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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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Diaconașu DE, Stoleriu I, Câmpanu IA, Andrei AM, Boncu Ș, Honceriu C, Mocanu V, Juravle G. Predictors of sustained physical activity: behaviour, bodily health, and the living environment. Front Physiol 2024; 14:1213075. [PMID: 38260099 PMCID: PMC10800461 DOI: 10.3389/fphys.2023.1213075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 12/08/2023] [Indexed: 01/24/2024] Open
Abstract
This study examined the determinants of sustained physical activity. Eighty-four participants undertook a 7-weeks walking regime (i.e., a 1-h biometrically-monitored walk, at least 5 days/week), with bioelectrical impedance (BIA) and total cholesterol capillary blood measurements performed before and after programme. To investigate behavioural habit formation, 7 weeks after walking termination, all participants were interviewed and (health) re-tested. Data were modelled with an artificial neural network (ANN) cascading algorithm. Our results highlight the successful prediction of continued physical activity by considering one's physical fitness state, the environmental living context, and risk for cardiovascular disease. Importantly, those artificial neural network models also taking body mass index (BMI) and blood cholesterol as predictors excel at predicting walking continuation (i.e., predictions with 93% predictability). These results are first to highlight the type and importance of available physiological drivers in maintaining a sustained physical activity regime such as walking. They are discussed within the framework of habit formation and the nowadays health and/or wellbeing focus.
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Affiliation(s)
- Delia Elena Diaconașu
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
- Department of Social Sciences and Humanities, Institute of Interdisciplinary Research, Alexandru Ioan Cuza University, Iasi, Romania
| | - Iulian Stoleriu
- Faculty of Mathematics, Alexandru Ioan Cuza University, Iasi, Romania
| | - Ioana Andreea Câmpanu
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Ana-Maria Andrei
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
- Faculty of Educational Sciences, Stefan cel Mare University, Suceava, Romania
| | - Ștefan Boncu
- Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
| | - Cezar Honceriu
- Faculty of Physical Education and Sports, Alexandru Ioan Cuza University, Iasi, Romania
| | - Veronica Mocanu
- Department of Morpho-Functional Sciences 2—Pathophysiology, Grigore T. Popa Medical University of Iasi, Iasi, Romania
| | - Georgiana Juravle
- Sensorimotor Dynamics Laboratory, Faculty of Psychology and Educational Sciences, Alexandru Ioan Cuza University, Iasi, Romania
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Hansel MC, Murphy HR, Brunner J, Wang C, Miller RK, O'Connor TG, Barrett ES, Rivera-Núñez Z. Associations between neighborhood stress and maternal sex steroid hormones in pregnancy. BMC Pregnancy Childbirth 2023; 23:730. [PMID: 37845614 PMCID: PMC10577914 DOI: 10.1186/s12884-023-06043-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Neighborhood stressors (e.g., crime and deprivation) have been associated with adverse pregnancy outcomes including preterm birth and low birth weight. A potential mechanism is disruption of maternal endocrine pathways. While stress hormones (e.g., cortisol) have received much attention, other relevant hormones, including sex steroids, have been overlooked. METHODS Pregnant women in the Understanding Pregnancy Signals and Infant Development (UPSIDE) study contributed biospecimens, questionnaires, and medical record data (n = 262). In each trimester, maternal serum total testosterone [TT], estrone, estradiol, and estriol were measured using LC/MS-MS and serum free testosterone was measured by equilibrium dialysis. In the third trimester, participants reported on neighborhood stress over the last year through the validated City Stress Inventory. We examined two subscales: 11-item neighborhood disorder (e.g., vacant buildings, crime) and 7-item exposure to violence (personal experiences of violence). Composite scores were calculated and examined categorically (quartile (Q) for neighborhood disorder and any/none for exposure to violence). We fitted linear mixed models examining associations between neighborhood stressors and sex steroid hormones across pregnancy as well as trimester-specific linear regression models, all adjusting for confounders. Secondarily, we stratified by fetal sex. Results are presented as percentage change (∆%) and 95% confidence interval (CI) in hormones. RESULTS Most participants (73%) reported one or more exposures to neighborhood disorder; 22% reported any exposure to violence. In adjusted models, neighborhood disorder was associated with higher TT across pregnancy (Q2: %∆= 37.3, 95%CI: 13.2, 66.5; Q3: %∆= 22.2, 95%CI: 1.2, 47.5; and Q4: %∆= 25.7, 95%CI: 1.6, 55.3), with the strongest associations observed in the third trimester (Q2: %∆= 38.0, 95%CI: 10.6, 72.1; Q3: %∆= 29.2, 95%CI: 4.4, 59.9; and Q4: %∆=33.4, 95%CI: 4.9, 69.6). In stratified models, neighborhood disorder was associated with higher TT among women carrying male fetuses (%∆ range: 48.2-84.8). Exposure to violence was not associated with any hormones. CONCLUSION Neighborhood disorder is associated with higher maternal testosterone levels, which may have implications for maternal and child health. Additional research is needed to understand the mechanisms by which neighborhood stress impacts endocrine physiology.
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Affiliation(s)
- Megan C Hansel
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Hannah R Murphy
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Jessica Brunner
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Christina Wang
- Clinical and Translational Science Institute, The Lundquist Institute at Harbor -UCLA Medical Center, Torrance, CA, USA
| | - Richard K Miller
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA
| | - Thomas G O'Connor
- Departments of Psychiatry, Psychology, Neuroscience, University of Rochester, Rochester, NY, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Zorimar Rivera-Núñez
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.
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Emlaw JE, Ajibewa TA, Toledo-Corral CM, Hasson RE. Racial Discrimination and Hypothalamic-Pituitary-Adrenal Axis Dysregulation in Adolescents With Overweight and Obesity: Does Context Matter? Psychosom Med 2023; 85:691-698. [PMID: 37506297 PMCID: PMC10543631 DOI: 10.1097/psy.0000000000001235] [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: 07/30/2023]
Abstract
OBJECTIVES In adolescents at higher risk for chronic disease, the role that context of a discriminatory event may play on cortisol dysregulation is unclear. The purpose of this study was to perform a cross-sectional analysis examining the association between racial discrimination context (peer, educational, institutional, and cumulative) and diurnal cortisol patterning in adolescents with overweight and obesity. METHODS One hundred adolescents (13-19 years; 49% non-Hispanic Black; 65% female; body mass index percentile = 93.9% [4.14%]) were included in this analysis. Racial discrimination context was measured using the self-reported Adolescent Discrimination Distress Index. Salivary cortisol, collected across 3 days at five time points during the day, was used to calculate Δ 0-30 minutes, diurnal slope, and average total diurnal cortisol area under the curve. Sixteen separate multivariable linear regression models were performed to analyze the relationship between racial discrimination and diurnal cortisol patterns. RESULTS Primary findings show that cumulative racial discrimination and peer discrimination were associated with a greater diurnal slope (cumulative: β = 0.010 ± 0.004, p = .03; peer: β = 0.023 ± 0.010, p = .026). CONCLUSIONS Findings from this study identified cross-sectional associations between racial discrimination experienced among peers and diurnal cortisol patterns in adolescents with overweight/obesity. If our findings were to be confirmed in longitudinal analyses, evidence-based programs should be considered to buffer the effects of discrimination on adolescent health, and more importantly, policy makers should work to eliminate discrimination exposure.
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Affiliation(s)
- Jonel E Emlaw
- From the University of Michigan, School of Kinesiology (Emlaw, Ajibewa, Hasson), Ann Arbor, Michigan; and Department of Health Sciences (Toledo-Corral), California State University at Northridge, Northridge, California
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Kim R, Lin T, Pang G, Liu Y, Tungate AS, Hendry PL, Kurz MC, Peak DA, Jones J, Rathlev NK, Swor RA, Domeier R, Velilla MA, Lewandowski C, Datner E, Pearson C, Lee D, Mitchell PM, McLean SA, Linnstaedt SD. Derivation and validation of risk prediction for posttraumatic stress symptoms following trauma exposure. Psychol Med 2023; 53:4952-4961. [PMID: 35775366 DOI: 10.1017/s003329172200191x] [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: 11/06/2022]
Abstract
BACKGROUND Posttraumatic stress symptoms (PTSS) are common following traumatic stress exposure (TSE). Identification of individuals with PTSS risk in the early aftermath of TSE is important to enable targeted administration of preventive interventions. In this study, we used baseline survey data from two prospective cohort studies to identify the most influential predictors of substantial PTSS. METHODS Self-identifying black and white American women and men (n = 1546) presenting to one of 16 emergency departments (EDs) within 24 h of motor vehicle collision (MVC) TSE were enrolled. Individuals with substantial PTSS (⩾33, Impact of Events Scale - Revised) 6 months after MVC were identified via follow-up questionnaire. Sociodemographic, pain, general health, event, and psychological/cognitive characteristics were collected in the ED and used in prediction modeling. Ensemble learning methods and Monte Carlo cross-validation were used for feature selection and to determine prediction accuracy. External validation was performed on a hold-out sample (30% of total sample). RESULTS Twenty-five percent (n = 394) of individuals reported PTSS 6 months following MVC. Regularized linear regression was the top performing learning method. The top 30 factors together showed good reliability in predicting PTSS in the external sample (Area under the curve = 0.79 ± 0.002). Top predictors included acute pain severity, recovery expectations, socioeconomic status, self-reported race, and psychological symptoms. CONCLUSIONS These analyses add to a growing literature indicating that influential predictors of PTSS can be identified and risk for future PTSS estimated from characteristics easily available/assessable at the time of ED presentation following TSE.
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Affiliation(s)
- Raphael Kim
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
- Department of Statistics and Operations Research, University of North Carolina, Chapel Hill, NC, USA
| | - Tina Lin
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Gehao Pang
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Yufeng Liu
- Department of Statistics and Operations Research, University of North Carolina, Chapel Hill, NC, USA
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
- Department of Genetics, Carolina Center for Genome Sciences, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Andrew S Tungate
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama, Birmingham, AL, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jeffrey Jones
- Department of Emergency Medicine, Spectrum Health Butterworth Campus, Grand Rapids, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, Baystate State Health System, Springfield, MA, USA
| | - Robert A Swor
- Department of Emergency Medicine, Beaumont Hospital, Royal Oak, MI, USA
| | - Robert Domeier
- Department of Emergency Medicine, St Joseph Mercy Health System, Ann Arbor, MI, USA
| | | | | | - Elizabeth Datner
- Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Detroit Receiving, Detroit, MI, USA
| | - David Lee
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA
| | - Patricia M Mitchell
- Department of Emergency Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, University of North Carolina, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
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Association of Neighborhood Social Context and Perceived Stress Among Mothers of Young Children. Acad Pediatr 2022; 22:1414-1421. [PMID: 35346861 DOI: 10.1016/j.acap.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Chronic parental stress may negatively impact health among both parents and children. Adverse neighborhood social conditions like crime may increase stress while a supportive neighborhood may buffer stress and promote well-being. Our objective was to examine associations between neighborhood social factors and stress among mothers of young children. METHODS We surveyed 300 mothers/female caregivers of Medicaid-enrolled 2 to 4-year-old children in Philadelphia. Maternal stress was measured via the 10-item Perceived Stress Scale (range 0-40). Mothers' perceived neighborhood safety and collective efficacy were assessed using validated scales. Addresses were geocoded to link census tract-level violent crime rates. We used multivariable linear regression to examine associations of neighborhood safety, collective efficacy, and crime with maternal stress, adjusted for demographics, household socioeconomic status, and neighborhood poverty. RESULTS Among mothers (mean age 31, 60% Black/African American), higher perceived neighborhood safety and collective efficacy were associated with lower stress scores after adjustment for covariates. Each 1-point increase (on a 5-point scale) in perceived neighborhood safety was associated with a 2.30-point decrease in maternal stress (95% CI: -3.07, -1.53). Similarly, each 1-point increase in perceived collective efficacy was associated with a 3.08-point decrease in maternal stress (95% CI: -4.13, -2.02). Police-recorded violent crime rates were not associated with maternal stress. CONCLUSION Mothers of young children who perceive their neighborhood social environment more favorably report less stress compared to those who feel their neighborhood environment is less safe and cohesive. Future work is warranted to investigate whether interventions that increase perceived neighborhood safety and collective efficacy reduce stress.
