths continue to occur, and disadvantaged populations bear a disproportionate burden. Reducing the burden of cancer and eliminating cancer-related disparities will require more focused and coordinated action across multiple sectors and in partnership with communities. This article, part of the American Cancer Society's Cancer Control Blueprint series, introduces a framework for understanding and addressing social determinants to advance cancer health equity and presents actionable recommendations for practice, research, and policy. The article aims to accelerate progress toward eliminating disparities in cancer and achieving health equity.
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Affiliation(s)
- Kassandra I Alcaraz
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, Georgia
| | - Tracy L Wiedt
- Cancer Control Department, American Cancer Society, Atlanta, Georgia
| | - Elvan C Daniels
- Extramural Research, American Cancer Society, Atlanta, Georgia
| | - K Robin Yabroff
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Carmen E Guerra
- Perelman School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Richard C Wender
- Cancer Control Department, American Cancer Society, Atlanta, Georgia
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175
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Abstract
BACKGROUND To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization. METHODS A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework. RESULTS Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources. CONCLUSIONS Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of African and African American Studies, Department of Sociology, Harvard University, Cambridge, Massachusetts
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cecilia Vu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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176
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Neighborhoods to Nucleotides - Advances and gaps for an obesity disparities systems epidemiology model. CURR EPIDEMIOL REP 2019; 6:476-485. [PMID: 36643055 PMCID: PMC9839192 DOI: 10.1007/s40471-019-00221-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose of Review Disparities in obesity rates in the US continue to increase. Here we review progress and highlight gaps in understanding disparities in obesity with a focus on the Hispanic/Latino population from a systems epidemiology framework. We review seven domains: environment, behavior, biomarkers, nutrition, microbiome, genomics, and epigenomics/transcriptomics. We focus on recent advances that include at least two or more of these domains, and then provide a real world example of data collection efforts that reflect these domains. Recent Findings Research into DNA methylation related to discrimination and microbiome relating to eating behaviors and food content is furthering understanding of why disparities in obesity persist. Environmental and neighborhood level research is uncovering the importance of exposures such as air and noise pollution and systematic or structural racism for obesity and related outcomes through behaviors such as sleep.
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177
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Brownlow BN, Sosoo EE, Long RN, Hoggard LS, Burford TI, Hill LK. Sex Differences in the Impact of Racial Discrimination on Mental Health Among Black Americans. Curr Psychiatry Rep 2019; 21:112. [PMID: 31686220 DOI: 10.1007/s11920-019-1098-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Greater racial discrimination is associated with poorer mental health among Black Americans; yet, there remains an incomplete understanding of sex differences in exposure to racial discrimination, and further, of how sex differences in coping with racial discrimination may heighten or diminish risk for poorer mental health. RECENT FINDINGS Black men may experience greater exposure to both structural and communal forms of racial discrimination, whereas Black women may face both a wider range of potential sources, as well as encounter greater variability in the subjective experience of racial discrimination. For both Black women and men, racial discrimination may be similarly associated with maladaptive coping strategies (i.e., emotional eating, rumination) that also are linked to poorer mental health; however, emerging findings suggest that mindfulness may partially buffer these deleterious effects. Overall, the recent literature reveals mixed findings with respect to sex differences in the experience and negative mental health impact of racial discrimination. Despite this heterogeneity, evidence documents sex differences in the settings, type, and qualitative experience of racial discrimination among Black Americans. Additionally, growing evidence indicating that racial discrimination is associated with physiological markers of stress reactivity and psychopathology risk further bolsters its characterization as a unique form of chronic stress among Black Americans and other minority groups in the USA.
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Affiliation(s)
- Briana N Brownlow
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Effua E Sosoo
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Risa N Long
- Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lori S Hoggard
- Department of Psychology, Rutgers-The State University of New Jersey, New Brunswick, NJ, USA
| | - Tanisha I Burford
- Department of Psychology, North Carolina Central University, Durham, NC, USA
| | - LaBarron K Hill
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
- Center for Biobehavioral Health Disparities Research, Duke University-Social Science Research Institute, Durham, NC, USA.
- Center for the Study of Aging and Human Development, Duke University Medical Center, Box 3119, Durham, NC, 27710, USA.
