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Jaspan VN, Greenberg GS, Parihar S, Park CM, Somers VK, Shapiro MD, Lavie CJ, Virani SS, Slipczuk L. The Role of Sleep in Cardiovascular Disease. Curr Atheroscler Rep 2024; 26:249-262. [PMID: 38795275 PMCID: PMC11192677 DOI: 10.1007/s11883-024-01207-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/27/2024]
Abstract
PURPOSE OF REVIEW Sleep is an important component of cardiovascular (CV) health. This review summarizes the complex relationship between sleep and CV disease (CVD). Additionally, we describe the data supporting the treatment of sleep disturbances in preventing and treating CVD. RECENT FINDINGS Recent guidelines recommend screening for obstructive sleep apnea in patients with atrial fibrillation. New data continues to demonstrate the importance of sleep quality and duration for CV health. There is a complex bidirectional relationship between sleep health and CVD. Sleep disturbances have systemic effects that contribute to the development of CVD, including hypertension, coronary artery disease, heart failure, and arrhythmias. Additionally, CVD contributes to the development of sleep disturbances. However, more data are needed to support the role of screening for and treatment of sleep disorders for the prevention of CVD.
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Affiliation(s)
- Vita N Jaspan
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Garred S Greenberg
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Siddhant Parihar
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Christine M Park
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael D Shapiro
- Center for Preventive Cardiology, Section On Cardiovascular Medicine, Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA
| | - Carl J Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Salim S Virani
- Office of the Vice Provost (Research), The Aga Khan University, Karachi, Pakistan
- Division of Cardiology, The Texas Heart Institute/Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - Leandro Slipczuk
- Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, USA.
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Lewis TT, Parker R, Erving CL, Udaipuria S, Murden RJ, Fields ND, Booker B, Moore RH, Vaccarino V. Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women. Soc Sci Med 2024; 345:116699. [PMID: 38412624 PMCID: PMC11014723 DOI: 10.1016/j.socscimed.2024.116699] [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: 07/19/2023] [Revised: 01/06/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND African-American women have excess rates of elevated blood pressure (BP) and hypertension compared to women of all other racial/ethnic backgrounds. Several researchers have speculated that race and gender-related socioeconomic status (SES) stressors might play a role. OBJECTIVE To examine the association between a novel SES-related stressor highly salient among African-American women, financial responsibility for one's household, and 48-h ambulatory BP. We further examined whether aspects related to African-American women's financial context (e.g., single parenthood, household income, marital status) played a role. METHODS Participants were N = 345 employed, healthy African-American women aged 30-46 from diverse SES backgrounds who underwent 48-h ambulatory BP monitoring. Linear regression analyses were conducted to examine associations between self-reported financial responsibility and daytime and nighttime BP, adjusting for age, SES and other sociodemographics, cardiovascular risk factors, financial strain and depressive symptoms. Interactions between financial responsibility and single parenthood, household income, and marital/partnered status were tested. RESULTS In age-adjusted analyses, reporting financial responsibility was associated with higher daytime systolic (β = 4.42, S.E. = 1.36, p = 0.0013), and diastolic (β = 2.82, S.E. = 0.98, p = 0.004) BP. Associations persisted in fully adjusted models. Significant associations were also observed for nighttime systolic and diastolic BP. There were no significant interactions with single parenthood, household income, nor marital/partnered status. CONCLUSION Having primary responsibility for one's household may be an important driver of BP in early middle-aged African-American women, independent of SES, financial strain, and across a range of financial contexts. Future studies examining prospective associations are needed, and policy interventions targeting structural factors contributing to financial responsibility in African-American women may be warranted.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christy L Erving
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Reneé H Moore
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