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Mosley-Johnson E, Walker R, Hawks L, Walker SL, Mendez C, Campbell JA, Egede LE. Pathways between neighbourhood factors, stress and glycaemic control in individuals with type 2 diabetes in Southeastern United States: a cross-sectional pathway analysis. BMJ Open 2022; 12:e060263. [PMID: 36283754 PMCID: PMC9608530 DOI: 10.1136/bmjopen-2021-060263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Understanding the pathway by which neighbourhood factors influence glycaemic control may be crucial to addressing health disparities in diabetes. This study aimed to examine if the pathway between neighbourhood factors and glycaemic control is mediated by stress. DESIGN Structured equation modelling (SEM) was used to investigate direct and indirect effects in the relationship between neighbourhood factors, stress and glycaemic control, with standardised estimates to allow comparison of paths. PARTICIPANTS Data was obtained from 615 adults with type 2 diabetes in the Southeastern United States. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome variable was glycaemic control determined by glycated haemoglobin (HbA1c) within the prior 6 months. Neighbourhood factors included neighbourhood violence, aesthetic quality of the neighbourhood, access to healthy food, and social cohesion. Stress was measured using the perceived stress scale. RESULTS In the final model (χ2(158)=406.97, p<0.001, root mean square error of approximation=0.05, p-close 0.38, Comparative Fit Index=0.97, Tucker-Lewis index=0.96, the coefficient of determination=1.0), violence (r=0.79, p=0.006), neighbourhood aesthetics (r=0.74, p=0.02) and social cohesion (r=0.57, p=0.04) were significantly associated with higher perceived stress. Stress (r=0.06, p=0.004) was directly associated with higher glycaemic control. Significant indirect effects existed between violence and higher HbA1c (r=0.05, p=0.04). After controlling for other neighbourhood factors, there was no significant relationship between access to healthy food and either stress or glycaemic control. CONCLUSIONS While a number of neighbourhood factors were directly associated with stress, only neighbourhood violence had a significant indirect effect on glycaemic control via stress within the tested pathway. Future studies should examine individual-level stress management interventions and should consider community-level interventions targeting neighbourhood violence as strategies for addressing disparities in diabetes.
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Affiliation(s)
- Elise Mosley-Johnson
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Rebekah Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Laura Hawks
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Shannon L Walker
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Carlos Mendez
- Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA
| | - Jennifer A Campbell
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Leonard E Egede
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Mezuk B, Kalesnikava V, Spears E, Kirk K, Rafferty J, Del Toro J. Self-Regulatory Coping Behaviors and Stress Reactivity: Exploring the Environmental Affordance Model of Health Disparities. J Aging Health 2022; 34:307-319. [DOI: 10.1177/08982643221085403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives To explore the relationship between self-regulatory coping behaviors (SRCB) and hypothalamic pituitary adrenal (HPA) stress reactivity. Methods Data came from the Richmond Stress and Sugar Study (n=125, median age: 57 years, 46% non-Hispanic White, 48% African American). The relationships between 11 SRCB (“health-harming” [e.g., smoking] and “health-promoting” [e.g., exercising]) with HPA stress reactivity, indicated by salivary cortisol response to the Trier Social Stress Test, was assessed using multi-level modeling. Results Health-harming and health-promoting SRCB were positively correlated (+0.33, p<0.001). Several individual behaviors were related to HPA stress reactivity, for example, smoking and meditation were associated with shallower increases in cortisol (smoking: −13.0%, 95%CI: −20.9% to −4.3%; meditation: −14.0%, 95%CI: −22.0% to −5.1%). However, SRCB summary measures were unrelated to stress reactivity. Discussion Health-harming and health-promoting SRCB are inter-related. Specific behaviors, rather than groupings as health-harming versus -promoting, are related to HPA stress reactivity.
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Affiliation(s)
- Briana Mezuk
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Viktoryia Kalesnikava
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Erica Spears
- Department of Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Keri Kirk
- Department of Family Medicine, MedStar Georgetown University Hospital, Georgetown University, Washington DC, USA
| | - Jane Rafferty
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Juan Del Toro
- Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA, USA
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Baranyi G, Sieber S, Pearce J, Cullati S, Dibben C, Cheval B. Lower social participation partly explains the association between perceived neighbourhood crime and depressive symptoms in European adults aged 50 years or older: A longitudinal mediation analysis. Prev Med 2022; 155:106954. [PMID: 35065978 DOI: 10.1016/j.ypmed.2022.106954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 12/28/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
Neighbourhood crime likely increases the risk of developing depression among older adults. However, little is known about the underlying behavioural and social pathways. We examined the association between perceived neighbourhood crime and depressive symptoms and whether this relationship was mediated by health behaviours (physical activity, smoking, and alcohol consumption) and social participation. Furthermore, we explored differential vulnerability across age, gender, education and household wealth. Data were drawn from six waves of longitudinal data (from 2004/2005 to 2017) of approximately 15,000 adults aged 50 years and older, derived from the multi-national Survey of Health, Ageing and Retirement in Europe. Perceived neighbourhood crime and covariates were measured at baseline, time-variant mediators and depressive symptoms across all waves. Confounder-adjusted mediator and outcome models were fitted with mixed-effects models. Total association was decomposed into direct and indirect pathways applying causal mediation analyses with Monte-Carlo simulations. Perceived crime was associated with higher risk of depressive symptoms; 4.6% of the effect was mediated via lower engagement in social activities (b = 0.005; 95% CI: 0.001-0.009). No mediation was detected through physical activity, smoking or alcohol consumption. Exploratory analyses revealed that the mediating role of social participation was more pronounced among participants with low household wealth (b = 0.012; 95% CI: 0.004-0.023; 7.3% mediated). Lower engagement in social activities partly explained the association between perceived neighbourhood crime and depressive symptoms in adults aged 50 years or older. Policies targeting disadvantaged communities to prevent crime and support social participation might be beneficial for population mental health, especially among financially vulnerable older residents.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Stefan Sieber
- LIVES Centre, Swiss Centre of Expertise in Life Course Research, Switzerland; Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Switzerland; Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Switzerland
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10
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Murillo R, Ayalew L, Hernandez DC. The association between neighborhood social cohesion and sleep duration in Latinos. ETHNICITY & HEALTH 2021; 26:1000-1011. [PMID: 31455094 PMCID: PMC7323589 DOI: 10.1080/13557858.2019.1659233] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To examine the association between neighborhood social cohesion and sleep duration among Latinos, and whether this association varies by Latino subgroup. DESIGN We used cross-sectional data from the 2013-2015 National Health Interview Survey (NHIS) on 13,537 Latino adults aged ≥18 years originating from 5 countries/regions (i.e. Latinos of Mexican/Mexican-American, Puerto Rican, Dominican, Central or South American, and Cuban/Cuban-American origin). Multivariate logistic regression models were used to estimate the associations between neighborhood social cohesion and sleep duration, and whether associations varied by Latino subgroup. RESULTS Among Mexicans/Mexican-Americans, medium and high levels of neighborhood social cohesion were associated with normal sleep duration, relative to short sleep duration (Odds Ratio [OR]: 1.31; 95% Confidence Interval [CI]: 1.08-1.57, and OR: 1.46; 95% CI: 1.26-1.69, respectively). Among Puerto Ricans, Cubans/Cuban Americans, and Central or South Americans, high neighborhood social cohesion was significantly associated with normal sleep duration (OR: 1.53; 95% Confidence Interval [CI]: 1.10-2.11, OR: 1.94; 95% CI: 1.10-3.42, and OR: 1.78; 95% CI: 1.35-2.34, respectively). CONCLUSIONS The variation in the contribution of neighborhood social cohesion to sleep duration by Latino subgroup should be considered in health promotion programs aimed at improving sleep among Latinos.
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Affiliation(s)
- Rosenda Murillo
- University of Houston, Department of Psychological, Health,
and Learning Sciences, Houston, TX 77204-5029
- HEALTH Research Institute, University of Houston, TX
77204
| | - Leilina Ayalew
- University of Texas Health Science Center at Houston,
School of Public Health, Houston, TX 77030
| | - Daphne C. Hernandez
- University of Houston, Department of Psychological, Health,
and Learning Sciences, Houston, TX 77204-5029
- HEALTH Research Institute, University of Houston, TX
77204
- University of Houston, Department of Health and Human
Performance, Houston, TX 77204-6015
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11
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Miller KG, Gianaros PJ, Kamarck TW, Anderson BA, Muldoon MF, Manuck SB. Cortisol activity partially accounts for a relationship between community socioeconomic position and atherosclerosis. Psychoneuroendocrinology 2021; 131:105292. [PMID: 34144404 DOI: 10.1016/j.psyneuen.2021.105292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
Compared to others, individuals living in communities of socioeconomic disadvantage experience more atherosclerotic cardiovascular disease (CVD) and a greater extent of preclinical atherosclerosis. Although the mechanisms underlying these associations remain unclear, it is widely hypothesized that alterations in normative cortisol release from the Hypothalamic Pituitary Adrenal (HPA) axis may play a role in linking lower community socioeconomic position (C-SEP) to CVD risk. The current study examined this hypothesis in relation to a marker of preclinical atherosclerosis among 488 healthy midlife adults (30-54 years, Mean age= 43, 52% Female, 81% White). All participants were employed and without clinical CVD. C-SEP was estimated from census tract data, and atherosclerosis was measured as intima-medial thickness of the carotid arteries (cIMT) by duplex ultrasonography. Four indicators of HPA activity [cortisol at awakening and the cortisol awakening response (CAR), rate of diurnal decline in cortisol (diurnal slope), and total output expressed as area under the curve (AUC)] were derived from salivary cortisol measurements obtained from 5 samples on each of 3 working days. Path analyses were used to examine associations of C-SEP with cIMT and HPA activity and to test whether individual differences in HPA activity could account for any association of C-SEP with cIMT using bootstrapping (5000 iterations). All models were adjusted for age, sex, race, and composite measures of both individual-level socioeconomic position (income, education, occupation), and cardiometabolic risk (systolic and diastolic blood pressure, waist circumference, fasting lipids and glucose). Lower C-SEP was related to both greater cIMT (b = -0.004, p = .021) and a flatter diurnal slope of cortisol (b = -0.001, p = .039). An indirect effect showed attenuated diurnal slope to partially mediate the relationship between C-SEP and cIMT (95% CI = -0.0018 to -0.0001), and a residual direct effect of C-SEP on cIMT remained significant (95% CI = -0.0097 to -0.004). These results suggest that low C-SEP associations with preclinical atherosclerosis may be due in part to correlated variation in adrenocortical activity.
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Affiliation(s)
- Karissa G Miller
- Department of Psychology, California State University, Long Beach, CA 90808, USA.
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
| | - Thomas W Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
| | - Barbara A Anderson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
| | - Matthew F Muldoon
- Division of Cardiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, USA.
| | - Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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12
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Baranyi G, Di Marco MH, Russ TC, Dibben C, Pearce J. The impact of neighbourhood crime on mental health: A systematic review and meta-analysis. Soc Sci Med 2021; 282:114106. [PMID: 34139480 DOI: 10.1016/j.socscimed.2021.114106] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 06/02/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND Growing evidence indicates that the residential neighbourhood contributes to the complex aetiology of mental disorders. Although local crime and violence, key neighbourhood stressors, may be linked to mental health through direct and indirect pathways, studies are inconclusive. This systematic review and meta-analysis aimed to synthetize the evidence on the association between neighbourhood crime and individual-level mental health problems. METHOD We searched 11 electronic databases, grey literature and reference lists to identify relevant studies published before September 14, 2020. Studies were included if they reported confounder-adjusted associations between objective or perceived area-level crime and anxiety, depression, psychosis or psychological distress/internalising symptoms in non-clinical samples. Effect measures were first converted into Fisher's z-s, pooled with three-level random-effects meta-analyses, and then transformed into Pearson's correlation coefficients. Univariate and multivariate mixed-effects models were used to explore between-study heterogeneity. RESULTS We identified 63 studies reporting associations between neighbourhood crime and residents' mental health. Pooled associations were significant for depression (r = 0.04, 95% CI 0.03-0.06), psychological distress (r = 0.04, 95% CI 0.02-0.06), anxiety (r = 0.05, 95% CI 0.01-0.10), and psychosis (r = 0.04, 95% CI 0.01-0.07). Moderator analysis for depression and psychological distress identified stronger associations with perceived crime measurement and weaker in studies adjusted for area-level deprivation. Importantly, even after accounting for study characteristics, neighbourhood crime remained significantly linked to depression and psychological distress. Findings on anxiety and psychosis were limited due to low number of included studies. CONCLUSIONS Neighbourhood crime is an important contextual predictor of mental health with implications for prevention and policy. Area-based crime interventions targeting the determinants of crime, prevention and service allocation to high crime neighbourhoods may have public mental health benefits. Future research should investigate the causal pathways between crime exposure and mental health, identify vulnerably groups and explore policy opportunities for buffering against the detrimental effect of neighbourhood stressors.
