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Gillespie A, Song R, Barile JP, Okada L, Brown S, Traub K, Trout J, Simoncini GM, Hall CDX, Tan Y, Gadegbeku CA, Ma GX, Wong FY. Discrimination and hypertension among a diverse sample of racial and sexual minority men living with HIV: baseline findings of a longitudinal cohort study. J Hum Hypertens 2024:10.1038/s41371-024-00919-0. [PMID: 38926521 DOI: 10.1038/s41371-024-00919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Racial and sexual orientation discrimination may exacerbate the double epidemic of hypertension (HTN) and HIV that affects men of color who have sex with men (MSM). This was a cross-sectional analysis of African American, Asian American, Native Hawaiian, or Pacific Islander (NHPI) MSM living with HIV (PLWH) cohort in Honolulu and Philadelphia. Racial and sexual orientation discrimination, stress, anxiety, and depression were measured with computer-assisted self-interview questionnaires (CASI). We examined the associations between racial and sexual orientation discrimination with hypertension measured both in the office and by 24-h ambulatory blood pressure monitoring (ABPM) using multivariable logistic regression. Sixty participants (60% African American, 18% Asian, and 22% NHPI) completed CASIs and 24-h ABPM. African American participants (80%) reported a higher rate of daily racial discrimination than Asian American (36%) and NHPI participants (17%, p < 0.001). Many participants (51%) reported daily sexual orientation discrimination. Sixty-six percent of participants had HTN by office measurement and 59% had HTN by 24-h ABPM measurement. Participants who experienced racial discrimination had greater odds of having office-measured HTN than those who did not, even after adjustment (Odds Ratio 5.0 (95% Confidence Interval [1.2-20.8], p = 0.03)). This association was not seen with 24-h ABPM. Hypertension was not associated with sexual orientation discrimination. In this cohort, MSM of color PLWH experience significant amounts of discrimination and HTN. Those who experienced racial discrimination had higher in-office blood pressure. This difference was not observed in 24-h APBM and future research is necessary to examine the long-term cardiovascular effects.
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Affiliation(s)
- Avrum Gillespie
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
| | - Rui Song
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - John P Barile
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Lorie Okada
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Shari Brown
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Kerry Traub
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Julia Trout
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Gina M Simoncini
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
- Absolute Care, Philadelphia, PA, USA
| | - Casey D Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
| | - Yin Tan
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Crystal A Gadegbeku
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Grace X Ma
- Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Frank Y Wong
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
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Abreu TC, Mackenbach JD, Heuvelman F, Schoonmade LJ, Beulens JW. Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis. SSM Popul Health 2024; 25:101559. [PMID: 38148999 PMCID: PMC10749911 DOI: 10.1016/j.ssmph.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 12/28/2023] Open
Abstract
Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses. Results From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.
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Affiliation(s)
- Taymara C. Abreu
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Fleur Heuvelman
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
| | - Linda J. Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, the Netherlands
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Poindexter M, Stokes A, Mellman TA. Neighborhood Stress Predicts Fear of Sleep Independently of Posttraumatic Stress Disorder. Behav Sleep Med 2023; 21:185-192. [PMID: 35471154 PMCID: PMC10292665 DOI: 10.1080/15402002.2022.2067162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Chronic insufficient sleep is linked to a variety of adverse health outcomes, and African Americans have been found to have poorer sleep than their non-Hispanic White counterparts. African Americans disproportionately live in low-income disordered neighborhoods which increases their risk of trauma exposure and adversely affects their sleep. Fear of sleep is a construct linked to posttraumatic stress disorder (PTSD). We have reported a relationship between fear of sleep and insomnia in urban residing African Americans. Our objective is to report the relative contributions of neighborhood stress along with PTSD to fear of sleep. METHODS The present study features a nonclinical sample of 117 African Americans (ages 18-35) who reside in DC. RESULTS After controlling for gender, hierarchical linear regression analyses revealed that PTSD severity and perceptions of the neighborhood environment accounted for approximately 32% of the variance in sleep-related fears (∆R2 = .320, p < .001). Regression coefficients suggest that perceptions of the neighborhood (β = .360) predict sleep-related fears to a similar degree as PTSD severity (β = .368). CONCLUSION Results from this study have implications for interventions to help African Americans to cope with their neighborhood environments effect on their sleep.