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Johnson DA, Wallace DA, Ward L. Racial/ethnic and sex differences in the association between light at night and actigraphy-measured sleep duration in adults: NHANES 2011-2014. Sleep Health 2024; 10:S184-S190. [PMID: 37951773 PMCID: PMC11031299 DOI: 10.1016/j.sleh.2023.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE Historically minoritized individuals experience greater exposure to light at night, yet it is unclear whether the association between light at night and sleep duration vary by race/ethnicity or sex. We examined the association between light at night and sleep duration by race/ethnicity and sex. METHODS Participants (N = 6089, mean age=49.5, 52% women, 13% Asian, 27% Black, 14% Mexican, 46% White) in the 2011-2014 National Health and Nutrition Examination Survey underwent 9-day of actigraphy. Light at night was defined as light exposure within the 5-hour activity nadir (L5). Sleep duration within a 24-hour period was analyzed as short (<7 hours) or long (>9 hours) compared to recommended (≥7 and <9 hours). Poisson models were fit to estimate the association between light at night and sleep duration after adjustment for covariates. RESULTS Light at night was most common among Black participants, who also had the shortest sleep duration. Overall, light at night was associated with 80% higher prevalence of short sleep duration [1.80 (1.49, 2.18)]. Compared to no-light at night, low and high light at night were associated with higher prevalence of short sleep duration, [1.61 (1.31, 1.98) and 2.01 (1.66, 2.44), respectively]. Associations varied by race/ethnicity and sex. Light at night was associated with shorter sleep duration in Black, Mexican and White females and Mexican and White males only. Black males exposed to light at night vs. no-light at night had lower prevalence of long sleep duration. There were no associations between light at night and sleep duration among Asian participants. CONCLUSION Light at night was associated with shorter sleep duration, particularly among females. Targeting light exposure may help to improve sleep duration.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
| | - Danielle A Wallace
- Department of Medicine, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Laura Ward
- Department of Biostatistics and Informatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Lucey BP. Paradoxical effects of daytime sleepiness and memory in African Americans at risk for Alzheimer's disease. Sleep 2024; 47:zsad301. [PMID: 38011628 PMCID: PMC10782496 DOI: 10.1093/sleep/zsad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Indexed: 11/29/2023] Open
Affiliation(s)
- Brendan P Lucey
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
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Pantesco EJ, Kan IP. Racial and ethnic disparities in self-reported sleep duration: Roles of subjective socioeconomic status and sleep norms. Sleep Med 2023; 112:246-255. [PMID: 37925851 DOI: 10.1016/j.sleep.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES There are racial and ethnic disparities in sleep duration, with members of historically marginalized groups typically reporting shorter sleep than White Americans. This study examines subjective social status (SSS) as a moderator, and variation in ideal sleep norms as a mediator, of differences in sleep duration between racial/ethnic groups. METHODS Asian, Black, Hispanic, and non-Hispanic White respondents in an online survey reported their typical weeknight and weekend-night sleep duration, along with estimates of ideal sleep duration norms. Objective and subjective indicators of socioeconomic status were also assessed. A conditional process analysis was used to examine whether racial or ethnic differences in sleep duration were a) moderated by SSS and b) mediated by ideal sleep duration norms. RESULTS Racial/ethnic disparities in sleep duration varied by group. Hispanic participants reported shorter weeknight sleep than White participants. In Asian and Black participants, shorter weeknight sleep relative to White participants was only observed at medium (Black) or high (Black and Asian) levels of SSS. Shorter norms for ideal sleep duration partially mediated differences in sleep duration between Black and White adults, but not the other racial/ethnic groups. There was no evidence of moderated mediation. Neither income nor education moderated racial/ethnic disparities in sleep duration. CONCLUSIONS Racial and ethnic disparities in sleep duration may partially depend on SSS. Continued research into moderators and mediators of racial/ethnic differences in sleep duration is warranted.
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Affiliation(s)
- Elizabeth J Pantesco
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA, United States.
| | - Irene P Kan
- Department of Psychological and Brain Sciences, Villanova University, Villanova, PA, United States.