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Affiliation(s)
- Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Martín Hernán Di Marco
- National Scientific and Technical Research Council, Buenos Aires, Argentina; Gino Germani Research Institute, Buenos Aires University, Buenos Aires, Argentina
| | - Tom C Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, United Kingdom
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13
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Community violence exposure and cortisol awakening responses in adolescents who are overweight/obese. Psychoneuroendocrinology 2020; 121:104842. [PMID: 32892064 DOI: 10.1016/j.psyneuen.2020.104842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 06/26/2020] [Accepted: 08/08/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Community violence exposure has been identified as a salient environmental stressor associated with dysregulated cortisol awakening response (CAR), which may act to exacerbate hypothalamic-pituitary-adrenal (HPA) axis dysregulation observed in adolescents who are overweight/obese. PURPOSE To perform an exploratory cross-sectional analysis examining the association between community violence exposure and CAR in adolescents who are overweight/obese. METHODS One-hundred adolescents (ages: 13-19 years; 65% female; average BMI percentile: 93.80 ± 4.13) were included in this analysis. Community violence exposure was measured using the Survey of Children's Exposure to Community Violence. Salivary cortisol collected across three days at awakening and 30 min post-awakening was used to calculate CAR area under the curve (AUC). RESULTS Community violence exposure was associated with a lower CAR AUC when controlling for baseline cortisol, sex, BMI, pubertal development, race and perceived stress (β = -0.04 ± 0.02; p = 0.04). CONCLUSION Findings from this study identified cross-sectional association between community violence and HPA dysregulation in adolescents who were overweight/obese. If long-term exposure to community violence does indeed accelerate HPA dysregulation in adolescents at increased weight status, policymakers and interventionists should consider implementing programs that limit adolescent violence exposure.
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14
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Stress Reactivity as a Contributor to Racial and Socioeconomic Disparities: Rationale and Baseline Results From the Richmond Stress and Sugar Study. Psychosom Med 2020; 82:658-668. [PMID: 32541545 DOI: 10.1097/psy.0000000000000830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE There are pronounced racial and socioeconomic disparities in type 2 diabetes. Although "stress" as a general phenomenon is hypothesized to contribute to these disparities, few studies have objective measures of stress reactivity in diverse samples to test hypotheses about purported mechanisms. This study describes the rationale and baseline characteristics of a cohort designed to address the question: how does stress contribute to disparities in diabetes risk? METHODS The Richmond Stress and Sugar Study recruited 125 adults at elevated risk of type 2 diabetes using a two-by-two sampling frame wherein non-Hispanic whites and African Americans (AAs) were each recruited from neighborhoods of higher and lower socioeconomic status (SES). Stress reactivity was assessed using the Trier Social Stress Test (TSST) and salivary cortisol. Analyses of variance and multilevel modeling were used to examine how stress reactivity varied both within and across race and neighborhood SES. RESULTS The mean (SD) age was 57.4 (7.3) years, 49% were female, 54% were AA or another racial/ethnic minority, and mean hemoglobin A1c level was in the prediabetes range (5.8%; range, 5.50%-5.93%). Living in a lower-SES neighborhood was associated with 16% (95% confidence interval [CI] = -0.04 to 34) higher pre-TSST cortisol, 8.4% (95% CI = -14 to -3) shallower increase in response to the TSST, and 1% (95% CI = 0.3 to 1.7) steeper decline post-TSST than living in the higher neighborhood SES. Post-TSST cortisol decline was 3% greater among AA compared with non-Hispanic whites. Race-by-SES interaction terms were generally small and nonsignificant. CONCLUSIONS SES is associated with stress reactivity among adults at high risk of diabetes.
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15
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Hajat A, Hazlehurst MF, Golden SH, Merkin SS, Seeman T, Szpiro AA, Kaufman JD, Roux AD. The cross-sectional and longitudinal association between air pollution and salivary cortisol: Evidence from the Multi-Ethnic Study of Atherosclerosis. ENVIRONMENT INTERNATIONAL 2019; 131:105062. [PMID: 31491811 PMCID: PMC6994173 DOI: 10.1016/j.envint.2019.105062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cortisol, a stress hormone released by the activation of the hypothalamic-pituitary-adrenal (HPA) axis, is critical to the body's adaptive response to physiological and psychological stress. Cortisol has also been implicated in the health effects of air pollution through the activation of the sympathetic nervous system. This study evaluates the cross-sectional and longitudinal association between several air pollutants and salivary cortisol. METHODS We used data from the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort of 45-85 years old participants from six US cities. Salivary cortisol was evaluated at two time points between 2004 and 2006 and then again from 2010 to 2012. Cortisol samples were taken several times per day on two or three consecutive days. Particulate matter <2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2) and nitrogen oxides (NOx) in the year prior to cortisol sampling were examined. We used piecewise linear mixed models that were adjusted for demographics, socioeconomic status and cardiovascular risk factors to examine both cross-sectional and longitudinal associations. Longitudinal models evaluated change in cortisol over time. RESULTS The pooled cross-sectional results revealed largely null results with the exception of a 9.7% higher wake-up cortisol associated with a 10 ppb higher NO2 (95% CI, -0.2%, 20.5%). Among all participants, the features of the cortisol curve became flatter over 5 years. The wake-to-bed slope showed a more pronounced flattening over time (0.014, 95% CI, 0.0, 0.03) with a 10 ppb higher NO2 level. Other air pollutants were not associated with change in cortisol over time. CONCLUSIONS Our results suggest only a moderate association between traffic related air pollution and cortisol. Very few epidemiologic studies have examined the long-term impact of air pollution on the stress response systems, thus warranting further exploration of these findings.
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Affiliation(s)
- Anjum Hajat
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Marnie F Hazlehurst
- University of Washington, Department of Epidemiology, Box 357236, Seattle, WA 98195, USA.
| | - Sherita Hill Golden
- Johns Hopkins University, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, 1830 E. Monument Street, Room 9052, Baltimore, MD 21287, USA.
| | - Sharon Stein Merkin
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Teresa Seeman
- University of California Los Angeles, Geffen School of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Adam A Szpiro
- University of Washington, Department of Biostatistics, Box 357232, Seattle, WA 98195, USA.
| | - Joel D Kaufman
- University of Washington, Departments of Environmental and Occupational Health Sciences and Epidemiology, Box 354695, Seattle, WA 98195, USA.
| | - Ana Diez Roux
- Drexel University Dornsife School of Public Health, Urban Health Collaborative Nesbitt Hall 3215 Market Street Philadelphia, PA 19104, USA.
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16
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Petteway R, Mujahid M, Allen A. Understanding Embodiment in Place-Health Research: Approaches, Limitations, and Opportunities. J Urban Health 2019; 96:289-299. [PMID: 30613858 PMCID: PMC6458222 DOI: 10.1007/s11524-018-00336-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Research on how place affects health continues to grow. Within the place-health research field, there is increasing focus on how place becomes embodied-i.e., how place-based social and environmental experiences and exposures "get under our skin" to affect physiological functioning and health. While much has been learned, currently favored place-embodiment research approaches present limitations that inhibit continued gains in understanding. This article presents a brief summary of place-health literature related to place-embodiment, highlighting common approaches. Core limitations are then discussed with an eye towards improving research going forward, highlighting mixed-method, spatially dynamic, and participatory intergenerational approaches as promising considerations.
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Affiliation(s)
- Ryan Petteway
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
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Zanelatto C, Höfelmann DA, Giehl MWC, Nishida W, Bastos JL. Perception of neighborhood disorder and blood pressure in adults: a multilevel population-based study. CAD SAUDE PUBLICA 2019; 35:e00016418. [PMID: 30785484 DOI: 10.1590/0102-311x00016418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 06/21/2018] [Indexed: 09/20/2023] Open
Abstract
The aim of this study was to verify whether the perception of neighborhood physical and social disorder is associated with increased systolic (SBP) and diastolic blood pressure (DBP), as well as to examine the influence of the residential census tract's socioeconomic status on this association. This was a cross-sectional study that included a representative sample of 1,720 adults 20 to 59 years of age living in Florianópolis, Santa Catarina State, Brazil. Two blood pressure measurements were taken, and information was collected on the perception of neighborhood disorder. The contextual variable was the mean head-of-household's years of schooling in the selected census tracts. Statistical analysis included multilevel models with the first level represented by individuals and the second by census tracts. Interaction terms were examined between schooling tertiles in the census tract and tertiles of perception of neighborhood disorder on blood pressure. No statistically significant overall associations were identified between neighborhood disorder and SBP or DBP. However, the study showed a mean increase in SBP of 7.88mmHg (95%CI: 1.38; 14.40) in subjects that perceived more neighborhood disorder and lived in census tracts with less schooling, when compared to the reference category. Public policies aimed at lowering or that have an impact on SBP and DBP in the population should also address the characteristics of the context where the population lives, specifically in contexts marked by lower levels of schooling.
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Affiliation(s)
- Carla Zanelatto
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | | | | | - Waleska Nishida
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - João Luiz Bastos
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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18
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Petteway RJ, Mujahid M, Allen A, Morello-Frosch R. The body language of place: A new method for mapping intergenerational "geographies of embodiment" in place-health research. Soc Sci Med 2019; 223:51-63. [PMID: 30708171 DOI: 10.1016/j.socscimed.2019.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/23/2018] [Accepted: 01/15/2019] [Indexed: 01/19/2023]
Abstract
Research on place and health has grown rapidly in recent years, including examining the physiological embodiment of place-based exposures. While this research continues to improve understanding of why place matters, there is particular need for work capable of revealing: 1) which places matter, i.e. spatially-specific notions of "place"); 2) how these places matter-processes and mechanisms of the physiological embodiment of place; and 3) potential intergenerational and life stage differences in place-embodiment experiences/perceptions. The research presented here seeks to make contributions in each of these areas through developing the "geographies of embodiment" concept. Drawing from a multi-method intergenerational community-based participatory research project examining place and health, the research presented here specifically highlights X-Ray Mapping as a new methodology to elucidate subjective notions of place-embodiment within place-health research. Participants were recruited as parent-child dyads and trained in four participatory research methods, including X-Ray Mapping. Participants used X-Ray Mapping and a multimedia-enabled web-based mapping platform to map their "geographies of embodiment". X-Ray Mapping results revealed that 49% of youth place-embodiment locations were spatially outside of their residential census tract-with 75% of positive place-embodiment locations outside, and 66% of negative place-embodiment locations inside. Overall, 67% of youth and adult positive place-embodiment locations were outside of their residential census tract. Through mapping "geographies of embodiment" via participatory methods like X-Ray Mapping, we can gain greater insight into what is embodied (i.e. specific experiences/exposures), and where (i.e. spatially-specific). These gains could improve development of quantitative place-health metrics and enhance efforts to uncover/intervene on the "pathways of embodiment"-specifically, those elements of local social, political, economic, and environmental contexts that constitute expressions of social inequality.