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Forshaw PE, Correia ATL, Roden LC, Lambert EV, Rae DE. Sleep characteristics associated with nocturnal blood pressure nondipping in healthy individuals: a systematic review. Blood Press Monit 2022; 27:357-370. [PMID: 36094364 DOI: 10.1097/mbp.0000000000000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The current literature investigating nocturnal blood pressure (BP) nondipping has largely focused on clinical populations, however, conditions such as hypertension, obstructive sleep apnoea and insomnia are recognized confounding factors for BP dipping. The exact mechanisms responsible for BP nondipping remain unclear, therefore, there is a need to investigate BP nondipping in healthy individuals to better understand the underlying mechanisms. This review identifies sleep characteristics that may contribute to BP nondipping in healthy individuals. It is anticipated that an understanding of the sleep characteristics that contribute to BP nondipping may inform future sleep-related behavioral interventions to ultimately reducing the burden of cardiovascular disease. METHODS The PubMed, Scopus and Web of Science databases were searched for relevant, English language, peer-reviewed publications (from inception to March 2022). The search identified 550 studies. After duplicates were removed, the titles and abstracts of the remaining 306 studies were screened. Of these, 250 studies were excluded leaving 56 studies to test for eligibility. Thirty-nine studies were excluded such that 17 studies fully met the inclusion criteria for the review. RESULTS Findings from this review indicate that short sleep duration, more sleep fragmentation, less sleep depth and increased variability in sleep timing may be associated with BP nondipping in healthy individuals. CONCLUSION While there is no evidence-based approach for the treatment of nocturnal BP nondipping, it seems promising that addressing one's sleep health may be an important starting point to reduce the prevalence of BP nondipping and perhaps the progression to cardiovascular disease.
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Affiliation(s)
- Philippa Eileen Forshaw
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arron Taylor Lund Correia
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Laura Catherine Roden
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, United Kingdom
| | - Estelle Victoria Lambert
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dale Elizabeth Rae
- Health through Physical Activity Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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Ferguson TS, Younger-Coleman NOM, Mullings J, Francis D, Greene LG, Lyew-Ayee P, Wilks R. Neighbourhood socioeconomic characteristics and blood pressure among Jamaican youth: a pooled analysis of data from observational studies. PeerJ 2020; 8:e10058. [PMID: 33083129 PMCID: PMC7546221 DOI: 10.7717/peerj.10058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 09/07/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction Neighbourhood characteristics are associated with several diseases, but few studies have investigated the association between neighbourhood and health in Jamaica. We evaluated the relationship between neighbourhood socioeconomic status (SES) and blood pressure (BP) among youth, 15-24 years old, in Jamaica. Methods A pooled analysis was conducted using data from three studies (two national surveys and a birth cohort), conducted between 2005-2008, with individual level BP, anthropometric and demographic data, and household SES. Data on neighbourhood SES were obtained from the Mona Geo-Informatics Institute. Neighbourhood was defined using community boundaries from the Social Development Commission in Jamaica. Community characteristics (poverty, unemployment, dependency ratio, population density, house size, and proportion with tertiary education) were combined into SES scores using principal component analysis (PCA). Multivariable analyses were computed using mixed effects multilevel models. Results Analyses included 2,556 participants (1,446 females; 1,110 males; mean age 17.9 years) from 306 communities. PCA yielded two neighbourhood SES variables; the first, PCA-SES1, loaded highly positive for tertiary education and larger house size (higher value = higher SES); while the second, PCA-SES2, loaded highly positive for unemployment and population density (higher value = lower SES). Among males, PCA-SES1 was inversely associated with systolic BP (β-1.48 [95%CI -2.11, -0.84] mmHg, p < 0.001, for each standard deviation unit increase in PCA-SES1 score) in multivariable model accounting for age, household SES, study, BMI, fasting glucose, physical activity and diet. PCA-SES1 was not significantly associated with systolic BP among females (β -0.48 [-1.62, 0.66], p = 0.410) in a similar model. Associations for PCA-SES2 was assessed using linear splines to account for non-linear effects. The were no significant associations between systolic BP and PCA-SES2 among males. Among females, higher PCA-SES2 (i.e. lower SES) was associated with higher systolic BP at spline 2 [z-score -1 to 0] (β4.09 [1.49, 6.69], p = 0.002), but with lower systolic BP at spline 3 [z-core 0 to 1] (β-2.81 [-5.04, -0.59], p = 0.013). There were no significant associations between diastolic BP and PCA-SES1, but PCA-SES2 showed non-linear associations with diastolic BP particularly among males. Conclusion Higher neighbourhood SES was inversely associated with systolic BP among male Jamaican youth; there were non-linear associations between neighbourhood SES and systolic BP among females and for diastolic BP for both males and females.