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178
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Williams DR, Lawrence JA, Davis BA, Vu C. Understanding how discrimination can affect health. Health Serv Res 2019; 54 Suppl 2:1374-1388. [PMID: 31663121 PMCID: PMC6864381 DOI: 10.1111/1475-6773.13222] [Citation(s) in RCA: 354] [Impact Index Per Article: 70.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization. METHODS A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework. RESULTS Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources. CONCLUSIONS Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination.
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Affiliation(s)
- David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of African and African American Studies, Department of Sociology, Harvard University, Cambridge, Massachusetts
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cecilia Vu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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179
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Sonnega J, Sonnega A, Kruger D. The City Doesn't Sleep: Community Perceptions of Sleep Deficits and Disparities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203976. [PMID: 31635232 PMCID: PMC6843266 DOI: 10.3390/ijerph16203976] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/23/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022]
Abstract
While sleep research has focused primarily on aspects of the immediate physical environment and behavioral factors, a growing body of evidence suggests that broader social determinants may play an important role in sleep insufficiency. Yet public health education efforts for sleep largely address “sleep hygiene”, with an emphasis on information for getting a good night’s rest. The Flint Sleep Project employed community-based-participatory research methods to try to understand more about the sleep experiences of residents of an urban community reporting sleep insufficiency. The academic and community partner developed recruitment materials with community residents. The focus group protocol also utilized community input. Seven focus groups, with a total of 70 participants, were conducted. When asked about their view of causes for poor sleep, participants identified a range of stressors reflective of social determinants. Economic, safety, and future insecurity were the dominant themes emerging across all seven discussions. Participants also expressed feeling a lack of control over important aspects of their lives. Interventions to improve sleep are more likely to be effective if they include the perspectives of the community. A community-based approach offers opportunities for community empowerment and engagement that can improve efforts at sleep health promotion.
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Affiliation(s)
- John Sonnega
- Department of Public Health Education, School of Health Promotion and Human Performance, College of Health and Human Services, Eastern Michigan University, Ypsilanti, MI 48197, USA.
| | - Amanda Sonnega
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA.
| | - Daniel Kruger
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104, USA.
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180
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Butler ES, McGlinchey E, Juster R. Sexual and gender minority sleep: A narrative review and suggestions for future research. J Sleep Res 2019; 29:e12928. [DOI: 10.1111/jsr.12928] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Eliana S. Butler
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
| | - Eleanor McGlinchey
- School of Psychology Fairleigh Dickinson University Teaneck NJ USA
- Division of Child and Adolescent Psychiatry Columbia University Medical Center/New York State Psychiatric Institute New York NY USA
| | - Robert‐Paul Juster
- Department of Psychiatry and Addiction University of Montreal Montreal QC Canada
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181
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Abstract
OBJECTIVE This set of studies examines the bidirectional links between social rejection and poor sleep, a ubiquitous and increasingly problematic health behavior. METHODS In study 1, a multiday field experiment, 43 participants completed a neutral task just before sleep on night 1 and a social rejection task on night 2. Objective and subjective sleep, postrejection affect, and physiological responses were measured. In study 2, 338 participants reported typical sleep quality before coming to the laboratory where they received social rejection or social acceptance feedback from a stranger. Physiological and affective responses were measured throughout the session. RESULTS In study 1, after social rejection, participants took longer going to bed (M [SD] = 38.06 [48.56] versus 11.18 [15.52], t(42) = 3.86, p < .001) and had shorter sleep durations (6:46 [1:27] versus 7:19 [1:38], t(41) = 2.92, p = .006) compared with the baseline night. Trait rumination moderated these effects, with high ruminators taking the longest to go to bed postrejection (t(38) = 2.90, p = .006). In both studies, there was (inconsistent) evidence that sleep influences reactions to rejection: some sleep measures predicted physiological reactivity during the rejection task in study 1 and greater negative affect after social rejection in study 2. CONCLUSIONS These studies provide evidence that social rejection may affect sleep outcomes, particularly for trait ruminators, and poor sleep in turn may exacerbate affective responses to social rejection. Given the mixed findings, small sample size, and no active control condition, more work is needed to confirm and build on these findings.