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Affiliation(s)
- Ryan J Petteway
- Portland State University, OHSU-PSU School of Public Health Department of Community Health, 506 SW Mill St, Suite 450, Portland, OR 97201 USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA; University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA
| | - Rachel Morello-Frosch
- University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA; University of California, College of Natural Resources Department of Environmental Science, Policy, & Management 130 Mulford, Berkeley, CA, 94720, USA
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19
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Neergheen VL, Topel M, Van Dyke ME, Sullivan S, Pemu PE, Gibbons GH, Vaccarino V, Quyyumi AA, Lewis TT. Neighborhood social cohesion is associated with lower levels of interleukin-6 in African American women. Brain Behav Immun 2019; 76:28-36. [PMID: 30686334 PMCID: PMC6370481 DOI: 10.1016/j.bbi.2018.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Social cohesion is a positive neighborhood characteristic defined by feelings of connectedness and solidarity within a community. Studies have found significant associations between social cohesion and cardiovascular disease (CVD) risk factors and outcomes. Inflammation is one potential physiological pathway linking social cohesion to CVD development, but few studies have evaluated the relationship between social cohesion and inflammatory biomarkers. Prior research has also established that race and gender can modify the effects of neighborhood features, including social cohesion, on CVD risk factors and outcomes. This study aimed to examine the association between social cohesion and the inflammatory biomarkers interleukin-6 (IL-6) and C-reactive protein (CRP) in a cohort of African American and White women and men. MATERIALS AND METHODS Data from the Morehouse and Emory Team Up to Eliminate Health Disparities (META-Health) Study were used to assess the association between social cohesion and inflammation among African American (n = 203) and White (n = 176) adults from the Atlanta metropolitan area. Social cohesion was measured using the social cohesion subscale from the Neighborhood Health Questionnaire. Inflammatory biomarkers were measured from plasma frozen at -70 °C. Multivariable linear regression analyses were conducted, controlling for demographic, clinical, behavioral, and psychosocial factors sequentially. Interaction by race and gender was also examined. RESULTS In models adjusted for age, race, gender, and education, social cohesion was significantly associated with lower levels of IL-6 (β = -0.06, p = 0.03). There was a significant race × social cohesion interaction (p = 0.04), and a marginally significant gender × race × social cohesion interaction (p = 0.09). In race-stratified models controlling for age, gender, and education, social cohesion was associated with lower IL-6 levels in African Americans (β = -0.11, p = 0.01), but not Whites (β = 0.01, p = 0.91). In fully adjusted race- and gender-stratified models, social cohesion was associated with lower levels of IL-6 in African American women only (β = -0.15, p = 0.003). CRP was not associated with social cohesion in fully adjusted models. CONCLUSION The association between social cohesion and lower levels of IL-6 is modified by gender and race, with the strongest association emerging for African American women. Although the pathways through which social cohesion impacts inflammation remain unclear, it is possible that for African American women social cohesion manifests through neighborhood networks.
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Affiliation(s)
- Vanessa L Neergheen
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Matthew Topel
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Miriam E Van Dyke
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Samaah Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Gary H Gibbons
- National Heart, Lung, and Blood Institute, Bethesda, MD, United States
| | - Viola Vaccarino
- Rollins School of Public Health, Emory University, Atlanta, GA, United States; Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Arshed A Quyyumi
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Tené T Lewis
- Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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Abstract
Our social environment, from the microscopic to the macro-social, affects us for the entirety of our lives. One integral line of research to examine how interpersonal and societal environments can get "under the skin" is through the lens of epigenetics. Epigenetic mechanisms are adaptations made to our genome in response to our environment which include tags placed on and removed from the DNA itself to how our DNA is packaged, affecting how our genes are read, transcribed, and interact. These tags are affected by social environments and can persist over time; this may aid us in responding to experiences and exposures, both the enriched and the disadvantageous. From memory formation to immune function, the experience-dependent plasticity of epigenetic modifications to micro- and macro-social environments may contribute to the process of learning from comfort, pain, and stress to better survive in whatever circumstances life has in store.
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Affiliation(s)
- Sarah M Merrill
- Centre for Molecular Medicine and Therapeutics, British Columbia Children's Hospital, Vancouver, BC, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Nicole Gladish
- Centre for Molecular Medicine and Therapeutics, British Columbia Children's Hospital, Vancouver, BC, Canada
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Michael S Kobor
- Centre for Molecular Medicine and Therapeutics, British Columbia Children's Hospital, Vancouver, BC, Canada.
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.
- Human Early Learning Partnership, University of British Columbia, Vancouver, BC, Canada.
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21
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Goldwater D, Karlamangla A, Merkin SS, Watson K, Seeman T. Interleukin-10 as a predictor of major adverse cardiovascular events in a racially and ethnically diverse population: Multi-Ethnic Study of Atherosclerosis. Ann Epidemiol 2018; 30:9-14.e1. [PMID: 30249450 DOI: 10.1016/j.annepidem.2018.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/20/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To understand if baseline levels of the anti-inflammatory cytokine interleukin-10 (IL-10) are associated with either subclinical atherosclerosis or risk for adverse cardiovascular (CV) events. METHODS The study included 930 adults from the Multi-Ethnic Study of Atherosclerosis (MESA) ancillary Stress Study. Participants, age 48-90 years at enrollment, were followed for an average of 10.2 years. IL-10 level was measured at the initial Stress Study visit. Cardiovascular outcomes were defined as composite CV death, myocardial infarction, stroke, stroke death, and resuscitated cardiac arrest. Coronary calcification was determined by Agatston coronary artery calcium (CAC) score. The association between IL-10 level and CV event risk was evaluated by Cox proportional hazard modeling, while that of IL-10 level and CAC presence and amount was determined with prevalence risk ratio (PRR) and linear regression modeling, respectively. Models were adjusted for CV risk factors and proinflammatory biomarkers. RESULTS After full adjustment, IL-10 level did not predict CV events (HR 1.19, 95%CI 0.89, 1.60) and was not associated with CAC prevalence (PRR 1.00, 95%CI 0.94, 1.07), nor amount of CAC in those with nonzero CAC (β -0.01, 95%CI -0.23, 0.21). CONCLUSION In individuals without clinical heart disease, baseline IL-10 level appears unrelated to risk of CV events and is a poor marker of subclinical coronary atherosclerosis.
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Affiliation(s)
- Deena Goldwater
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095; Department of Medicine, Division of Cardiology, University of California, Los Angeles, 10833 Le Conte Ave, A2-237 Center for Health Sciences, Los Angeles, CA 90095.
| | - Arun Karlamangla
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
| | - Sharon Stein Merkin
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
| | - Karol Watson
- Department of Medicine, Division of Cardiology, University of California, Los Angeles, 10833 Le Conte Ave, A2-237 Center for Health Sciences, Los Angeles, CA 90095
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Ave, Ste 2339, Los Angeles, CA 90095
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More than a feeling: A unified view of stress measurement for population science. Front Neuroendocrinol 2018; 49:146-169. [PMID: 29551356 PMCID: PMC6345505 DOI: 10.1016/j.yfrne.2018.03.001] [Citation(s) in RCA: 423] [Impact Index Per Article: 70.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/01/2018] [Accepted: 03/14/2018] [Indexed: 12/16/2022]
Abstract
Stress can influence health throughout the lifespan, yet there is little agreement about what types and aspects of stress matter most for human health and disease. This is in part because "stress" is not a monolithic concept but rather, an emergent process that involves interactions between individual and environmental factors, historical and current events, allostatic states, and psychological and physiological reactivity. Many of these processes alone have been labeled as "stress." Stress science would be further advanced if researchers adopted a common conceptual model that incorporates epidemiological, affective, and psychophysiological perspectives, with more precise language for describing stress measures. We articulate an integrative working model, highlighting how stressor exposures across the life course influence habitual responding and stress reactivity, and how health behaviors interact with stress. We offer a Stress Typology articulating timescales for stress measurement - acute, event-based, daily, and chronic - and more precise language for dimensions of stress measurement.
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Does spending time outdoors reduce stress? A review of real-time stress response to outdoor environments. Health Place 2018; 51:136-150. [PMID: 29604546 DOI: 10.1016/j.healthplace.2018.03.001] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 02/20/2018] [Accepted: 03/04/2018] [Indexed: 11/23/2022]
Abstract
Everyday environmental conditions impact human health. One mechanism underlying this relationship is the experience of stress. Through systematic review of published literature, we explore how stress has been measured in real-time non-laboratory studies of stress responses to deliberate exposure to outdoor environments. The types of exposures evaluated in this review include: nature viewing, outdoor walks, outdoor exercise and gardening. We characterize study design, modalities of stress measurements, and statistical estimates of effect and significance. Heart rate, blood pressure, and self-report measures provide the most convincing evidence that spending time in outdoor environments, particularly those with green space, may reduce the experience of stress, and ultimately improve health. More work is needed to understand effects of in situ modifications to outdoor environments on residents' stress response.
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McNamara CL, Balaj M, Thomson KH, Eikemo TA, Bambra C. The contribution of housing and neighbourhood conditions to educational inequalities in non-communicable diseases in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. Eur J Public Health 2018; 27:102-106. [PMID: 28355640 DOI: 10.1093/eurpub/ckw224] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Social gradients have been found across European populations, where less affluent groups are more often affected by poor housing and neighbourhood conditions. While poor housing and neighbourhood quality have been associated with a range of non-communicable diseases (NCDs), these conditions have rarely been applied to the examination of socioeconomic differences in NCDs. This study therefore asks ‘to what extent does adjusting for poor housing and neighbourhood conditions reduce inequalities in NCDs among men and women in Europe’? Methods Our analysis used pooled-data from 20 European countries for women (n= 12 794) and men (n= 11 974), aged 25–75, from round 7 of the European Social Survey. Fourteen NCDs were investigated: heart/circulatory problems, high blood pressure, back pain, arm/hand pain, foot/leg pain, allergies, breathing problems, stomach/digestion problems, skin conditions, diabetes, severe headaches, cancer, obesity and depression. We used binary logistic regression models, stratified by gender, and adjusted rate ratios to examine whether educational inequalities in NCDs were reduced after controlling for poor housing and neighbourhood quality. Results Overall, we find that adjusting for poor housing and neighbourhood quality reduces inequalities in NCDs. While reductions were relatively small for some NCDs–for high blood pressure, reductions were found in the range of 0–4.27% among women—for other conditions reductions were more considerable. Controlling for both housing and neighbourhood conditions for example, reduced inequalities by 16–24% for severe headaches and 14–30% for breathing problems. Conclusions Social gradients in poor housing and neighbourhood quality could be an important contributor to educational inequalities in some NCDs.
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Affiliation(s)
- Courtney L McNamara
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mirza Balaj
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Katie H Thomson
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK
| | - Terje A Eikemo
- Department of Sociology and Political Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Clare Bambra
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, UK
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Gianaros PJ, Kuan DCH, Marsland AL, Sheu LK, Hackman DA, Miller KG, Manuck SB. Community Socioeconomic Disadvantage in Midlife Relates to Cortical Morphology via Neuroendocrine and Cardiometabolic Pathways. Cereb Cortex 2018; 27:460-473. [PMID: 26498832 DOI: 10.1093/cercor/bhv233] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Residing in communities of socioeconomic disadvantage confers risk for chronic diseases and cognitive aging, as well as risk for biological factors that negatively affect brain morphology. The present study tested whether community disadvantage negatively associates with brain morphology via 2 biological factors encompassing cardiometabolic disease risk and neuroendocrine function. Participants were 448 midlife adults aged 30-54 years (236 women) who underwent structural neuroimaging to assess cortical and subcortical brain tissue morphology. Community disadvantage was indexed by US Census data geocoded to participants' residential addresses. Cardiometabolic risk was indexed by measurements of adiposity, blood pressure, glucose, insulin, and lipids. Neuroendocrine function was indexed from salivary cortisol measurements taken over 3 days, from which we computed the cortisol awakening response, area-under-the-curve, and diurnal cortisol decline. Community disadvantage was associated with reduced cortical tissue volume, cortical surface area, and cortical thickness, but not subcortical morphology. Moreover, increased cardiometabolic risk and a flatter (dysregulated) diurnal cortisol decline mediated the associations of community disadvantage and cortical gray matter volume. These effects were independent of age, sex, and individual-level socioeconomic position. The adverse risks of residing in a disadvantaged community may extend to the cerebral cortex via cardiometabolic and neuroendocrine pathways.