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Sosso FAE, Matos E, Papadopoulos D. Social disparities in sleep health of African populations: A systematic review and meta-analysis of observational studies. Sleep Health 2023; 9:828-845. [PMID: 37880077 DOI: 10.1016/j.sleh.2023.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES To document the relationship between socioeconomic status (SES) and sleep health in African populations. METHODS Observational cross-sectional or cohort studies examining the association between SES indicators and sleep outcomes in participants from African countries were included. The search was performed in the MEDLINE, Embase, and Web of Science Core Collection electronic databases in June 2021. Selection, confounding, attrition/exclusion, detection, and selective reporting bias were assessed using the OHAT Risk of Bias Tool. Random effects meta-analysis was used for summarizing the effect estimates. RESULTS Forty-three reports were selected, having sampled 153,372 Africans from 26 countries. Education was the most frequent SES indicator and composite measures of sleep quality or disturbances was the most common sleep outcome. Low educational attainment was significantly associated with lower odds of short sleep (odds ratio [OR]=0.65, 95% confidence intervals [0.50, 0.84], p = .001) and higher odds of insomnia (OR=1.53, [1.18, 1.99], p = .001) or poor sleep quality (OR=1.60, [1.17, 2.18], p = .003). Low levels of income/assets were related to higher odds of insomnia (OR=1.38, [1.02, 1.86], p = .04) and low occupational/employment status was linked to lower odds of short sleep duration (OR=0.49, [0.30, 0.79], p = .004). CONCLUSIONS Socioeconomic disadvantage was a significant predictor of insomnia and poor sleep quality, while it was associated with longer sleep duration. Significant heterogeneity in terms of exposure and outcomes, scarcity of longitudinal designs, lack of objective outcome measurement, and low representation of rural samples and participants from low-income countries limit the quality of evidence.
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Affiliation(s)
| | - Elsa Matos
- Sleep Laboratory of Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Lei T, Li M, Qian H, Yang J, Hu Y, Hua L. The Effect of Sleep on Metabolism, Musculoskeletal Disease, and Mortality in the General US Population: Analysis of Results From the National Health and Nutrition Examination Survey. JMIR Public Health Surveill 2023; 9:e46385. [PMID: 37934562 PMCID: PMC10664015 DOI: 10.2196/46385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/22/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Sleep is an important physiological behavior in humans that is associated with the occurrence and development of various diseases. However, the association of sleep duration with health-related outcomes, including obesity-related factors, musculoskeletal diseases, and mortality because of different causes, has not been systematically reported. OBJECTIVE This study aims to systematically investigate the effect of sleep duration on health-related outcomes. METHODS Overall, 54,664 participants with sleep information from 8 survey cycles of the National Health and Nutrition Examination Survey (2005-2020) were included in the analysis. Health-related outcomes comprised obesity-related outcomes (ie, BMI, obesity, waist circumference, and abdominal obesity), metabolism-related outcomes (ie, uric acid, hyperuricemia, and bone mineral density [BMD]), musculoskeletal diseases (ie, osteoarthritis [OA] and rheumatoid arthritis [RA]), and mortality because of different causes. The baseline information of participants including age, sex, race, educational level, marital status, total energy intake, physical activity, alcohol consumption, smoking, hypertension, and diabetes was also collected as covariates. Information about the metabolism index, disease status, and covariates was acquired from the laboratory, examination, and questionnaire data. Survival information, including survival status, duration, and cause of death, was obtained from the National Death Index records. Quantile regression models and Cox regression models were used for association analysis between sleep duration and health-related outcomes. In addition, the threshold effect analysis, along with smooth curve fitting method, was applied for the nonlinear association analysis. RESULTS Participants were divided into 4 groups with different sleep durations. The 4 groups showed significant differences in terms of baseline data (P<.001). The quantile regression analysis indicated that participants with increased sleep duration showed decreased BMI (β=-.176, 95% CI -.220 to -.133; P<.001), obesity (odds ratio [OR] 0.964, 95% CI 0.950-0.977; P<.001), waist circumference (β=-.219, 95% CI -.320 to -.117; P<.001), abdominal obesity (OR 0.975, 95% CI 0.960-0.990; P<.001), OA (OR 0.965, 95% CI 0.942-0.990; P=.005), and RA (OR 0.940, 95% CI 0.912-0.968; P<.001). Participants with increased sleep duration also showed increased BMD (β=.002, 95% CI .001-.003; P=.005), as compared with participants who slept <5.5 hours. A significant saturation effect of sleep duration on obesity, abdominal obesity, and hyperuricemia was detected through smooth curve fitting and threshold effect analysis (sleep duration>inflection point). In addition, a significant threshold effect of sleep duration on BMD (P<.001); OA (P<.001); RA (P<.001); and all-cause (P<.001), cardiovascular disease-cause (P<.001), cancer-cause (P=.005), and diabetes-cause mortality (P<.001) was found. The inflection point was between 6.5 hours and 9 hours. CONCLUSIONS The double-edged sword effect of sleep duration on obesity-related outcomes, embolism-related diseases, musculoskeletal diseases, and mortality because of different causes was detected in this study. These findings provided epidemiological evidence that proper sleep duration may be an important factor in the prevention of multisystem diseases.