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182
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Cave L, Cooper MN, Zubrick SR, Shepherd CCJ. Caregiver-perceived racial discrimination is associated with diverse mental health outcomes in Aboriginal and Torres Strait Islander children aged 7-12 years. Int J Equity Health 2019; 18:142. [PMID: 31492177 PMCID: PMC6729036 DOI: 10.1186/s12939-019-1045-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/03/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Racial discrimination is acknowledged as a central social determinant of Australian Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) health, although quantitative empirical literature on the impacts of racism on Aboriginal children remains sparse. We use a novel, longitudinal dataset to explore the relationship between caregiver-perceived racism exposure and a range of mental health and related behavioural and physiological outcomes in childhood. METHOD The study cohort comprised 1759 Aboriginal children aged 4-12 years from waves 2-8 (2009-2015) of the Footprints in Time: The Longitudinal Study of Indigenous Children (LSIC) dataset. We examined exposure to caregiver-perceived racism between 4 and 11 years as a predictor for mental health and related outcomes at ages 7-12 and substance use at 10-12 years. Unadjusted models and models adjusted for remoteness, community-level and family-level socio-economic status, child age and gender were used in analysis. Multilevel logistic regression was used in all analysis. RESULTS In fully adjusted models, perceived exposure to racism at ages 4-11 was associated with twice the risk of negative mental health (95% CI: 1.3-3.0), sleep difficulties (95% CI: 1.4-3.0), and behaviour issues at school (95% CI: 1.2-2.9), 1.7 times the risk of obesity (95% CI: 1.1-2.5), and nearly 7 times the risk of trying cigarettes (95% CI: 1.1-43.9). Increased risks were also found for being underweight and trying alcohol though estimates did not reach statistical significance. There was no evidence that racism was associated with poorer general health. CONCLUSION Exposure to racial discrimination in Aboriginal children increased the risk for a spectrum of interrelated psychological, behavioural and physiological factors linked to negative mental health. Our results further affirm the importance of interventions aimed at reducing the prevalence of racial discrimination for the benefits of population health and health inequalities. The services and institutions which aim to support the mental health and wellbeing of Aboriginal children should also support interventions to reduce racism and implement accountable policies which prioritise this goal.
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Affiliation(s)
- Leah Cave
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia. .,School of Population and Global Health, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia.
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia
| | - Stephen R Zubrick
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.,Centre for Child Health Research, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia, 6009, Australia
| | - Carrington C J Shepherd
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Western Australia, 6872, Australia.,Ngangk Yira Research Centre for Aboriginal Health & Social Equity, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia
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183
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Caceres BA, Hickey KT, Heitkemper EM, Hughes TL. An intersectional approach to examine sleep duration in sexual minority adults in the United States: findings from the Behavioral Risk Factor Surveillance System. Sleep Health 2019; 5:621-629. [PMID: 31377249 DOI: 10.1016/j.sleh.2019.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 05/20/2019] [Accepted: 06/18/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Investigate sexual identity differences in sleep duration and the multiplicative effect of sexual identity and race/ethnicity among US adults. DESIGN Cross-sectional. PARTICIPANTS The sample consisted of 267,906 participants from the Behavioral Risk Factor Surveillance System. MEASUREMENTS Sleep duration was categorized as very short (≤4 hours), short (5-6 hours), adequate (7-8 hours), or long (≥9 hours). Sex-stratified multinomial logistic regressions were used to examine sexual identity differences in sleep duration. We then examined sleep duration by comparing sexual minorities to (1) same-race/-ethnicity heterosexuals and (2) White participants with the same sexual identity. RESULTS Sexual minority women had higher odds of very short sleep compared to heterosexual women, regardless of race/ethnicity. Black gay men had higher rates of very short sleep but lower rates of long sleep relative to Black heterosexual men. Latino and Asian/Pacific Islander bisexual men reported higher rates of short sleep than their heterosexual counterparts. Black lesbian and other-race bisexual women were more likely to have very short sleep than their heterosexual peers. Black lesbian women also had higher rates of long sleep. Analyses examining racial/ethnic differences by sexual identity found that Black and Latino gay men reported higher rates of very short sleep compared to White gay men. Black bisexual women had higher rates of short sleep duration than White bisexual women. CONCLUSIONS More research is needed to understand how to promote sleep health among sexual minorities, particularly racial/ethnic minorities, and the impact of inadequate sleep duration on health outcomes in this population.