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Affiliation(s)
- Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.,Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213, USA
| | - Dora C-H Kuan
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Anna L Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Lei K Sheu
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Daniel A Hackman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Karissa G Miller
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Stephen B Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA
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Finegood ED, Rarick JRD, Blair C. Exploring longitudinal associations between neighborhood disadvantage and cortisol levels in early childhood. Dev Psychopathol 2017; 29:1649-1662. [PMID: 29162174 PMCID: PMC5772682 DOI: 10.1017/s0954579417001304] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Children who grow up in poverty are more likely to experience chronic stressors that generate "wear" on stress regulatory systems including the hypothalamus-pituitary-adrenal (HPA) axis. This can have long-term consequences for health and well-being. Prior research has examined the role of proximal family and home contributions to HPA axis functioning. However, there is evidence to suggest that more distal levels of context, including neighborhoods, also matter. Prior evidence has primarily focused on adolescents and adults, with little evidence linking the neighborhood context with HPA activity in infancy and toddlerhood. We tested whether neighborhood disadvantage (indexed by US Census data) was associated with basal salivary cortisol levels at 7, 15, and 24 months of child age in a large sample of families (N = 1,292) residing in predominately low-income and rural communities in the United States. Multilevel models indicated that neighborhood disadvantage was positively associated with salivary cortisol levels and that this effect emerged across time. This effect was moderated by the race/ethnicity of children such that the association was only observed in White children in our sample. Findings provide preliminary evidence that the neighborhood context is associated with stress regulation during toddlerhood, elucidating a need for future work to address possible mechanisms.
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Richardson AS, Troxel WM, Ghosh-Dastidar M, Hunter GP, Beckman R, Colabianchi N, Collins RL, Dubowitz T. Pathways through which higher neighborhood crime is longitudinally associated with greater body mass index. Int J Behav Nutr Phys Act 2017; 14:155. [PMID: 29121957 PMCID: PMC5679366 DOI: 10.1186/s12966-017-0611-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 11/01/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Although crime and perceived safety are associated with obesity and body mass index (BMI), the pathways are less clear. Two likely pathways by which crime and perceived safety may impact obesity are through distress and physical activity. METHODS We examined data from 2013 to 2014 for 644 predominantly African-American adults (mean age 57 years; 77% female) living in low-income Pittsburgh, PA neighborhoods, including self-reported perceptions of safety and emotional distress, interviewer-measured height/weight, and physical activity measured via accelerometry. We used secondary data on neighborhood crime from 2011 to 2013. We built a structural equation model to examine the longitudinal direct and indirect pathways from crime to BMI through perceived safety, distress and physical activity. RESULTS Long-term exposure to crime was positively associated with lack of perceived safety (β = 0.11, p = 0.005) and lack of perceived safety was positively associated with BMI (β = 0.08, p = 0.03). The beneficial association between physical activity and BMI (β = -0.15, p < 0.001) was attenuated by a negative association between crime and physical activity (β = -0.09, p = 0.01). Although crime was associated with distress we found no evidence of a path from crime to BMI via distress. CONCLUSIONS Our findings suggest decrements in perceived safety and physical activity are important processes that might explain why neighborhood crime is associated with greater BMI.
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Affiliation(s)
| | - Wendy M. Troxel
- RAND Corporation, Health Division, 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
| | | | - Gerald P. Hunter
- RAND Corporation, Health Division, 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
| | - Robin Beckman
- RAND Corporation, Health Division, 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
| | | | - Rebecca L. Collins
- RAND Corporation, Health Division, 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
| | - Tamara Dubowitz
- RAND Corporation, Health Division, 4570 Fifth Avenue, Pittsburgh, PA 15213 USA
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28
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Novak NL, Wang X, Clarke PJ, Hajat A, Needham BL, Sánchez BN, Rodriguez CJ, Seeman TE, Castro-Diehl C, Golden SH, Diez Roux AV. Diurnal salivary cortisol and nativity/duration of residence in Latinos: The Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 2017; 85:179-189. [PMID: 28886460 PMCID: PMC5623131 DOI: 10.1016/j.psyneuen.2017.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
Abstract
Latino immigrants have lower prevalence of depression, obesity and cardiovascular disease than US-born Latinos when they are recently arrived in the US, but this health advantage erodes with increasing duration of US residence. Cumulative exposure to psychosocial stress and its physiological sequelae may mediate the relationship between nativity and duration of US residence and poor health. We used data from Latino cohort study participants ages 45-84 to examine cross-sectional (n=558) and longitudinal (n=248) associations between nativity and duration of US residence and features of the diurnal cortisol curve including: wake-up cortisol, cortisol awakening response (CAR, wake-up to 30min post-awakening), early decline (30min to 2h post-awakening) and late decline (2h post-awakening to bed time), wake-to-bed slope, and area under the curve (AUC). In cross-sectional analyses, US-born Latinos had higher wake-up cortisol than immigrants with fewer than 30 years of US residence. In the full sample, over 5 years the CAR and early decline became flatter and AUC became larger. Over 5 years, US-born Latinos had greater increases in wake-up cortisol and less pronounced flattening of the early diurnal cortisol decline than immigrants with fewer than 30 years of US residence. Immigrants with 30 or more years of US residence also had less pronounced flattening of the early decline relative to more recent immigrants, and also had a less pronounced increase in AUC. In sum, we saw limited cross-sectional evidence that US-born Latinos have more dysregulated cortisol than recently-arrived Latino immigrants, but over time US-born Latinos had slower progression of cortisol dysregulation.
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Affiliation(s)
- Nicole L Novak
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Xu Wang
- Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19104, USA.
| | - Philippa J Clarke
- Survey Research Center, Institute for Social Research, University of Michigan, 426 S. Thompson St., Ann Arbor, MI 48109, USA.
| | - Anjum Hajat
- University of Washington School of Public Health Department of Epidemiology, 4225 Roosevelt Way NE, Suite 303, Seattle, WA 98105, USA.
| | - Belinda L Needham
- Department of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA.
| | - Brisa N Sánchez
- Department of Biostatistics, University of Michigan School of Public Health, SPH II, Room 4164, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Carlos J Rodriguez
- Department of Internal Medicine, Section of Cardiology, Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Teresa E Seeman
- Division of Geriatrics, David Geffen School of Medicine at UCLA, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Cecilia Castro-Diehl
- Departments of Medicine and Epidemiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, 630 West 168th Street PH9 105, New York, NY 10032, USA.
| | - Sherita Hill Golden
- Departments of Medicine and Epidemiology, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Division of Endocrinology, Diabetes,and Metabolism, 1830 E. Monument Street, Suite 333, Baltimore, MD 21287, USA.
| | - Ana V Diez Roux
- Dornsife School of Public Health, Drexel University, 3215 Market St., Philadelphia, PA 19104, USA.
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Johnson DA, Simonelli G, Moore K, Billings M, Mujahid MS, Rueschman M, Kawachi I, Redline S, Diez Roux AV, Patel SR. The Neighborhood Social Environment and Objective Measures of Sleep in the Multi-Ethnic Study of Atherosclerosis. Sleep 2017; 40:2957268. [PMID: 28364474 DOI: 10.1093/sleep/zsw016] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2017] [Indexed: 01/22/2023] Open
Abstract
Study objectives To investigate cross-sectional associations of neighborhood social environment (social cohesion, safety) with objective measures of sleep duration, timing, and disturbances. Methods A racially/ethnically diverse population of men and women (N = 1949) aged 54 to 93 years participating in the Multi-Ethnic Study of Atherosclerosis Sleep and Neighborhood Ancillary studies. Participants underwent 1-week actigraphy between 2010 and 2013. Measures of sleep duration, timing, and disruption were averaged over all days. Neighborhood characteristics were assessed via questionnaires administered to participants and an independent sample within the same neighborhood and aggregated at the neighborhood (census tract, N = 783) level using empirical Bayes estimation. Multilevel linear regression models were used to assess the association between the neighborhood social environment and each sleep outcome. Results Neighborhood social environment characterized by higher levels of social cohesion and safety were associated with longer sleep duration and earlier sleep midpoint. Each 1 standard deviation higher neighborhood social environment score was associated with 6.1 minutes longer [95% confidence interval (CI): 2.0, 10.2] sleep duration and 6.4 minutes earlier (CI: 2.2, 10.6) sleep midpoint after adjustment for age, sex, race, socioeconomic status, and marital status. These associations persisted after adjustment for other risk factors. Neighborhood social factors were not associated with sleep efficiency or sleep fragmentation index. Conclusions A more favorable neighborhood social environment is associated with longer objectively measured sleep duration and earlier sleep timing. Intervening on the neighborhood environment may improve sleep and subsequent health outcomes.
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Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine Harvard Medical School, Boston, MA
| | - Guido Simonelli
- Department of Behavioral Biology, Walter Reed Army Institute of Research, Silver Spring, MD
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University,Philadelphia, PA
| | - Martha Billings
- UW Medicine Sleep Center, Division of Pulmonary Critical Care, University of Washington, Seattle, WA
| | | | - Michael Rueschman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine Harvard Medical School, Boston, MA
| | - Ana V Diez Roux
- UW Medicine Sleep Center, Division of Pulmonary Critical Care, University of Washington, Seattle, WA
| | - Sanjay R Patel
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Research performed at the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital
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Zilioli S, Slatcher RB, Fritz H, Booza JC, Cutchin MP. Brief report: Neighborhood disadvantage and hair cortisol among older urban African Americans. Psychoneuroendocrinology 2017; 80:36-38. [PMID: 28315608 PMCID: PMC5450496 DOI: 10.1016/j.psyneuen.2017.02.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 02/23/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
Abstract
Previous studies have shown that living in poor neighborhoods is associated with increased morbidity and mortality. However, researchers are now investigating the biological pathways responsible for the deleterious effects of neighborhood disadvantage on health. This study investigated whether neighborhood disadvantage (i.e., a measure of relative neighborhood quality derived by combining social and built environmental conditions) was associated with hair cortisol-a retrospective indicator of long-term hypothalamic pituitary adrenal (HPA) axis activation-and whether this link would be mediated by self-reported neighborhood satisfaction. Forty-nine older African Americans were recruited from thirty-nine Detroit census tracts across five strata of census tract adversity. Participants were interviewed face-to-face to collect psychosocial measures. Each provided a hair sample for analysis of cortisol. Multiple regression analyses revealed that higher neighborhood disadvantage was associated with higher levels of hair cortisol levels and that neighborhood satisfaction partially explained this association. These results are the first to our knowledge to demonstrate a direct link between neighborhood disadvantage and hair cortisol in a sample of older adults and to show that self-reported neighborhood satisfaction may be a psychological intermediary of this association.
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Affiliation(s)
- Samuele Zilioli
- Department of Psychology, Wayne State University, United States; School of Medicine, Wayne State University, United States.
| | | | - Heather Fritz
- Department of Health Care Sciences, Wayne State University
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31
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Wagner KJP, Boing AF, Subramanian SV, Höfelmann DA, D'Orsi E. Effects of neighborhood socioeconomic status on blood pressure in older adults. Rev Saude Publica 2016; 50:78. [PMID: 28099662 PMCID: PMC5152802 DOI: 10.1590/s1518-8787.2016050006595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/25/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To test if the neighborhood socioeconomic status is associated with systolic blood pressure and hypertension in older adults. METHODS A cross-sectional population-based study with a sample of 1,705 older adults from Florianópolis, SC, Southern Brazil. The contextual variable used was the average years of schooling of the head of the household in census tracts. Participants were considered hypertensive when the systolic blood pressure was ≥ 140 mmHg, diastolic ≥ 90 mmHg, or both. Additionally, the use of antihypertensive medication was also considered. Data were analyzed by using multilevel models of logistic and linear regression. RESULTS The average age of the sample was 70.7 years and the average of systolic and diastolic blood pressure was 133.5 mmHg (SD = 20.5 mmHg) and 81.9 mmHg (SD = 12.5 mmHg), respectively. The systolic blood pressure was 4.46 mmHg (95%CI 1.00-7.92) higher and the chance of hypertension was 1.80 (95%CI 1.26-2.57) among those who lived in census tracts with lower level of schooling. When the use of antihypertensive medication was combined with blood pressure levels, none association was found between the outcome and the level of schooling of the census tract. CONCLUSIONS Analytical models more robust (such as multilevel analysis) in Brazil are still little used, with a small number of articles published. Neighborhood socioeconomic status is associated with systolic blood pressure and the chance of hypertension, regardless of individual characteristics.