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Affiliation(s)
- Ting Lei
- Department of Orthopedic Surgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, Changsha, China
| | - Mingqing Li
- Department of Orthopedic Surgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, Changsha, China
| | - Hu Qian
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Junxiao Yang
- Department of Orthopedic Surgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, Changsha, China
| | - Yihe Hu
- Department of Orthopedic Surgery, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, Changsha, China
- Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University, Hangzhou, China
- College of Medicine, Zhejiang University, Hangzhou, China
| | - Long Hua
- Department of Orthopedic Surgery, The First Affiliated Hospital, Xinjiang Medical University, Urumqi, China
- Key Laboratory of High Incidence Disease Research in Xinjiang, Ministry of Education, Xinjiang Medical University, Urumqi, China
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Hittle BM, Wardlaw C, Lambert J, Bankston K. A Cross-Sectional Study of the Social Work Environment and Black Registered Nurses' Sleep. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01717-z. [PMID: 37450253 DOI: 10.1007/s40615-023-01717-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Workplace experiences may place Black nurses at higher risk for poor sleep and adverse health outcomes. This study aimed to identify poor sleep prevalence and associations of workplace discrimination and workplace social capital with sleep. METHODOLOGY Descriptive statistics and multiple linear regression with exploratory analyses were conducted of cross sectional survey data from US Black nurses. RESULTS On average, 63 respondents reported sleeping 6.15 h, 45 min less daily than 6.9 h reported nationally for nurses. Ninety-percent of respondents reported poor sleep quality. While no direct significance was found, respondents reporting sleep quality changes had lower workplace social capital and higher workplace discrimination. CONCLUSION Black nurses may have higher prevalence of poor sleep than the larger nursing workforce. A potential relationship between decreased sleep quality and negative perceptions of the work environment may exist. Organizations should examine sleep and potential occupational health inequities among Black nurses when considering worker health.
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Affiliation(s)
- Beverly M Hittle
- University of Cincinnati, College of Nursing, 3110 Vine Street, Cincinnati, OH, 45221, USA.
| | - Cassie Wardlaw
- University of Cincinnati, College of Nursing, 3110 Vine Street, Cincinnati, OH, 45221, USA
- Cincinnati Children's Hospital Medical Center, Division of Psychiatry, 3333 Burnett Avenue, Cincinnati, OH, 45229, USA
| | - Joshua Lambert
- University of Cincinnati, College of Nursing, 3110 Vine Street, Cincinnati, OH, 45221, USA
| | - Karen Bankston
- University of Cincinnati, College of Nursing, 3110 Vine Street, Cincinnati, OH, 45221, USA
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Simonsen SE, Sunada GR, Digre K, Stark LA, Mukundente V, Napia E, Tavake-Pasi F, Villalta J, Lee D, Davis F, Sanchez-Birkhead A, Brown BH, Baron KG. Short sleep duration and interest in sleep improvement in a multi-ethnic cohort of diverse women participating in a community-based wellness intervention: an unmet need for improvement. BMC Womens Health 2023; 23:188. [PMID: 37081433 PMCID: PMC10120218 DOI: 10.1186/s12905-023-02341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Disparities in sleep duration are a modifiable contributor to increased risk for cardiometabolic disorders in communities of color. We examined the prevalence of short sleep duration and interest in improving sleep among a multi-ethnic sample of women participating in a culturally tailored wellness coaching program and discussed steps to engage communities in sleep health interventions. METHODS Secondary analysis of data from a randomized trial were used. The wellness coaching trial utilized a Community-Based Participatory Research (CBPR) approach. Data were from the baseline survey and baseline wellness coaching notes. Short sleep duration was defined as < 7 h of self-reported sleep. Participants were prompted to set a goal related to healthy eating/physical activity and had the opportunity to set another goal on any topic of interest. Those who set a goal related to improving sleep or who discussed a desire to improve sleep during coaching were classified as having an interest in sleep improvement. Analyses utilized multivariable models to evaluate factors contributing to short sleep and interest in sleep improvement. We present our process of discussing results with community leaders and health workers. RESULTS A total of 485 women of color participated in the study. Among these, 199 (41%) reported short sleep duration. In adjusted models, Blacks/African Americans and Native Hawaiians/Pacific Islanders had higher odds of reporting < 7 h of sleep than Hispanics/Latinas. Depression symptoms and self-reported stress management scores were significantly associated with short sleep duration. Interest in sleep improvement was noted in the wellness coaching notes of 52 women (10.7%); sleep was the most common focus of goals not related to healthy eating/physical activity. African Immigrants/Refugees and African Americans were less likely to report interest in sleep improvement. Community leaders and health workers reported lack of awareness of the role of sleep in health and discussed challenges to obtaining adequate sleep in their communities. CONCLUSION Despite the high prevalence of short sleep duration, interest in sleep improvement was generally low. This study highlights a discrepancy between need and interest, and our process of community engagement, which can inform intervention development for addressing sleep duration among diverse women.