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Affiliation(s)
- Billy A Caceres
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032.
| | - Kathleen T Hickey
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032
| | - Elizabeth M Heitkemper
- Department of Biomedical Informatics, Columbia University, 622 W 168th St, PH20, New York, NY 10032
| | - Tonda L Hughes
- Columbia University School of Nursing, 560 W 168th St, New York, NY 10032
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184
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Johnson DA, Jackson CL, Williams NJ, Alcántara C. Are sleep patterns influenced by race/ethnicity - a marker of relative advantage or disadvantage? Evidence to date. Nat Sci Sleep 2019; 11:79-95. [PMID: 31440109 PMCID: PMC6664254 DOI: 10.2147/nss.s169312] [Citation(s) in RCA: 204] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
Sleep is a fundamental necessity of life. However, sleep health and sleep disorders are not equitably distributed across racial/ethnic groups. In fact, growing research consistently demonstrates that racial/ethnic minorities are more likely to experience, for instance, shorter sleep durations, less deep sleep, inconsistent sleep timing, and lower sleep continuity in comparison to Whites. However, racial/ethnic disparities in reports of sleepiness and sleep complaints are inconsistent. Racial/ethnic groups have significant heterogeneity, yet within-group analyses are limited. Among the few published within-group analyses, there are differences in sleep between non-US-born and US-born racial/ethnic groups, but the group with the more favorable sleep profile is consistent for non-US-born Latinos compared to US-born Latinos and Whites but unclear for other racial/ethnic minority groups. These sleep health disparities are a significant public health problem that should garner support for more observational, experimental, intervention, and policy/implementation research. In this review, we 1) summarize current evidence related to racial/ethnic disparities in sleep health and within-group differences, focusing on the sleep of the following racial/ethnic minority categories that are defined by the United States Office of Management and Budget as: American Indian/Alaska Native, Asian, African American/Black, Hispanic/Latino, and Native Hawaiian/Pacific Islander; 2) discuss measurement challenges related to investigating sleep health disparities; 3) discuss potential contributors to sleep health disparities; 4) present promising interventions to address sleep health disparities; and 5) discuss future research directions on intersectionality and sleep health.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute on Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Department of Health and Human Services, Intramural Program, National Institute of Minority Health and Health Disparities, Bethesda, MD, USA
| | - Natasha J Williams
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY, USA
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185
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Bell KA, Kobayashi I, Akeeb A, Lavela J, Mellman TA. Emotional response to perceived racism and nocturnal heart rate variability in young adult African Americans. J Psychosom Res 2019; 121:88-92. [PMID: 30955911 PMCID: PMC6703551 DOI: 10.1016/j.jpsychores.2019.03.180] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 03/15/2019] [Accepted: 03/23/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Heightened autonomic nervous system (ANS) arousal is a well-established contributor to the effect of stress on adverse cardiovascular health outcomes which disproportionately affect African Americans. ANS arousal is normally attenuated during sleep and compromise of this shift is associated with multiple adverse cardiovascular outcomes. Parasympathetic nervous system (PNS) dominance during sleep can be altered by stress. Racism has been recognized to have many negative health consequences in African Americans. Perceived racism has been linked to ANS activity, however, we are not aware of prior research on racism and nocturnal ANS balance. OBJECTIVE To examine relationships between perceived racism and nocturnal ANS activity indexed by heart rate variability (HRV) in healthy African American men and women age 18-35. METHODS Fifty-four participants completed the Perceived Racism Scale and had 24-hour ambulatory electrocardiogram recordings in their homes. Power spectral analysis was used to derive normalized high frequency (nHF) to index PNS activity which was computed by 5-minute epochs during wake and sleep. RESULTS Endorsement of racism and negative emotional reactions during the past year were inversely related to nHF during time in bed. Multiple regression analysis indicated that negative emotional reactions were a significant predictor of nHF during the sleep period F(2,54) = 4.213, p = .020, R2 = 0.135 (adjusted R2 = 0.103). Relationships during wake were not statistically significant. CONCLUSION Findings suggest that perseverative thoughts triggered by negative emotional reactions to racism influencing nocturnal ANS activity may be a pathway by which perceived racism affects health. Support: 3UL1TR001409-02S1 and R01HL087995 to Dr. Mellman.