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Affiliation(s)
| | - Antonio Fernando Boing
- Programa de Pós-Graduação em Saúde Pública. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil.,Department of Society, Human Development and Health. Harvard School of Public Health. Massachusetts, United States
| | - S V Subramanian
- Department of Society, Human Development and Health. Harvard School of Public Health. Massachusetts, United States
| | | | - Eleonora D'Orsi
- Programa de Pós-Graduação em Saúde Pública. Universidade Federal de Santa Catarina. Florianópolis, SC, Brasil
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Burke-Miller JK, Weber K, Cohn SE, Hershow RC, Sha B, French AL, Cohen MH. Measurement of Neighborhood Context in an Urban Cohort of HIV-infected or at risk Low-Income Women. JOURNAL OF POVERTY 2016; 21:80-96. [PMID: 29230088 PMCID: PMC5722238 DOI: 10.1080/10875549.2016.1262933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The study of neighborhood disadvantage and health relies on census socioeconomic data but would benefit from reliable survey measures of factors that influence health within low income communities. The Perceptions of Neighborhood Environment Scale (PNES) was developed for use in the general U.S. population, and its measurement properties in a cohort of low-income urban women living with or at risk for HIV are described. The scale and all but one subscale have good psychometric and ecometric reliability, as well as convergent, construct, and concurrent validity, and are not collinear with household and community area income in low-income urban neighborhoods.
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Affiliation(s)
| | - Kathleen Weber
- Ruth M. Rothstein CORE Center, Cook County Bureau of Health Services, 2020 W. Harrison St., Chicago IL 60612 USA
| | - Susan E. Cohn
- Northwestern University Feinberg School of Medicine, 420 E. Superior St., Chicago IL 60611 USA
| | - Ronald C. Hershow
- University of Illinois at Chicago School of Public Health, 1601 W. Taylor St., Chicago IL 60612 USA
| | - Beverly Sha
- Rush University Medical Center, 600 S. Paulina St., Chicago IL 60612 USA
| | - Audrey L. French
- Ruth M. Rothstein CORE Center, Cook County Bureau of Health Services, 2020 W. Harrison St., Chicago IL 60612 USA
- Rush University Medical Center, 600 S. Paulina St., Chicago IL 60612 USA
| | - Mardge H. Cohen
- Rush University Medical Center, 600 S. Paulina St., Chicago IL 60612 USA
- Stroger Hospital, Cook County Bureau of Health Services, Chicago IL 60612 USA
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Diez Roux AV, Mujahid MS, Hirsch JA, Moore K, Moore LV. The Impact of Neighborhoods on CV Risk. Glob Heart 2016; 11:353-363. [PMID: 27741982 PMCID: PMC5098701 DOI: 10.1016/j.gheart.2016.08.002] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 07/28/2016] [Accepted: 08/01/2016] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular disease (CVD) continues to be the leading cause of death and a major source of health disparities in the Unites States and globally. Efforts to reduce CVD risk and eliminate cardiovascular health disparities have increasingly emphasized the importance of the social determinants of health. Neighborhood environments have emerged as a possible target for prevention and policy efforts. Hence there is a need to better understand the role of neighborhood environments in shaping cardiovascular risk. The MESA (Multi-Ethnic Study of Atherosclerosis) Neighborhood Study provided a unique opportunity to build a comprehensive place-based resource for investigations of associations between specific features of neighborhood physical and social environments and cardiovascular risk factors and outcomes. This review summarizes the approaches used to characterize residential neighborhood environments in the MESA cohort, provides an overview of key findings to date, and discusses challenges and opportunities in neighborhood health effects research. Results to date suggest that neighborhood physical and social environments are related to behavioral and biomedical risk factors for CVD and that cardiovascular prevention efforts may benefit from taking neighborhood context into account.
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Affiliation(s)
- Ana V Diez Roux
- Department of Epidemiology and Biostatistics and Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Mahasin S Mujahid
- Division of Epidemiology, University of California, Berkeley School of Public Health, Berkeley, CA, USA
| | - Jana A Hirsch
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kari Moore
- Urban Health Collaborative, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Vo P, Bair-Merritt M, Camargo CA, Eisenberg S, Long W. Individual factors, neighborhood social context and asthma at age 5 years. J Asthma 2016; 54:265-272. [PMID: 27485524 DOI: 10.1080/02770903.2016.1216563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Childhood asthma is a major public health problem and its development is multifactorial. We examined whether neighborhood cohesion and disorder were associated with caregiver-report of asthma at age 5 years. METHODS This study is a secondary data analysis of the 2011-2012 United States National Survey of Children's Health. Data were available for 4680 children, age 5 years old born at term or preterm with birthweight >2500 g. Neighborhood disorder and cohesion were assessed based on caregivers' responses to validated questionnaires. Child asthma diagnosis was reported by the caregiver. Multivariable logistic regression was used to examine the relationship between these neighborhood factors and caregiver-report of child asthma, while accounting for individual level covariates. RESULTS Approximately two-thirds of the 4680 children were White and lived in households with income >400% of federal poverty line. Asthma was present in 399 (9%) children. Child female sex was associated with reduced risk of caregiver-reported asthma while non-Hispanic Black race and having smokers in the household were independently associated with increased risk in multivariable models. In these models, neighborhood disorder was significantly associated with asthma (adjusted Odds Ratio [aOR] 1.70, 95% Confidence Interval [CI] 1.04-2.78), while neighborhood cohesion was not (aOR 0.93, 95% CI 0.51-1.68). CONCLUSION Even after adjustment for several individual level factors, neighborhood disorder was associated with caregiver-report of asthma in this nationally representative sample of 5-year-old children. Further research is needed to better understand how risk factors at different levels of the socio-ecological framework may interact to affect childhood asthma development.
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Affiliation(s)
- Phuong Vo
- a Department of Pediatrics , Boston Medical Center , Boston , MA , USA
| | | | - Carlos A Camargo
- b Department of Emergency Medicine , Massachusetts General Hospital , Boston , MA , USA
| | - Staci Eisenberg
- c Departments of Pediatrics and Medicine , Brown University/Hasboro , Providence , RI , USA
| | - Webb Long
- d Child Health Associates , Auburn , MA , USA
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Burke-Miller JK, Weber K, Cohn SE, Hershow RC, Sha BE, French AL, Cohen MH. Neighborhood community characteristics associated with HIV disease outcomes in a cohort of urban women living with HIV. AIDS Care 2016; 28:1274-9. [PMID: 27098593 DOI: 10.1080/09540121.2016.1173642] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Recent studies have found geographic variations in immune and viral human immunodeficiency virus (HIV) disease outcomes associated with census measures of neighborhood poverty and segregation. Although readily available, such aggregate census measures are not based on health behavior models and provide limited information regarding neighborhood effect pathways. In contrast, survey-based measures can capture specific aspects of neighborhood disadvantage that may better inform community-based interventions. Therefore, the aim of this study is to assess the measurement validity of multi-dimensional survey measures of neighborhood disorder compared with census measures as predictors of HIV outcomes in a cohort of 197 low-income women in a major metropolitan area. The multi-dimensional survey measures were related to each other and to census measures of concentrated poverty and racial segregation, but not so highly correlated as to be uniform. We found notable variation between community areas in women's CD4 levels but there was no corresponding geographic variance in viral load, and relationships between community area measures and viral load disappeared after adjustment for individual characteristics, including HIV treatment adherence. In multilevel models adjusting for individual characteristics including substance use, depression, and HIV treatment adherence, one survey measure of neighborhood disadvantage (poor-quality built environment) and one census measure (racial segregation) were significantly associated with greater likelihood of CD4 < 500 (p < .05).
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Affiliation(s)
| | - Kathleen Weber
- a Hektoen Institute of Medicine , Chicago , IL , USA.,b Ruth M. Rothstein CORE Center, Cook County Health and Hospitals System , Chicago , IL , USA
| | - Susan E Cohn
- c Feinberg School of Medicine , Northwestern University , Chicago , IL , USA
| | - Ronald C Hershow
- d University of Illinois at Chicago School of Public Health , Chicago , IL , USA
| | - Beverly E Sha
- e Rush University Medical Center , Chicago , IL , USA
| | - Audrey L French
- b Ruth M. Rothstein CORE Center, Cook County Health and Hospitals System , Chicago , IL , USA.,e Rush University Medical Center , Chicago , IL , USA
| | - Mardge H Cohen
- e Rush University Medical Center , Chicago , IL , USA.,f Stroger Hospital, Cook County Health and Hospitals System , Chicago , IL , USA
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Olstad DL, Ball K, Wright C, Abbott G, Brown E, Turner AI. Hair cortisol levels, perceived stress and body mass index in women and children living in socioeconomically disadvantaged neighborhoods: the READI study. Stress 2016; 19:158-67. [PMID: 27023344 DOI: 10.3109/10253890.2016.1160282] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Disadvantaged communities provide adverse psychosocial exposures that have been linked to high levels of stress, and this may provide one explanatory pathway linking socioeconomic disadvantage to obesity. This study used hair cortisol analysis to quantify associations between stress and body mass index (BMI), and between hair cortisol and perceived psychological stress levels, in women and children living in socioeconomically disadvantaged neighborhoods. Participants were a volunteer sample of 70 women from the Resilience for Eating and Activity Despite Inequality study, including 30 maternal-child pairs. Women self-reported body weight, height and perceived psychological stress using the Perceived Stress Scale (PSS), and provided hair samples for themselves and their child. Children's body weight and height were measured. Following extraction, hair cortisol levels were measured using enzyme-linked immunosorbent assay. Multiple linear regression models examined associations between stress and BMI, and between hair cortisol and perceived stress levels in women and children. Women's hair cortisol levels were not associated with their BMI or PSS scores. Women's PSS scores were positively associated with their BMI (p = 0.015). Within maternal-child pairs, mothers and children's hair cortisol levels were strongly positively associated (p = 0.006). Maternal hair cortisol levels and PSS scores were unrelated to their child's zBMI. Children's hair cortisol levels were not associated with their zBMI or with their mother's PSS score. Findings suggest that cortisol-based and perceived psychological measures of stress may be distinct among women and children living in disadvantaged neighborhoods. Perceived psychological measures may be more important predictors of weight-related risk.
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Affiliation(s)
- Dana Lee Olstad
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
| | - Kylie Ball
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
| | - Craig Wright
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
| | - Gavin Abbott
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
| | - Erin Brown
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
| | - Anne Isabella Turner
- a Faculty of Health , Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University , Burwood , VIC , Australia
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Tomarken AJ, Han G, Corbett BA. Temporal patterns, heterogeneity, and stability of diurnal cortisol rhythms in children with autism spectrum disorder. Psychoneuroendocrinology 2015; 62:217-26. [PMID: 26318632 PMCID: PMC4945957 DOI: 10.1016/j.psyneuen.2015.08.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 08/17/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
Abstract
The current study used a multifaceted approach to assess whether children with ASD have a distinctive diurnal rhythm of cortisol that differentiates them from typically developing (TD) peers and whether sub-groups of ASD children can be identified with unique diurnal profiles. Salivary cortisol was sampled at four time points during the day (waking, 30-min post-waking, afternoon, and evening) across three days in a sample of 36 children with autism spectrum disorder (ASD) and 27 typically developing (TD) peers. Between-group comparisons on both mean levels and featural components of diurnal cortisol indicated elevated evening cortisol and a dampened linear decline across the day in the ASD group. No differences were evident on the cortisol awakening response (CAR). Group-based trajectory modeling indicated that a subgroup (25%) of ASD children demonstrated an attenuated linear decline while the cortisol trajectory of the second subgroup was indistinguishable from that of the TD group. Intraclass correlations indicated that, when aggregated across days, cortisol measures were generally stable over the interval assessed. There were few significant relations between cortisol measures or sub-groups and measures of stress, temperament, and symptoms. Results encourage follow-up studies to investigate the functional significance, heterogeneity and longer-term stability of diurnal cortisol profiles in children with ASD.
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Affiliation(s)
| | - Gloria Han
- Vanderbilt University, Department of Psychology
| | - Blythe A. Corbett
- Vanderbilt University, Department of Psychology,Vanderbilt University, Department of Psychiatry
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Lindfors P, Riva R, Lundberg U. SINGLE AND AGGREGATE SALIVARY CORTISOL MEASURES IN WORKING WOMEN LIVING IN HIGH AND LOW STATUS NEIGHBORHOODS IN SWEDEN. Psychol Rep 2015; 117:380-9. [PMID: 26444834 DOI: 10.2466/16.06.pr0.117c23z3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Contextual factors including neighborhood status have consistently been associated with health disparities. This may relate to a poorer neighborhood status involving an exposure to chronic stressors, which dysregulates cortisol secretion. This study investigated single and aggregate cortisol measures in 88 working women living in high and low status neighborhoods. Results showed significantly lower waking cortisol among women in low status neighborhoods. However, there were no group differences in aggregate cortisol measures. The lower morning cortisol among women in the low status neighborhoods follows previous research suggesting hypocortisolism as a pathway linking neighborhood status and health disparities, albeit a less consistent finding across cortisol measures in this sample. This may relate to the Swedish welfare state and its fostering of equality.