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Affiliation(s)
- Sara E Simonsen
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA.
| | - Grant R Sunada
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
| | - Kathleen Digre
- Departments of Neurology, Ophthalmology, and Obstetrics and Gynecology, University of Utah, 175 N Medical Dr E Rm 5001, Salt Lake City, UT, 84132, USA
| | - Louisa A Stark
- University of Utah Genetic Science Learning Ctr, 515 E 100 S Rm 300, Salt Lake City, Utah, 84112, USA
| | | | - Ed Napia
- Urban Indian Center of Salt Lake, 120 West 1300 South, Salt Lake City, Utah, 84115, USA
| | - Fahina Tavake-Pasi
- National Tongan American Society, 3007 South West Temple #H, Salt Lake City, Utah, 84115, USA
| | - Jeannette Villalta
- Hispanic Health Care Task Force, 5280 Commerce Dr. Suite E140, Murray, Utah, 84107, USA
| | - Doriena Lee
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - France Davis
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - Ana Sanchez-Birkhead
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA
| | - B Heather Brown
- University of Utah Center for Clinical and Translational Science, 515 East 100 South, Salt Lake City, Utah, 84102, USA
| | - Kelly G Baron
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
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Nyarko SH, Luo L, Schlundt DG, Xiao Q. Individual and neighborhood socioeconomic status and long-term individual trajectories of sleep duration among Black and White adults: the Southern Community Cohort Study. Sleep 2023; 46:zsac225. [PMID: 36124765 PMCID: PMC9832512 DOI: 10.1093/sleep/zsac225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/24/2022] [Indexed: 01/14/2023] Open
Abstract
STUDY OBJECTIVES Sleep duration can change over the life course; however, previous studies rarely investigated the association between socioeconomic status (SES) and individual sleep trajectories over time. We examined the association between baseline socioeconomic characteristics and long-term sleep trajectories among Black and White adults. METHODS This study used data from the Southern Community Cohort Study (N = 45 035). Diverse trajectories of sleep duration were constructed using self-reported sleep duration at baseline and after ~10 years of follow-up. The associations between baseline socioeconomic characteristics and sleep trajectories were examined using multinomial logistic regression. RESULTS Both Black and White participants experienced similar long-term individual sleep trajectories for baseline educational attainment and employment status albeit the associations appeared stronger among White participants. Lower education and unemployment were associated with higher odds of various suboptimal sleep trajectories suggesting worsening long-term sleep patterns among both racial groups. However, there were some racial differences in the experience of long-term sleep trajectories for household income and neighborhood SES. Household income was notably more important among White than Black individuals; lower household income was associated with higher odds of more suboptimal long-term sleep trajectories for White than Black individuals. Also, neighborhood SES was slightly more important among White than Black individuals; lower neighborhood SES was associated with higher odds of a few suboptimal long-term sleep trajectories for both racial groups. CONCLUSIONS Lower socioeconomic characteristics were associated with various suboptimal long-term sleep trajectories among Black and White participants. Substantial improvements in socio-economic characteristics may contribute to improved sleep patterns.