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Affiliation(s)
- Trevor S Ferguson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Novie O M Younger-Coleman
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
| | - Jasneth Mullings
- Health Research Resource Unit, Dean's Office, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica
| | - Damian Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, United States of America
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, The University of the West Indies, Mona, Kingston, Jamaica
| | - Rainford Wilks
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona, Kingston, Jamaica
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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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Mellman TA, Bell KA, Abu-Bader SH, Kobayashi I. Neighborhood stress and autonomic nervous system activity during sleep. Sleep 2019; 41:4960063. [PMID: 29635440 DOI: 10.1093/sleep/zsy059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Indexed: 01/07/2023] Open
Abstract
Study Objectives Stressful neighborhood environments are known to adversely affect health and contribute to health disparities but underlying mechanisms are not well understood. Healthy sleep can provide a respite from sustained sympathetic nervous system (SNS) activity. Our objective was to evaluate relationships between neighborhood stress and nocturnal and daytime SNS and parasympathetic nervous system (PNS) activity. Methods Eighty-five urban-residing African Americans (56.5% female; mean age of 23.0) participated. Evaluation included surveys of neighborhood stress and sleep-related vigilance, and continuous electrocardiogram (ECG) and actigraphic recording in participants' homes from which heart rate variability (HRV) analysis for low frequency/high frequency (LF/HF) ratio and normalized high frequency (nHF), as indicators of SNS and PNS activity, respectively, and total sleep time (TST), and wake after sleep onset were derived. Results All significant relationships with HRV measures were from the sleep period. Neighborhood disorder correlated negatively with nHF (r = -.24, p = .035). There were also significant correlations of HRV indices with sleep duration and sleep fears. Among females, LF/HF correlated with exposure to violence, r = .39, p = .008, and nHF with census tract rates for violent crime (r = -.35, p = .035). In a stepwise regression, TST accounted for the variance contributed by violent crime to nHF in the female participants. Conclusions Further investigation of relationships between neighborhood environments and SNS/PNS balance during sleep and their consequences, and strategies for mitigating such effects would have implications for health disparities.
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Affiliation(s)
- Thomas Alan Mellman
- Department of Psychiatry and Behavioral Medicine, Howard University College of Medicine
| | | | | | - Ihori Kobayashi
- Department of Psychiatry and Behavioral Medicine, Howard University College of Medicine
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Cave B, Hough AR. Evaluation of posttraumatic stress disorder diagnosis and therapy on diurnal blood pressure patterns from 24-hour ambulatory blood pressure monitoring. Ment Health Clin 2019; 9:24-29. [PMID: 30627500 PMCID: PMC6322823 DOI: 10.9740/mhc.2019.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction The veteran population has a high incidence of posttraumatic stress disorder (PTSD), which is associated with increased risk of hypertension and cardiovascular death. Ambulatory blood pressure monitoring (ABPM) can identify abnormal diurnal blood pressure (BP) patterns, which are associated with increased risk of cardiovascular events. The intent of this evaluation was to examine prior ABPM studies to determine whether veterans with PTSD are more likely to have abnormal nocturnal dipping patterns compared with the general veteran population. Methods Retrospective chart review was performed on all archived ABPM studies and classified by nocturnal dipping status and BP control rates. Pertinent patient demographics of age, sex, concomitant PTSD, and use of selected PTSD therapies were identified at the time of ABPM study. Association between dipping status, BP control rates, and patient demographics were analyzed using appropriate statistical tests. Results A total of 470 ABPM studies were determined to be valid and included. There were no differences in the distribution of nocturnal dipping patterns in veterans with or without PTSD. Likewise, rates of nocturnal, awake, and 24-hour hypertension were similar between groups. In patients with PTSD who were treated with evening PTSD therapy, there was a higher rate of normal dipping status compared with those without treatment (66.7% vs 29.7%, P = .03). Discussion Veterans with PTSD had similar distributions of dipping patterns and rates of overall, awake, and nocturnal hypertension compared with the general veteran population. The association of nocturnal PTSD therapy prescription in patients with PTSD and higher rates of normal dipping status may warrant further investigation.