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An K, Salyer J, Brown RE, Kao HFS, Starkweather A, Shim I. Salivary Biomarkers of Chronic Psychosocial Stress and CVD Risks. Biol Res Nurs 2015; 18:241-63. [DOI: 10.1177/1099800415604437] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The use of salivary biomarkers in stress research is increasing, and the precision and accuracy with which researchers are able to measure these biomarkers have dramatically improved. Chronic psychosocial stress is often linked to the pathogenesis of cardiovascular disease (CVD). Salivary biomarkers represent a noninvasive biological method of characterizing the stress phenomenon that may help to more fully describe the mechanism by which stress contributes to the pathogenesis and outcomes of CVD. Objectives: We conducted a systematic review of 40 research articles to identify the salivary biomarkers researchers have most commonly used to help describe the biological impact of chronic psychosocial stress and explore its associations with CVD risk. We address strengths and weaknesses of specimen collection and measurement. Methods: We used PubMed, CINAHL, EBSCO host, Web of Science, BIOSIS Previews, Biological Sciences (ProQuest), and Dissertations/Theses (ProQuest) to retrieve 387 initial articles. Once we applied our inclusion/exclusion criteria to specifically target adult human studies dealing with chronic stress rather than acute/laboratory-induced stress, 40 studies remained, which we synthesized using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Results: Cortisol was the biomarker used most frequently. Sources of psychosocial stress included job strain, low socioeconomic status, and environmental factors. Overall, psychosocial stress was associated with CVD risks such as vascular pathology (hypertension, blood pressure fluctuation, and carotid artery plaque) as well as metabolic factors such as abnormal blood glucose, dyslipidemia, and elevated cardiac enzymes. Conclusion: Diverse salivary biomarkers have been useful in stress research, particularly when linked to CVD risks.
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Affiliation(s)
- Kyungeh An
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Jeanne Salyer
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
| | - Roy E. Brown
- School of Nursing, Virginia Commonwealth University, Richmond VA, USA
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Powell-Wiley TM, Cooper-McCann R, Ayers C, Berrigan D, Lian M, McClurkin M, Ballard-Barbash R, Das SR, Hoehner CM, Leonard T. Change in Neighborhood Socioeconomic Status and Weight Gain: Dallas Heart Study. Am J Prev Med 2015; 49:72-9. [PMID: 25960394 PMCID: PMC4476924 DOI: 10.1016/j.amepre.2015.01.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/22/2015] [Accepted: 01/22/2015] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Despite a proposed connection between neighborhood environment and obesity, few longitudinal studies have examined the relationship between change in neighborhood socioeconomic deprivation, as defined by moving between neighborhoods, and change in body weight. The purpose of this study is to examine the longitudinal relationship between moving to more socioeconomically deprived neighborhoods and weight gain as a cardiovascular risk factor. METHODS Weight (kilograms) was measured in the Dallas Heart Study (DHS), a multiethnic cohort aged 18-65 years, at baseline (2000-2002) and 7-year follow-up (2007-2009, N=1,835). Data were analyzed in 2013-2014. Geocoded addresses were linked to Dallas County, TX, census block groups. A block group-level neighborhood deprivation index (NDI) was created. Multilevel difference-in-difference models with random effects and a Heckman correction factor (HCF) determined weight change relative to NDI change. RESULTS Forty-nine percent of the DHS population moved (263 to higher NDI, 586 to lower NDI, 47 within same NDI), with blacks more likely to move than whites or Hispanics (p<0.01), but similar baseline BMI and waist circumference were observed in movers versus non-movers (p>0.05). Adjusting for HCF, sex, race, and time-varying covariates, those who moved to areas of higher NDI gained more weight compared to those remaining in the same or moving to a lower NDI (0.64 kg per 1-unit NDI increase, 95% CI=0.09, 1.19). Impact of NDI change on weight gain increased with time (p=0.03). CONCLUSIONS Moving to more-socioeconomically deprived neighborhoods was associated with weight gain among DHS participants.
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Affiliation(s)
| | - Rebecca Cooper-McCann
- Blood Institute; Clinical Center, Office of Clinical Research Training and Medical Education, NIH, Bethesda
| | - Colby Ayers
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas
| | - David Berrigan
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Min Lian
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | | | - Rachel Ballard-Barbash
- Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | - Sandeep R Das
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas
| | | | - Tammy Leonard
- Department of Economics, University of Dallas, Irving, Texas
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Hajat A, Moore K, Do DP, Stein Merkin S, Punjabi NM, Sáñchez BN, Seeman T, Diez-Roux AV. Examining the cross-sectional and longitudinal association between diurnal cortisol and neighborhood characteristics: Evidence from the multi-ethnic study of atherosclerosis. Health Place 2015; 34:199-206. [PMID: 26073509 DOI: 10.1016/j.healthplace.2015.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/26/2015] [Accepted: 05/28/2015] [Indexed: 11/26/2022]
Abstract
We examined cross-sectional and longitudinal associations between neighborhood socioeconomic status, social cohesion and safety and features of the diurnal cortisol curve including: area under the curve (AUC), wake-to-bed slope, wake-up, cortisol awakening response (CAR, wake-up to 30 min post-awakening), early decline (30 min to 2 h post-awakening) and late decline (2 h post-awakening to bed time). In cross-sectional analyses, higher neighborhood poverty was associated with a flatter early decline and a flatter wake-to-bed slope. Higher social cohesion and safety were associated with higher wake-up cortisol, steeper early decline and steeper wake-to-bed slope. Over 5 years, wake-up cortisol increased, CAR, early decline, late decline and wake-to-bed slope became flatter and AUC became larger. Higher poverty was associated with less pronounced increases in wake-up and AUC, while higher social cohesion was associated with greater increases in wake-up and AUC. Adverse neighborhood environments were cross-sectionally associated with flatter cortisol profiles, but associations with changes in cortisol were weak and not in the expected direction.
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Affiliation(s)
- Anjum Hajat
- University of Washington, School of Public Health, Department of Epidemiology, 4225 Roosevelt Way NE, Suite 303, Seattle, WA 98105, USA.
| | - Kari Moore
- Drexel University, School of Public Health, Department of Epidemiology and Biostatistics, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA.
| | - D Phuong Do
- University of Wisconsin Milwaukee, Zilber School of Public Health, Department of Epidemiology and Public Health Policy and Administration, 1240 N, 10th Street, Milwaukee, WA 53201, USA.
| | - Sharon Stein Merkin
- University of California Los Angeles, David Geffen School of Medicine, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Naresh M Punjabi
- Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, 5501 Hopkins Bayview Circle, Room 4B.36, Baltimore, MD 21224, USA
| | - Brisa Ney Sáñchez
- University of Michigan, School of Public Health, Department of Biostatistics, 1415 Washington Heights, M4124 SPH II, Ann Arbor, MI 48109, USA.
| | - Teresa Seeman
- University of California Los Angeles, David Geffen School of Medicine, Department of Medicine, Division of Geriatrics, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095, USA.
| | - Ana V Diez-Roux
- Drexel University, School of Public Health, Department of Epidemiology and Biostatistics, Nesbitt Hall, 3215 Market Street, Philadelphia, PA 19104, USA.
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He Z, Payne EK, Mukherjee B, Lee S, Smith JA, Ware EB, Sánchez BN, Seeman TE, Kardia SLR, Diez Roux AV. Association between Stress Response Genes and Features of Diurnal Cortisol Curves in the Multi-Ethnic Study of Atherosclerosis: A New Multi-Phenotype Approach for Gene-Based Association Tests. PLoS One 2015; 10:e0126637. [PMID: 25993632 PMCID: PMC4439141 DOI: 10.1371/journal.pone.0126637] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 04/05/2015] [Indexed: 11/18/2022] Open
Abstract
The hormone cortisol is likely to be a key mediator of the stress response that influences multiple physiologic systems that are involved in common chronic disease, including the cardiovascular system, the immune system, and metabolism. In this paper, a candidate gene approach was used to investigate genetic contributions to variability in multiple correlated features of the daily cortisol profile in a sample of European Americans, African Americans, and Hispanic Americans from the Multi-Ethnic Study of Atherosclerosis (MESA). We proposed and applied a new gene-level multiple-phenotype analysis and carried out a meta-analysis to combine the ethnicity specific results. This new analysis, instead of a more routine single marker-single phenotype approach identified a significant association between one gene (ADRB2) and cortisol features (meta-analysis p-value=0.0025), which was not identified by three other commonly used existing analytic strategies: 1. Single marker association tests involving each single cortisol feature separately; 2. Single marker association tests jointly testing for multiple cortisol features; 3. Gene-level association tests separately carried out for each single cortisol feature. The analytic strategies presented consider different hypotheses regarding genotype-phenotype association and imply different costs of multiple testing. The proposed gene-level analysis integrating multiple cortisol features across multiple ethnic groups provides new insights into the gene-cortisol association.
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Affiliation(s)
- Zihuai He
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Erin K. Payne
- Life Sciences Program, Northrop Grumman Health Division, McLean, Virginia, United States of America
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
- * E-mail:
| | - Seunggeun Lee
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Jennifer A. Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Erin B. Ware
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Brisa N. Sánchez
- Department of Biostatistics, University of Michigan, Ann Arbor, United States of America
| | - Teresa E. Seeman
- Department of Medicine, Division of Geriatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, United States of America
| | - Sharon L. R. Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, United States of America
| | - Ana V. Diez Roux
- Department of Epidemiology, Drexel University, Philadelphia, United States of America
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Exposure to neighborhood immigrant concentration from adolescence to young adulthood and immune function among Latino young adults. Health Place 2015; 32:59-64. [PMID: 25618565 DOI: 10.1016/j.healthplace.2014.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 12/17/2014] [Accepted: 12/19/2014] [Indexed: 12/11/2022]
Abstract
The immune system plays a critical role in the prevention of infectious and chronic disease. We investigate associations between exposure to neighborhood immigrant concentration across the transition from adolescence to adulthood and immune function among Latino young adults, including moderation by nativity. Data from the National Longitudinal Study of Adolescent Health (1994-2008) were analyzed. Immune function was measured via Epstein-Barr virus (EBV) antibody levels (higher levels indicate impaired immune function) among EBV-positive Latino adults (N=1130). Results indicated the averaged individual exposure to immigrant concentration (mean % of foreign-born residents in the census tract across waves 1-4) was associated with immune function for foreign-born Latinos only (b=-0.37, P<0.05). For waves of exposure, only the cumulative measure of living in an immigrant enclave (census tracts with ≥40% foreign-born residents) across all waves was associated with immune function and only for foreign-born Latinos (b=-0.22, P<0.05). Research on the mechanisms through which neighborhood immigrant concentration confers salubrious physiological outcomes for foreign-born Latinos is needed.
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Plascak JJ, Llanos AA, Pennell ML, Weier RC, Paskett ED. Neighborhood factors associated with time to resolution following an abnormal breast or cervical cancer screening test. Cancer Epidemiol Biomarkers Prev 2014; 23:2819-28. [PMID: 25205516 PMCID: PMC4257881 DOI: 10.1158/1055-9965.epi-14-0348] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The effect of neighborhood and healthcare access factors on cancer outcomes among patients enrolled in navigator programs is not clearly understood. This study assessed associations between: (i) neighborhood factors and diagnostic time to resolution (TTR) and (ii) geographic access and TTR following an abnormal breast or cervical cancer screening test among women participating in the Ohio Patient Navigator Research Program (OPNRP). METHODS Patient (demographic, socioeconomic status, home-to-clinic distance) and neighborhood (deprivation, racial segregation) characteristics of 801 women living in one of 285 census tracts (CT) in greater Columbus, Ohio were examined. Randomization to receive navigation occurred at the clinic level. Multilevel Cox regression and spatial analysis were used to estimate effects of various factors on TTR and assess model assumptions, respectively. RESULTS TTR increased as neighborhood deprivation increased. After adjustment for age, friend social support, education, and healthcare status, the TTR among women living in a neighborhood with a moderate median household income (between $36,147 and $53,099) was shorter compared with women living in low median household income neighborhoods (<$36,147; P < 0.05). There is little evidence that unmeasured confounders are geographically patterned. CONCLUSIONS Increased neighborhood socioeconomic deprivation was associated with longer TTR following an abnormal breast or cervical cancer screening test. IMPACT These results highlight the need for addressing patient- and neighborhood-level factors to reduce cancer disparities among underserved populations.