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Affiliation(s)
- Samuel H Nyarko
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Liying Luo
- Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA
| | - David G Schlundt
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
| | - Qian Xiao
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
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Saelee R, Haardörfer R, Johnson DA, Gazmararian JA, Suglia SF. Racial/Ethnic and Sex/Gender Differences in Sleep Duration Trajectories From Adolescence to Adulthood in a US National Sample. Am J Epidemiol 2023; 192:51-61. [PMID: 36004702 PMCID: PMC10144618 DOI: 10.1093/aje/kwac156] [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: 11/15/2021] [Revised: 07/07/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
Racial/ethnic and sex/gender disparities in sleep duration have been documented in adolescence and adulthood. Identifying racial/ethnic and sex/gender differences in sleep duration trajectories from adolescence to adulthood can inform interventions on the developmental periods individuals are most at risk for short sleep duration. We examined racial/ethnic and sex/gender differences in self-reported sleep duration trajectories from adolescence to adulthood using data from waves I, III, IV, and V of the National Longitudinal Study of Adolescent to Adult Health (1994-2018; n = 12,593). Multigroup growth mixture modeling was used to enumerate sleep duration trajectories from adolescence to adulthood. There were 3 common trajectory types across race/ethnicity and sex/gender groups: 1) consistent increasing short sleepers (i.e., increasing probability of short sleep into adulthood) (67.3%); 2) late-onset short sleepers (i.e., no probability of short sleep duration in adolescence until adulthood) (20.2%); and 3) early-onset short sleepers (i.e., declining probability of short sleep duration from adolescence into adulthood) (12.5%). The prevalence of the consistent-increasing trajectory was highest among Black male respondents, while late onset was highest among White female respondents and early onset greatest among Latinx male respondents. Findings underscore the need to intervene in early adolescence to prevent short sleep duration in adulthood.
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Affiliation(s)
- Ryan Saelee
- Correspondence to Dr. Ryan Saelee, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 (e-mail: )
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McKinnon II, Johnson DA, Murden RJ, Erving CL, Parker R, Van Dyke ME, Vaccarino V, Booker B, Moore RH, Lewis TT. Extreme racism-related events and poor sleep in African-American women. Soc Sci Med 2023; 316:115623. [PMID: 36581549 DOI: 10.1016/j.socscimed.2022.115623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
RATIONALE Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. OBJECTIVE This study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. METHODS Among 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. RESULTS Direct (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = -0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). CONCLUSION Extreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.
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Affiliation(s)
- Izraelle I McKinnon
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Dayna A Johnson
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Raphiel J Murden
- Department of Biostatistics (R.J.M., R.P.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Christy L Erving
- Vanderbilt University (C.L.E.), Department of Sociology, 2301 Vanderbilt Place, 201E Garland Hall, Nashville, TN, 37235-1811, USA
| | - Rachel Parker
- Department of Biostatistics (R.J.M., R.P.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Miriam E Van Dyke
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Viola Vaccarino
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA; From the Division of Cardiology, Department of Medicine (V.V.), Emory University, School of Medicine, Atlanta, GA, 30322, USA
| | - Bianca Booker
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA
| | - Renee H Moore
- Department of Epidemiology and Biostatistics (R.H.M), Drexel University, Dornsife School of Public Health, Philadelphia, PA, 19104, USA
| | - Tené T Lewis
- Department of Epidemiology (I.I.M., D.A.J., M.E.V.D., V.V., T.T.L.), Emory University, Rollins School of Public Health, Atlanta, GA, 30322, USA.
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13
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Towards A Socioeconomic Model of Sleep Health among the Canadian Population: A Systematic Review of the Relationship between Age, Income, Employment, Education, Social Class, Socioeconomic Status and Sleep Disparities. Eur J Investig Health Psychol Educ 2022; 12:1143-1167. [PMID: 36005229 PMCID: PMC9407487 DOI: 10.3390/ejihpe12080080] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/05/2022] Open
Abstract
A better understanding of the contribution of the socioeconomic status (SES) in sleep health could guide the development of population-based interventions aiming to reduce “the silent public health issue” that are sleep disturbances. PRISMA was employed to identify relevant studies having examined the association between social class, social capital, education, income/assets, occupation/employment status, neighborhood deprivation and sleep health. Sixteen cross-sectional and three longitudinal studies were selected, having sampled 226,029 participants aged from 2 months to 85 years old. Findings showed that: (1) sleep health disparities among children and adolescent are strongly correlated to parental socioeconomic indicators; (2) poor parental income, poor family SES and poor parental education are associated with higher sleep disturbances among children and adolescents; (3) lower education is a predictor of increased sleep disturbances for adults; (4) low SES is associated with high sleep disturbances in adults and old people and; (5) low income and full-time employment was significantly associated with short sleep among adults and old people. In conclusion, sleep health should be an important public health target. Such intervention would be beneficial for populational health, for all taxpayers and public administrations, which would see a reduction in absenteeism and productivity losses attributable to sleep-related health problems in the global economy.
