1
|
Guan Y, Shen J, Zhang K, Fuemmeler BF, Zhao H. Allostatic Load, Cigarette Smoking, and Lung Cancer Risk. Cancers (Basel) 2024; 16:3235. [PMID: 39335207 PMCID: PMC11429585 DOI: 10.3390/cancers16183235] [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: 09/05/2024] [Revised: 09/17/2024] [Accepted: 09/20/2024] [Indexed: 09/30/2024] Open
Abstract
Background: Allostatic load (AL) is a biomarker of chronic stress associated with various chronic diseases. No study has evaluated the relationship between AL and lung cancer risk. Methods: To address this gap, we analyzed the association between AL and the development of lung cancer in 344,380 participants from the UK Biobank. Results: During the follow-up period from 2006 to 2020, 2517 participants were diagnosed with incident lung cancer. Participants who developed lung cancer had significantly higher AL compared to cancer-free controls (mean: 3.49 vs. 2.87, p < 0.001). In the multivariate analysis, a marginally significant association was observed between higher AL and increased lung cancer risk (per one AL unit: Hazard Ratio [HR] = 1.02, 95% Confidence Interval [CI]: 0.99, 1.04). In the categorical analysis, individuals with high AL (AL > 2) had a 15% higher risk of lung cancer compared to those with low AL (AL ≤ 2) (HR = 1.15, 95% CI: 1.05, 1.25). Stratified analyses revealed that this increased risk was only observed in former (HR = 1.38, 95% CI: 1.06, 1.43) and current smokers (HR = 1.25, 95% CI: 1.10, 1.42) but not in never-smokers (HR = 0.93, 95% CI: 0.74, 1.17). Moreover, we found that demographics, socioeconomics, and other health behaviors could modify the risk association. Finally, among cigarette smoking-related variables, a significant trend of increasing AL was observed with higher pack-years, longer smoking duration, earlier age of smoking initiation, and later age of smoking cessation. Conclusions: These findings suggest that higher AL is associated with an increased risk of lung cancer. The results need to be further confirmed in additional studies.
Collapse
Affiliation(s)
- Yufan Guan
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
| | - Jie Shen
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, State University of New York at Albany, Albany, NY 12222, USA
| | - Bernard F Fuemmeler
- Department of Family Medicine, School of Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Hua Zhao
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA
| |
Collapse
|
2
|
Keller MS, Guevara N, Guerrero JA, Mays AM, McCleskey SG, Reyes CE, Sarkisian CA. Experiences managing behavioral symptoms among Latino caregivers of Latino older adults with dementia and memory problems: a qualitative study. BMC Geriatr 2024; 24:725. [PMID: 39217285 PMCID: PMC11365257 DOI: 10.1186/s12877-024-05323-4] [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: 02/13/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Latinos are more likely than non-Latino Whites to develop dementia and be prescribed antipsychotics for dementia-related behavioral symptoms. Antipsychotics have significant risks yet are often overprescribed. Our understanding of how Latino caregivers of Latino older adults living with dementia perceive and address behavioral issues is limited, impeding our ability to address the root causes of antipsychotic overprescribing. METHODS We interviewed Latino older adults' caregivers and community-based organization workers serving older adults with cognitive impairment (key informants), focusing on the management of behavioral symptoms and experiences with health services. RESULTS We interviewed 8 caregivers and 2 key informants. Caregivers were the spouses, children, or grandchildren of the older adult living with cognitive impairment; their ages ranged from 30 to 95. We identified three categories of how caregivers learned about, managed, and coped with behavioral symptoms: caregivers often faced shortcomings with dementia care in the medical system, receiving limited guidance and support; caregivers found community organizations and senior day centers to be lifelines, as they received relevant, timely advice and support, caregivers often devised their own creative strategies to manage behavioral symptoms. CONCLUSION In-depth interviews suggest that the healthcare system is failing to provide support for behavioral symptoms from dementia; caregivers of Latino older adults rely on community organizations instead.
Collapse
Affiliation(s)
- Michelle S Keller
- USC Leonard Davis School of Gerontology, 3715 McClintock Avenue , Los Angeles, CA, 90089, USA.
- Department of Health Policy and Management, Fielding School of Public Health, University of California-Los Angeles, Los Angeles, CA, USA.
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Nathalie Guevara
- Section of Geriatric Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Allison M Mays
- Section of Geriatric Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Carmen E Reyes
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Catherine A Sarkisian
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Geriatric Research Education Clinical Center (GRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| |
Collapse
|
3
|
Assari S, Azad MA, Zare H. Race by Sex Intersectional Differences in the Association between Allostatic Load and Depression in US Adults: 2005-2018. GLOBAL JOURNAL OF EPIDEMIOLOGY AND INFECTIOUS DISEASE 2024; 4:20-33. [PMID: 39119133 PMCID: PMC11308993 DOI: 10.31586/gjeid.2024.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/10/2024]
Abstract
Objective Previous research has underscored the link between allostatic load-a comprehensive indicator of the cumulative physiological burden of chronic stress-and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. Methods This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. Results Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. Conclusion The study highlights the critical need to consider allostatic load as a key intervention point for preventing or reducing depression, particularly among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.