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Affiliation(s)
- Jesse J. Plascak
- Department of Health Services, School of Public Health, The University of Washington, Seattle, Washington USA
| | - Adana A. Llanos
- RBHS-School of Public Health and the Cancer Institute of New Jersey, Rutgers, the State University of New Jersey, New Brunswick, NJ, USA
| | - Michael L. Pennell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio USA
| | - Rory C. Weier
- Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, Ohio USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio USA
| | - Electra D. Paskett
- Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, Ohio USA
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio USA
- Division of Cancer Control and Prevention, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio USA
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HOSSEINI F, ADHA N, ZAINOL R, ISAHAK M, NEMATI N. Neighborhood-Level Stress and Circadian Cortisol: A Systematic Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2014; 43:1324-34. [PMID: 26060694 PMCID: PMC4441885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 07/11/2014] [Indexed: 11/23/2022]
Abstract
The main objective was to find association between basal cortisol and neighborhood-level stress. Systematic searches, including electronic and hand searches, were conducted. The most recent date of the search was July 26, 2013. Primary observational studies included if they considered stress related outcomes in the neighborhood context. Using the EndNote X7 advanced search option; the authors examined the abstracts and titles of the 18,092 articles to exclude obviously irrelevant studies, gray literature, discussion papers, reviews and, studies with no complete data. Two authors independently extracted data from the original reports into pre-designed data extraction forms based on the Data Extraction Template of the Cochrane Consumer and Communication Review Group (CCCRG). Ten studies with a total of 2,134 participants were synthesized and analyzed. Two studies out of ten received expanded meta-analysis. The overall effect size (95% CI) for cortisol level for residents in neighborhoods with lower stress compared to inhabitants from higher was 0.12 (0.01, 0.23). This review is demonstrating a link between psychosocial or physical stress and cortisol obtained from saliva. However, living in high disorder neighborhoods results in higher level of cortisol. This represents a biological indicator of psychosocial/physical stress exposure (i.e., neighborhood disorder) that reflects variances in stress exposure levels.
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Affiliation(s)
- Fatemeh HOSSEINI
- 1. Dept. of Urban and Regional Planning, Faculty of Built Environment, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nikmatul ADHA
- 1. Dept. of Urban and Regional Planning, Faculty of Built Environment, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Rosilawati ZAINOL
- 1. Dept. of Urban and Regional Planning, Faculty of Built Environment, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Marzuki ISAHAK
- 1. Dept. of Urban and Regional Planning, Faculty of Built Environment, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - Nahid NEMATI
- 2. Dept. of Geography, Islamic Azad University of Science and Research, Tehran, Iran
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Neighborhood-level socioeconomic deprivation predicts weight gain in a multi-ethnic population: longitudinal data from the Dallas Heart Study. Prev Med 2014; 66:22-7. [PMID: 24875231 PMCID: PMC4127483 DOI: 10.1016/j.ypmed.2014.05.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 05/13/2014] [Accepted: 05/18/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study is to examine a relationship between neighborhood-level socioeconomic deprivation and weight change in a multi-ethnic cohort from Dallas County, Texas and whether behavioral/psychosocial factors attenuate the relationship. METHODS Non-movers (those in the same neighborhood throughout the study period) aged 18-65 (N=939) in Dallas Heart Study (DHS) underwent weight measurements between 2000 and 2009 (median 7-year follow-up). Geocoded home addresses defined block groups; a neighborhood deprivation index (NDI) was created (higher NDI=greater deprivation). Multi-level modeling determined weight change relative to NDI. Model fit improvement was examined with adding physical activity and neighborhood environment perceptions (higher score=more unfavorable perceptions) as covariates. A significant interaction between residence length and NDI was found (p-interaction=0.04); results were stratified by median residence length (11 years). RESULTS Adjusting for age, sex, race/ethnicity, smoking, and education/income, those who lived in neighborhood >11 years gained 1.0 kg per one-unit increment of NDI (p=0.03), or 6 kg for those in highest NDI tertile compared with those in the lowest tertile. Physical activity improved model fit; NDI remained associated with weight gain after adjustment for physical activity and neighborhood environment perceptions. There was no significant relationship between NDI and weight change for those in their neighborhood ≤11 years. CONCLUSIONS Living in more socioeconomically deprived neighborhoods over a longer time period was associated with weight gain in DHS.
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47
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Pham DQ, Ommerborn MJ, Hickson DA, Taylor HA, Clark CR. Neighborhood safety and adipose tissue distribution in African Americans: the Jackson Heart Study. PLoS One 2014; 9:e105251. [PMID: 25166297 PMCID: PMC4148311 DOI: 10.1371/journal.pone.0105251] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 07/22/2014] [Indexed: 12/26/2022] Open
Abstract
Objective Patterns of fat distribution are heavily influenced by psychological stress, sex, and among women, by menopause status. Emerging evidence suggests the lack of perceived neighborhood safety due to crime may contribute to psychological stress and obesity among exposed residents. Our objective is to determine if perceived neighborhood safety is associated with abdominal adiposity among African-American men and women, and among pre- and postmenopausal women in the Jackson Heart Study. Design and Methods We examined associations between perceived neighborhood safety, fat distribution, and other individual-level covariates among Jackson Heart Study participants (N = 2,881). Abdominal adiposity was measured via computed tomography scans measuring the volumes of visceral, subcutaneous and total adipose tissue. We also measured body mass index (BMI), and waist circumference. Multivariable regression models estimated associations between perceived neighborhood safety, adiposity, and covariates by sex and menopause status. Results Adjusting for all covariates, women who strongly disagreed their neighborhood was safe from crime had a higher BMI compared to women who felt safe [Std B 0.083 95% CI (0.010, 0.156)]. Premenopausal women who felt most unsafe had higher BMI, waist circumference, and volumes of visceral and total adipose tissue than those who felt safe [Std B 0.160 (0.021, 0.299), Std B 0.142 (0.003, 0.280), Std B 0.150 (0.014, 0.285), Std B 0.154 (0.019, 0.290), respectively]. We did not identify associations between neighborhood safety and adiposity among men and postmenopausal women. Conclusions Our data suggest that abdominal adipose tissue distribution patterns are associated with perceived neighborhood safety in some groups, and that patterns may differ by sex and menopause status, with most associations observed among pre-menopausal women. Further research is needed to elucidate whether there are causal mechanisms underlying sex and menopause-status differences that may mediate associations between perceived safety and abdominal adiposity and potential protective factors that may modify this risk.
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Affiliation(s)
- Do Quyen Pham
- Center for Community Health and Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Mark J. Ommerborn
- Center for Community Health and Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - DeMarc A. Hickson
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Herman A. Taylor
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Cheryl R. Clark
- Center for Community Health and Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- * E-mail:
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48
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Ulirsch JC, Weaver MA, Bortsov AV, Soward AC, Swor RA, Peak DA, Jones JS, Rathlev NK, Lee DC, Domeier RM, Hendry PL, McLean SA. No man is an island: living in a disadvantaged neighborhood influences chronic pain development after motor vehicle collision. Pain 2014; 155:2116-23. [PMID: 25107859 DOI: 10.1016/j.pain.2014.07.025] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 07/16/2014] [Accepted: 07/29/2014] [Indexed: 11/28/2022]
Abstract
Living in a lower socioeconomic status neighborhood has been shown to alter stress system function and is associated with a number of adverse health outcomes, but its influence on musculoskeletal pain (MSP) outcomes after traumatic stress exposures such as motor vehicle collision (MVC) has not been assessed. We performed a multicenter, prospective study that enrolled 948 European-American individuals within 24 hours of MVC who were discharged home after emergency department evaluation. Follow-up evaluations were completed via telephone or Internet survey 6 weeks, 6 months, and 1 year after MVC on 91%, 89%, and 91% of participants, respectively. A robust aggregate measure of census tract neighborhood disadvantage was derived, and individual-level characteristics assessed included socioeconomic and demographic characteristics, pain prior to MVC, litigation status, and opioid use. MSP was assessed in the emergency department; MSP and pain interference with daily activity were assessed at 6 weeks, 6 months, and 1 year. After adjustment for individual-level factors, living in more disadvantaged neighborhoods was associated with increased MSP (P=0.0009) and increased pain interference with daily function (P<0.0001). The relationship between neighborhood disadvantage and MSP was moderated by a common single nucleotide polymorphism, rs2817038, 5' of the gene encoding FKBP5, a functional regulator of glucocorticoid receptor sensitivity (interaction P-value=0.0015). These data support the hypothesis that low neighborhood socioeconomic status increases the likelihood of worse MSP outcomes after traumatic stress exposures such as MVC, and that this influence is mediated in part via its influence on stress system function.
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Affiliation(s)
- Jacob C Ulirsch
- TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Mark A Weaver
- Departments of Medicine and Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Andrey V Bortsov
- TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - April C Soward
- TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Robert A Swor
- Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jeffrey S Jones
- Department of Emergency Medicine, Spectrum Health System, Grand Rapids, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, Baystate Medical Center, Springfield, MA, USA
| | - David C Lee
- Department of Emergency Medicine, North Shore University Hospital, Manhasset, NY, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Health System, Ypsilanti, MI, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida, Jacksonville, FL, USA
| | - Samuel A McLean
- TRYUMPH Research Program, University of North Carolina, Chapel Hill, NC, USA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA; Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC, USA.
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49
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Holt RIG, de Groot M, Lucki I, Hunter CM, Sartorius N, Golden SH. NIDDK international conference report on diabetes and depression: current understanding and future directions. Diabetes Care 2014; 37:2067-77. [PMID: 25061135 PMCID: PMC4113168 DOI: 10.2337/dc13-2134] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Comorbid diabetes and depression are a major clinical challenge as the outcomes of each condition are worsened by the other. This article is based on the presentations and discussions during an international meeting on diabetes and depression convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) in collaboration with the National Institute of Mental Health and the Dialogue on Diabetes and Depression. While the psychological burden of diabetes may contribute to depression in some cases, this explanation does not sufficiently explain the relationship between these two conditions. Shared biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, autonomic dysfunction, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors, are important to consider in understanding the link between depression and diabetes. Both individual psychological and pharmacological depression treatments are effective in people with diabetes, but the current range of treatment options is limited and has shown mixed effects on glycemic outcomes. More research is needed to understand what factors contribute to individual differences in vulnerability, treatment response, and resilience to depression and metabolic disorders across the life course and how best to provide care for people with comorbid diabetes and depression in different health care settings. Training programs are needed to create a cross-disciplinary workforce that can work in different models of care for comorbid conditions.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, U.K.
| | - Mary de Groot
- Diabetes Translational Research Center, Indiana University School of Medicine, Indianapolis, IN
| | - Irwin Lucki
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Christine M Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Norman Sartorius
- Association for the Improvement of Mental Health Programmes and the Dialogue on Diabetes and Depression, Geneva, Switzerland
| | - Sherita H Golden
- Departments of Medicine and Epidemiology, Johns Hopkins University Schools of Medicine and Public Health, Baltimore, MD
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50
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Abstract
Diabetes and depression occur together approximately twice as frequently as would be predicted by chance alone. Comorbid diabetes and depression are a major clinical challenge as the outcomes of both conditions are worsened by the other. Although the psychological burden of diabetes may contribute to depression, this explanation does not fully explain the relationship between these 2 conditions. Both conditions may be driven by shared underlying biological and behavioral mechanisms, such as hypothalamic-pituitary-adrenal axis activation, inflammation, sleep disturbance, inactive lifestyle, poor dietary habits, and environmental and cultural risk factors. Depression is frequently missed in people with diabetes despite effective screening tools being available. Both psychological interventions and antidepressants are effective in treating depressive symptoms in people with diabetes but have mixed effects on glycemic control. Clear care pathways involving a multidisciplinary team are needed to obtain optimal medical and psychiatric outcomes for people with comorbid diabetes and depression.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS Building), MP887, Southampton General Hospital, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK,
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