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Affiliation(s)
| | - Ihori Kobayashi
- Howard University, College of Medicine, Department of Psychiatry and Behavioral Sciences, United States.
| | - Ameenat Akeeb
- Howard University College of Medicine Department of Psychiatry and Behavioral Sciences
| | - Joseph Lavela
- Howard University, College of Medicine, Department of Psychiatry and Behavioral Sciences, United States.
| | - Thomas A. Mellman
- Howard University College of Medicine Department of Psychiatry and Behavioral Sciences
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186
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Cheon YM, Ip PS, Yip T. Adolescent profiles of ethnicity/race and socioeconomic status: Implications for sleep and the role of discrimination and ethnic/racial identity. ADVANCES IN CHILD DEVELOPMENT AND BEHAVIOR 2019; 57:195-233. [PMID: 31296316 PMCID: PMC11152316 DOI: 10.1016/bs.acdb.2019.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The present study seeks to explore the intersectionality of ethnicity/race and socioeconomic status (SES) among ethnic/racial minority adolescents in their developmental contexts, examining its implications for sleep disparities and the roles of discrimination and ethnic/racial identity (ERI; i.e., adolescents' understanding and feelings about who they are in relation to their ethnic/racial group). With 350 adolescents (Asian 41.4%, Black, 21.7%, and Latinx 36.9%, female=69.1%, Mage=14.27), we conducted a latent class analysis (LCA) to identify latent classes of adolescents' ethnicity/race, ethnic/racial diversity in their schools and neighborhoods along with SES of their families, schools, and neighborhoods. Next, with hierarchical regression, we tested the association between class membership and subjective and objective sleep duration and quality, followed by the moderating effect of discrimination and ERI. We expected to find adolescents living in low diversity and low SES across various developmental contexts to experience lower levels of subjective and objective sleep duration and quality compared to their counterparts. We also expected to find exacerbating effects of discrimination and ERI exploration, and protective effects of ERI commitment in these associations. Three latent groups were identified (C1: "Black/Latinx adolescents in low/moderate SES families in varying diversity and low SES schools and neighborhoods," C2: "Predominantly Latinx adolescents in low SES families and moderate diversity and SES schools and neighborhoods," and C3: "Predominantly Asian adolescents in low/moderate SES families in moderate/high diversity and SES schools and neighborhoods"). The class memberships to C1 and C2 were associated with compromised sleep duration and quality compared to C3. An interaction effect of discrimination was found for C1 in subjective sleep duration and for C2 in objective sleep duration. While no interactions were found for ERI, ERI commitment had a direct association with objective sleep duration and quality. Interpretations and implications for intersectionality approach in studies on sleep disparities and the roles of discrimination and ERI are discussed.
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Affiliation(s)
- Yuen Mi Cheon
- Psychology Department, Fordham University, Bronx, NY, United States
| | - Pak See Ip
- Psychology Department, Fordham University, Bronx, NY, United States
| | - Tiffany Yip
- Psychology Department, Fordham University, Bronx, NY, United States.