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Extreme racism-related events and poor sleep in African-American women. Soc Sci Med 2022; 310:115269. [PMID: 36041238 PMCID: PMC9598673 DOI: 10.1016/j.socscimed.2022.115269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 11/20/2022]
Abstract
RATIONALE Much of the research linking racism-related stressors to poor health has focused on fairly non-violent forms of racism that directly impact individuals under study. Exposure to particularly extreme and/or violent racist events are increasingly visible via smartphone recordings and social media, with consistent anecdotal reports of the effects of seeing and hearing about these events on sleep among minorities who racially identify with the victims. OBJECTIVE This study examines whether exposure to direct and vicarious racism-related events (RREs), including more extreme events, are associated with sleep quality. Additionally, we examine effects of less and more violent direct RREs and vicarious RREs witnessed in person and via social media. METHODS Among 422 African-American women, we assessed exposure to RREs using a modified version of the Race-Related Events Scale and assessed sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Linear regression analyses were used to model continuous global sleep. RESULTS Direct (β = 0.24 [95% CI: 0.13, 0.35]) RREs were associated with worse continuous global sleep quality scores in analyses adjusted for sociodemographics and risk factors for poor sleep. More violent direct RREs (β = 0.59 [95% CI: 0.30, 0.89]) had stronger associations with poor sleep quality than less violent direct RREs (β = 0.25 [95% CI: 0.11, 0.40]). Vicarious RREs overall (β = 0.04 [95% CI: 0.14, 0.21]) and those witnessed via social media (β = -0.07 [95% CI: 0.29, 0.14]) were not associated with global sleep quality; conversely, vicarious RREs witnessed in person were (β = 0.52 [95% CI: 0.21, 0.83]). CONCLUSION Extreme, direct experiences of racism, particularly those that are violent in nature, are associated with poor sleep quality. However, extreme vicarious experiences are not-- unless witnessed in person.
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Eubank JM, Oberlin DJ, Alto A, Sahyoun NR, Asongwed E, Monroe-Lord L, Harrison EA. Effects of Lifestyle Factors on Cognition in Minority Population of Older Adults: A Review. Front Nutr 2022; 9:841070. [PMID: 35369047 PMCID: PMC8966895 DOI: 10.3389/fnut.2022.841070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
The onset of dementia and Alzheimer's disease (AD) is projected to expand over the next several decades in the United States as the population ages. However, the cognitive health burden is not equally distributed among the population, as Hispanics and African Americans are at higher risk of AD when compared with Non-Hispanic Whites. There is some evidence to indicate that cognitive decline may be associated with lifestyle factors and that interventions in these domains may prevent or delay this decline. These lifestyle factors include social engagement, physical activity, both aerobic and strength training, dietary intake, sleep and stress. This review summarizes, in general, what is known about the relationship between risk factors and cognition and, in particular what is known about this relationship in minority populations. The results show that the relationship between these risk factors and cognitive decline is stronger for some of the factors such as physical activity and dietary intake and weaker for the other factors depending on what is measured and in what populations. It does appear, however, that the studies in minority populations is limited and warrants more targeted research and interventions.