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O'Brien DT, Farrell C, Welsh BC. Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors. Soc Sci Med 2018; 228:272-292. [PMID: 30885673 DOI: 10.1016/j.socscimed.2018.11.015] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/12/2018] [Accepted: 11/07/2018] [Indexed: 01/01/2023]
Abstract
The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.
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Affiliation(s)
- Daniel T O'Brien
- School of Public Policy & Urban Affairs, Northeastern University, Boston Area Research Initiative, Northeastern & Harvard Universities, USA.
| | - Chelsea Farrell
- School of Criminology & Criminal Justice, Northeastern University, USA
| | - Brandon C Welsh
- School of Criminology & Criminal Justice, Northeastern University, USA
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10
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Bell KA, Kobayashi I, Chen Y, Mellman TA. Nocturnal autonomic nervous system activity and morning proinflammatory cytokines in young adult African Americans. J Sleep Res 2017; 26:510-515. [PMID: 28211138 PMCID: PMC5501735 DOI: 10.1111/jsr.12480] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/23/2016] [Indexed: 11/29/2022]
Abstract
Compromised sleep and increased sympathetic nervous system (SNS) activity are implicated in the pathogenesis of, and disparities in, cardiovascular disease. Parasympathetic dominance during sleep may be important for cardiovascular health. Sleep and autonomic balance influence immune activity, which impacts atherogenesis. We evaluated relationships between autonomic balance during sleep and morning levels of the immune activating cytokines, C-reactive protein (CRP) and interleukin (IL)-6. Ninety-four (59 female) young adult African Americans without medical conditions and substance use disorders spent 2 consecutive nights in a clinical research unit for sleep recordings and blood drawing on awakening. Cardiac tracings from the second sleep recording were analysed for heart rate variability (HRV). Body mass index was the only non-HRV measure correlated with cytokine levels. Indicators of SNS activity for the presleep, and first non-rapid eye movement (REM) and REM sleep periods were correlated independently with morning IL-6 levels. Altered autonomic balance during sleep may be a modifiable factor that influences immune activation.
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Affiliation(s)
| | - Ihori Kobayashi
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, USA
| | - Yuanxiu Chen
- Department of Community Health and Family Medicine, Howard University, Washington, DC, USA
| | - Thomas A Mellman
- Department of Psychiatry and Behavioral Sciences, Howard University, Washington, DC, USA
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Abdalla M, Caughey MC, Tanner RM, Booth JN, Diaz KM, Anstey DE, Sims M, Ravenell J, Muntner P, Viera AJ, Shimbo D. Associations of Blood Pressure Dipping Patterns With Left Ventricular Mass and Left Ventricular Hypertrophy in Blacks: The Jackson Heart Study. J Am Heart Assoc 2017; 6:JAHA.116.004847. [PMID: 28381465 PMCID: PMC5533000 DOI: 10.1161/jaha.116.004847] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background Abnormal diurnal blood pressure (BP), including nondipping patterns, assessed using ambulatory BP monitoring, have been associated with increased cardiovascular risk among white and Asian adults. We examined the associations of BP dipping patterns (dipping, nondipping, and reverse dipping) with cardiovascular target organ damage (left ventricular mass index and left ventricular hypertrophy), among participants from the Jackson Heart Study, an exclusively black population–based cohort. Methods and Results Analyses included 1015 participants who completed ambulatory BP monitoring and had echocardiography data from the baseline visit. Participants were categorized based on the nighttime to daytime systolic BP ratio into 3 patterns: dipping pattern (≤0.90), nondipping pattern (>0.90 to ≤1.00), and reverse dipping pattern (>1.00). The prevalence of dipping, nondipping, and reverse dipping patterns was 33.6%, 48.2%, and 18.2%, respectively. In a fully adjusted model, which included antihypertensive medication use and clinic and daytime systolic BP, the mean differences in left ventricular mass index between reverse dipping pattern versus dipping pattern was 8.3±2.1 g/m2 (P<0.001) and between nondipping pattern versus dipping pattern was −1.0±1.6 g/m2 (P=0.536). Compared with participants with a dipping pattern, the prevalence ratio for having left ventricular hypertrophy was 1.65 (95% CI, 1.05–2.58) and 0.96 (95% CI, 0.63–1.97) for those with a reverse dipping pattern and nondipping pattern, respectively. Conclusions In this population‐based study of blacks, a reverse dipping pattern was associated with increased left ventricular mass index and a higher prevalence of left ventricular hypertrophy. Identification of a reverse dipping pattern on ambulatory BP monitoring may help identify black at increased risk for cardiovascular target organ damage.