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187
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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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188
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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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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, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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189
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Abstract
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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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, Boston, Massachusetts 02115, USA;
- Department of African and African American Studies and Department of Sociology, Harvard University, Cambridge, Massachusetts 02138-3654, USA
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Jourdyn A Lawrence
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
| | - Brigette A Davis
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA;
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190
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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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191
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Yip T, Wang Y, Mootoo C, Mirpuri S. Moderating the association between discrimination and adjustment: A meta-analysis of ethnic/racial identity. Dev Psychol 2019; 55:1274-1298. [PMID: 30907605 DOI: 10.1037/dev0000708] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The detrimental effects of discrimination are well documented; however, the influence of ethnic/racial identity (ERI) on this association is equivocal. There is theoretical and empirical support for both protective and detrimental effects of ERI. This meta-analysis includes 53 effect sizes from 51 studies and 18,545 participants spanning early adolescence to adulthood to synthesize the interaction of ERI and discrimination for adjustment outcomes. Consistent with existing meta-analyses, discrimination was associated with compromised adjustment; further, this effect was buffered by overall ERI particularly for academic and physical health outcomes. Different ERI dimensions and adjustment outcomes revealed important patterns. ERI exploration increased vulnerabilities associated with discrimination, particularly for negative mental health and risky health behaviors. The exacerbating influence of ERI exploration was strongest at age 24, and more recent publications reported weaker exacerbating effects. In contrast, ERI commitment conferred protection. A composite score of ERI exploration and commitment also conferred protection against discrimination. Sample demographics mattered. The buffering effect of ERI commitment was stronger for Latinx (compared with Asian heritage) individuals. The buffering effect of public regard was stronger for Asian heritage (compared with African heritage) individuals. For positive mental health outcomes, a composite score of ERI exploration and commitment had a stronger buffering effect for Latinx (compared with African heritage) individuals. For risky health behaviors, Latinx individuals reported a stronger buffering effect of ERI (compared with African heritage and Asian heritage) individuals. The current meta-analysis identifies gaps in the literature and offers suggestions for future research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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192
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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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193
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Ong AD, Williams DR. Lifetime discrimination, global sleep quality, and inflammation burden in a multiethnic sample of middle-aged adults. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2019; 25:82-90. [PMID: 30714770 PMCID: PMC6369702 DOI: 10.1037/cdp0000233] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Despite considerable evidence that greater exposure to discrimination over the life course increases risk for systemic inflammation, little is known about the mechanisms responsible for this association. Here we examine the role of global sleep quality as a potential pathway by which self-reported experiences of discrimination contribute to inflammatory dysfunction in a multiethnic sample of middle-aged adults. METHOD Participants were 300 adults (36-85 years; 65% women) from Milwaukee, Wisconsin, a subset of the Midlife in the United States Study 2 (2004-2006). Racial/ethnic representation included African American (77.7%), Hispanic (12.7%), Asian/Pacific Islander (5.6%), and Native American (4.0%). Global sleep quality and perceptions of lifetime and daily discrimination were measured by questionnaire. A composite score of inflammation burden was computed as the sum of five markers including C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, E-selectin, and intracellular adhesion molecule-1 (ICAM-1). RESULTS Greater lifetime exposure to discrimination was associated with higher inflammation burden. This relationship remained significant after adjustments for potential confounding factors, including demographics, medication use, health behaviors, psychological distress, and daily discrimination. Mediation analyses suggested that poor global sleep quality was a key mechanism underlying the link between lifetime discrimination and inflammation burden. CONCLUSION These results add to a growing literature on the effects of bias and unfair treatment experienced by people of color and other marginalized groups by demonstrating how such experiences may be particularly consequential for sleep and physiological functioning in midlife. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Anthony D. Ong
- Department of Human Development, Cornell University
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College
| | - David R. Williams
- Harvard T. H. Chan School of Public Health
- Department of Social and Behavioral Sciences, Harvard University
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194
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Smith JP, Hardy ST, Hale LE, Gazmararian JA. Racial disparities and sleep among preschool aged children: a systematic review. Sleep Health 2018; 5:49-57. [PMID: 30670165 DOI: 10.1016/j.sleh.2018.09.010] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/31/2018] [Accepted: 09/23/2018] [Indexed: 11/26/2022]
Abstract
Sleep disorders and sleep insufficiency are common among preschool-aged children. Studies among school-aged children show disordered sleep is often more prevalent among racial minority groups. The primary aim of this systematic review was to critically appraise empirical data to elucidate the relationship between race and key sleep variables among children aged 2 to 5 years old. By systematically searching PubMed, Web of Science, and EBSCO databases, we identified empirical research articles conducted in the United States that investigate this relationship. We searched for variables relevant to (1) insufficient sleep duration, (2) poor sleep quality, (3) irregular timing of sleep, including sleep/wake problems and irregular bedtime onset and wake times (4) and sleep/circadian disorders. Nine studies satisfied the criteria for inclusion: five investigated nocturnal sleep duration, five investigated bedtime-related variables, four investigated daytime sleep (napping), three investigated total sleep, two investigated sleep quality, and one investigated wake times. Four studies specifically addressed racial and demographic differences in sleep variables as the primary aim, while the remaining five contained analyses addressing racial and demographic differences in sleep as secondary aims. Non-Hispanic white, white, or European-American race was used as the reference category in all studies. The results provided consistent evidence that white, non-Hispanic children were more likely to go to bed earlier and more regularly, have longer nocturnal sleep, and nap less than most racial and ethnic minorities. Combined, this literature presents a compelling narrative implicating race as an important factor in sleep patterns among a preschool age population.