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Affiliation(s)
- Jacob M. Eubank
- Lehman College, City University of New York, New York, NY, United States
- *Correspondence: Jacob M. Eubank ; orcid.org/0000-0003-1806-9308
| | - Douglas J. Oberlin
- Lehman College, City University of New York, New York, NY, United States
| | - Andrew Alto
- Lehman College, City University of New York, New York, NY, United States
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, United States
| | - Elmira Asongwed
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
| | - Lillie Monroe-Lord
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
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Ogbenna BT, Ryu S, Lee S, Slopen N. Discrimination and Sleep among Asians and Pacific Islanders Adults. Sleep 2021; 44:6257851. [PMID: 33912974 DOI: 10.1093/sleep/zsab109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/13/2021] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES To examine the association between discrimination and sleep duration and difficulty among Asians and Pacific Islanders (APIs) in the United States, and to test nativity and ethnic identity (EI) as effect modifiers. METHODS This cross-sectional study of 1,765 adults from the National Epidemiology Study of Alcohol and Related Conditions III, assessed discrimination using the Experiences of Discrimination scale. Discrimimation was classified as low, moderate, and high. Regression models were used to examine self-reported sleep duration and difficulty. RESULTS In bivariate analyses, individuals with high discrimination had the shortest sleep and reported sleep difficulty most often. Using linear models adjusted for sociodemographic and health characteristics, moderate and high discrimination were associated with 9 minutes (standard error [SE]: 4.8, p <0.10) and 14.4 minutes (SE: 6.0, p <0.05) less sleep, respectively, relative to low discrimination. Individuals with moderate and high discrimination had higher prevalence of sleep difficulty compared to those with low discrimination (prevalence ratio [PR]: 1.51, 95% confidence interval [CI]: 1.14-1.99 and PR: 1.73, 95% CI: 1.33-2.24, respectively). Interaction effect was observed in sleep difficulty by nativity and EI, but not duration. The association between discrimination and sleep difficulty was stronger among US-born relative to foreign-born participants. Among participants with low EI, moderate and high discrimination were associated with sleep difficulty, whereas among those with high EI, only high discrimination displayed this association. CONCLUSIONS Discrimination is associated with sleep duration and difficulty, and varies by nativity and EI. Research is needed to improve sleep among APIs that experience discrimination.[.
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Affiliation(s)
- Bethany Townsend Ogbenna
- University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Soomin Ryu
- University of Maryland, College Park, School of Public Policy, USA
| | - Sunmin Lee
- University of California, Irvine, School of Medicine, Department of Medicine, USA
| | - Natalie Slopen
- Harvard T. H. Chan School of Public Health, Department of Social and Behavioral Sciences, USA
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Liang T, Munro HM, Hargreaves MK, Steinwandel MD, Blot WJ, Buchowski MS. Patterns and correlates of sleep duration in the Southern cohort community study. Sleep Med 2020; 75:459-467. [PMID: 32998092 DOI: 10.1016/j.sleep.2020.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate whether race (African American (AA) and white) is associated with sleep duration among adults from low socioeconomic (SES) strata and whether SES status, lifestyle behaviors, or health conditions are associated with sleep duration within race-sex groups. METHODS This cross-sectional study includes 78,549 participants from the Southern Community Cohort Study (SCCS). Averaged daily sleep duration was assessed by weighted averages of self-reported sleep duration on weekdays and weekends. Adjusted odds ratios (ORs) of very short (<5 h/day), short (5-6 h/day), and long sleep (≥9 h/day) associated with pre-selected risk factors in each race-sex group were determined by multinomial logistic models. RESULTS The prevalence of very short and short sleep was similar among AAs (6.2% and 29.1%) and whites (6.5% and 29.1%). Long sleep was considerably more prevalent among AAs (19.3%) than whites (13.0%). Very short sleep was associated with lower education and family income, with stronger associations among whites. Higher physical activity levels significantly decreased odds for both very short (OR = 0.80) and long sleep (OR = 0.78). Smoking, alcohol use, and dietary intake were not associated with sleep duration. Regardless of race or sex, very short, short, and long sleep were significantly associated with self-reported health conditions, especially depression (ORs were 2.06, 1.33, and 1.38, respectively). CONCLUSIONS Sleep duration patterns differed between AAs and whites from the underrepresented SCCS population with low SES. Sleep duration was associated with several socioeconomic, health behaviors, and health conditions depending on race and sex.
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Affiliation(s)
- Tao Liang
- Division of Gastroenterology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Heather M Munro
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Mark D Steinwandel
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William J Blot
- International Epidemiology Field Station, Rockville, MD, USA; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, USA; Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Maciej S Buchowski
- Division of Gastroenterology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
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