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Affiliation(s)
- Marwah Abdalla
- Department of Medicine, Columbia University Medical Center, New York, NY
| | - Melissa C Caughey
- Department of Medicine, University of North Carolina at Chapel Hill, NC
| | - Rikki M Tanner
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - John N Booth
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - Keith M Diaz
- Department of Medicine, Columbia University Medical Center, New York, NY
| | - D Edmund Anstey
- Department of Medicine, Columbia University Medical Center, New York, NY
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Joseph Ravenell
- Department of Population Health, Center for Healthful Behavior Change, New York University Medical Center, New York, NY
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, AL
| | - Anthony J Viera
- Hypertension Research Program and Department of Family Medicine, University of North Carolina at Chapel Hill, NC
| | - Daichi Shimbo
- Department of Medicine, Columbia University Medical Center, New York, NY
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Anderson MR, Akeeb A, Lavela J, Chen Y, Mellman TA. Period 3 gene polymorphism and sleep adaptation to stressful urban environments. J Sleep Res 2016; 26:115-118. [PMID: 27593530 DOI: 10.1111/jsr.12451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022]
Abstract
This study's objective was to investigate the relationship between a variable-number tandem-repeat (VNTR) Period 3 gene (PER3) polymorphism and sleep adaptation to stressful urban environments. Seventy-five (49 female) African American participants (ages 18-35 years) living in neighbourhoods with high rates of violent crime were selected for the study based on converging criteria for good or poor sleep. Categorization of sleep quality was based on the Insomnia Severity Index (ISI), estimates of typical sleep duration and sleep efficiency. Other assessments included the Fear of Sleep Index (FOSI) and City Stress Inventory (CSI). Whole blood DNA was analysed for the 4 and 5 VNTR alleles using polymerase chain reaction (PCR) and restrictive enzyme digestion. Fifty-seven per cent of those who were homo- or heterozygous for the 4-repeat allele were poor sleepers versus 25% of those homozygous for the 5-repeat allele; χ2 = 4.17, P = 0.041. In a logistic regression model with all the variables with significant bivariate relationships to sleep quality group, FOSI was the only significant predictor (χ2 = 5.68, P = 0.017). FOSI scores were higher among those with the 4-repeat allele (t = 2.66, P = 0.013). The PER3 4 and 5 VNTR polymorphisms appear to influence sensitivity to the effects of stressful urban environments on sleep. While FOSI was the only variable associated independently with sleep quality category, the candidate vulnerability allele was also associated with greater 'fear of sleep'.
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Brudey C, Park J, Wiaderkiewicz J, Kobayashi I, Mellman TA, Marvar PJ. Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease. Am J Physiol Regul Integr Comp Physiol 2015; 309:R315-21. [PMID: 26062635 PMCID: PMC4538229 DOI: 10.1152/ajpregu.00343.2014] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 06/02/2015] [Indexed: 01/29/2023]
Abstract
Stress- and anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated long-term comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed.
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Affiliation(s)
- Chevelle Brudey
- Department of Internal Medicine at the University of Texas Southwestern, Dallas, Texas
| | - Jeanie Park
- Renal Division, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, and Research Service Line, Department of Veterans Affairs Medical Center, Decatur, Georgia
| | - Jan Wiaderkiewicz
- Department of Pharmacology and Physiology, George Washington University, Washington, DC
| | - Ihori Kobayashi
- Howard University College of Medicine Center for Clinical and Translational Research, Washington, DC; and the
| | - Thomas A Mellman
- Howard University College of Medicine Center for Clinical and Translational Research, Washington, DC; and the
| | - Paul J Marvar
- Department of Pharmacology and Physiology, George Washington University, Washington, DC
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