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Affiliation(s)
- Jonathan P Smith
- Department of Epidemiology, Emory University, Atlanta, GA, 30322.
| | - Shakia T Hardy
- Department of Epidemiology, Emory University, Atlanta, GA, 30322
| | - Lauren E Hale
- Department of Family, Population, and Preventative Medicine, Stony Brook University, Stony Brook, NY, 11794-8338
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195
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Lockwood KG, Marsland AL, Matthews KA, Gianaros PJ. Perceived discrimination and cardiovascular health disparities: a multisystem review and health neuroscience perspective. Ann N Y Acad Sci 2018; 1428:170-207. [PMID: 30088665 DOI: 10.1111/nyas.13939] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/03/2018] [Accepted: 07/09/2018] [Indexed: 12/19/2022]
Abstract
There are distinct racial disparities in cardiovascular disease (CVD) risk, with Black individuals at much greater risk than White individuals. Although many factors contribute to these disparities, recent attention has focused on the role of discrimination as a stress-related factor that contributes to racial disparities in CVD. As such, it is important to understand the mechanisms by which discrimination might affect CVD. Recent studies have examined these mechanisms by focusing on neurobiological mediators of CVD risk. Given this increase in studies, a systematic review of perceived discrimination and neurobiological mediators of CVD risk is warranted. Our review uses a multisystem approach to review studies on the relationship between perceived discrimination and (1) cardiovascular responses to stress, (2) hypothalamic-pituitary-adrenocortical axis function, and (3) the immune system, as well as (4) the brain systems thought to regulate these parameters of peripheral physiology. In addition to summarizing existing evidence, our review integrates these findings into a conceptual model describing multidirectional pathways linking perceived discrimination with a CVD risk.
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Affiliation(s)
- Kimberly G Lockwood
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Karen A Matthews
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
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196
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Martin-Storey A, Prickett KC, Crosnoe R. Disparities in sleep duration and restedness among same- and different-sex couples: findings from the American Time Use Survey. Sleep 2018; 41:4991884. [PMID: 29726972 PMCID: PMC6093344 DOI: 10.1093/sleep/zsy090] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 02/06/2018] [Indexed: 11/13/2022] Open
Abstract
Study Objectives The importance of sleep for health necessitates investigation of disparities in multiple aspects of sleep. Given the potential disruption to sleep posed by the well-documented discrimination experienced by sexual minorities, disparities related to sexual minority status warrant such attention. This study sought to (1) measure differences in same- and different-sex couples in sleep duration and perceived restedness, (2) examine how the link between sleep duration and restedness varied among same- and different-sex couples, and (3) assess variation in restedness across state-level sexual minority indicators. Methods Participants in the Wellbeing Module of the American Time Use Survey, assessed in 2010, 2012, and 2013 (n = 17378), completed time diaries assessing sleep duration and evaluated their own restedness. Results Multinomial and ordinal regression analyses showed no links between partner sex and sleep among men. Women with same-sex partners reported lower restedness than women with different-sex partners, and perceptions of restedness were more strongly linked to sleep duration for the former than the latter. Finally, women with the same-sex partners living in states more supportive of sexual minorities reported better restedness than those in less supportive states. Conclusions Women with same-sex partners were vulnerable to lower restedness, especially when they reported lower sleep duration or were in less supportive environments. Such disparities could underlie related disparities in health, as sleep health is predictive of health outcomes. Future research is needed to explore the role of sleep in explaining variation in health outcomes among sexual minority women.
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Affiliation(s)
- Alexa Martin-Storey
- Département de Psychoéducation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Kate C Prickett
- The Harris School of Public Policy Studies, University of Chicago, IL
| | - Robert Crosnoe
- Department of Sociology and The Population Research Center, University of Texas at Austin, TX
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197
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Lerman SF, Campbell CM, Buenaver LF, Medak M, Phillips J, Polley M, Smith MT, Haythornthwaite JA. Exploring the Role of Negative Cognitions in the Relationship Between Ethnicity, Sleep, and Pain in Women With Temporomandibular Joint Disorder. THE JOURNAL OF PAIN 2018; 19:1342-1351. [PMID: 29890298 DOI: 10.1016/j.jpain.2018.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 03/16/2018] [Accepted: 05/31/2018] [Indexed: 12/22/2022]
Abstract
Negative cognitions are central to the perpetuation of chronic pain and sleep disturbances. Patients with temporomandibular joint disorder (TMJD), a chronic pain condition characterized by pain and limitation in the jaw area, have a high comorbidity of sleep disturbances that possibly exacerbate their condition. Ethnic group differences are documented in pain, sleep, and coping, yet the mechanisms driving these differences are still unclear, especially in clinical pain populations. We recruited 156 women (79% white, 21% African American) diagnosed with TMJD as part of a randomized, controlled trial evaluating the effectiveness of interventions targeting sleep and pain catastrophizing on pain in TMJD. Analysis of baseline data demonstrated that, relative to white participants, African Americans exhibited higher levels of clinical pain, insomnia severity, and pain catastrophizing, yet there was no ethnic group difference in negative sleep-related cognitions. Mediation models revealed pain catastrophizing, but not sleep-related cognitions or insomnia severity, to be a significant single mediator of the relationship between ethnicity and clinical pain. Only the helplessness component of catastrophizing together with insomnia severity sequentially mediated the ethnicity-pain relationship. These findings identify pain catastrophizing as a potentially important link between ethnicity and clinical pain and suggest that interventions targeting pain-related helplessness could improve both sleep and pain, especially for African American patients. Perspective:Pain-related helplessness and insomnia severity contribute to ethnic differences found in clinical pain among woman with TMJD. Findings can potentially inform interventions that target insomnia and catastrophizing to assist in reducing ethnic disparities in clinical pain.
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Affiliation(s)
- Sheera F Lerman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland..
| | - Claudia M Campbell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland
| | - Luis F Buenaver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland
| | - Mary Medak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland
| | - Jane Phillips
- Department of Neural and Pain Sciences, Brotman Facial Pain Center, University of Maryland School of Dentistry, Baltimore, Maryland
| | - Michelle Polley
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland
| | - Michael T Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland
| | - Jennifer A Haythornthwaite
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine. Baltimore, Maryland
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198
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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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199
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Maki KA, DeVon HA. A nursing theory-guided framework for genetic and epigenetic research. Nurs Inq 2018; 25:e12238. [PMID: 29607615 DOI: 10.1111/nin.12238] [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] [Accepted: 03/01/2018] [Indexed: 11/27/2022]
Abstract
The notion that genetics, through natural selection, determines innate traits has led to much debate and divergence of thought on the impact of innate traits on the human phenotype. The purpose of this synthesis was to examine how innate theory informs genetic research and how understanding innate theory through the lens of Martha Rogers' theory of unitary human beings can offer a contemporary view of how innate traits can inform epigenetic and genetic research. We also propose a new conceptual model for genetic and epigenetic research. The philosophical, theoretical, and research literatures were examined for this synthesis. We have merged philosophical and conceptual phenomena from innate theory with the theory of unitary beings into the University of Illinois at Chicago model for genetic and epigenetic research. Innate traits are the cornerstone of the framework but may be modified epigenetically by biological, physiological, psychological, and social determinants as they are transcribed. These modifiers serve as important links between the concept of innate traits and epigenetic modifications, and, like the theory of unitary human beings, the process is understood in the context of individual and environmental interaction that has the potential to evolve as the determinants change.
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Affiliation(s)
- Katherine A Maki
- Department of Biobehavioral Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Holli A DeVon
- Department of Biobehavioral Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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200
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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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