Collapse
Affiliation(s)
- Shervin Assari
- 1 Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California, USA. 2 Department of Internal Medicine, Charles R Drew University of Medicine and Science, Los Angeles, California, USA. 3 Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, California, USA. 4 Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, California, USA
| | - Mahbube Askari Azad
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hossein Zare
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.; University of Maryland Global Campus, Health Services Management, Adelphi, Maryland, USA
| |
Collapse
|
4
|
Mao W, Shalaby R, Owusu E, Elgendy HE, Agyapong B, Eboreime E, Silverstone P, Chue P, Li XM, Vuong W, Ohinmaa A, Taylor V, Greenshaw AJ, Agyapong VIO. Depression, anxiety, and poor well-being at discharge from psychiatric hospitals: prevalence and risk factors. Front Psychiatry 2024; 15:1408095. [PMID: 39056021 PMCID: PMC11269243 DOI: 10.3389/fpsyt.2024.1408095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
Background Being ready for discharge is vital to successful hospital-to-home transitions. For many patients, however, the transition from psychiatric hospital care to outpatient care can be challenging. An in-depth understanding of the mental health conditions of patients at discharge is crucial and instructive for recovery research. Objective The purpose of this study was to determine the prevalence and risk factors of depression, anxiety, and poor well-being symptoms among patients who are about to be discharged from psychiatric units in Alberta, Canada. Our aim was to help determine the prevalence of anxiety, depression, and overall well-being among the general psychiatric inpatient population in Alberta before discharge and the potential factors which may influence this. Methods This epidemiological study used a cross-sectional quantitative survey from March 8, 2022, to November 5, 2023, to assess depression, anxiety, and well-being. Participants were invited to complete an online questionnaire that contained demographics, clinical information, and responses to the PHQ-9, GAD-7, and WHO-5 questionnaires. SPSS version 25 was used to analyze the data. Descriptive, univariate, and multivariate regression analyses were employed. Result The study found that the prevalence of likely depression, anxiety, and poor well-being among patients about to be discharged was 37.1%, 56.4%, and 48.3%, respectively. Based on a logistic regression model, there was a statistically significant association between anxiety, depression, and poor well-being diagnoses and multiple socio-demographic and clinical factors such as ethnicity, primary mental health diagnoses, education level, housing status, depression, anxiety, and well-being at baseline. Conclusion Mental health assessment at discharge is a critical step in the recovery and transition of care. There is still a need for further research to identify the underlying causes and robust predictors of mental health symptoms in patients about to be discharged and to provide appropriate interventions and supportive resources both before and following discharge. Future research utilizing these findings may help identify key opportunities to improve outcomes for patients after discharge.
Collapse
Affiliation(s)
- Wanying Mao
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ernest Owusu
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | | | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Peter Silverstone
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Pierre Chue
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Wesley Vuong
- Alberta Health Services, Addiction and Mental Health Services, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Valerie Taylor
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Vincent I. O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| |
Collapse
|
5
|
Petrova D, Ubago-Guisado E, Garcia-Retamero R, Redondo-Sánchez D, Pérez-Gómez B, Catena A, Caparros-Gonzalez RA, Sánchez MJ. Allostatic Load and Depression Symptoms in Cancer Survivors: A National Health and Nutrition Examination Survey Study. Cancer Nurs 2024; 47:290-298. [PMID: 36920171 DOI: 10.1097/ncc.0000000000001216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression. OBJECTIVE The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors. METHODS Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables. RESULTS Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL. CONCLUSION High AL is associated with more depressive symptoms among cancer survivors. IMPLICATIONS FOR PRACTICE Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.
Collapse
Affiliation(s)
- Dafina Petrova
- Author Affiliations: Instituto de Investigación Biosanitaria, ibs.GRANADA (Drs Petrova, Ubago-Guisado, Caparros-Gonzalez, and Sánchez, and Mr Rendondo-Sánchez), Granada; Escuela Andaluza de Salud Pública (Drs Petrova, Ubago-Guisado, and Sánchez, and Mr Rendondo-Sánchez), Granada; CIBER of Epidemiology and Public Health (Drs Petrova, Ubago-Guisado, Pérez-Gómez, and Sánchez, and Mr Rendondo-Sánchez), Madrid; University of Granada (Drs Garcia-Retamero, Catena, and Caparros-Gonzalez); National Center for Epidemiology, Health Institute Carlos III (Dr Pérez-Gómez), Madrid; and Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada (Dr Sánchez), Spain
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Li S, Liu HH, Zhang Y, Zhang M, Zhang HW, Zhu CG, Guo YL, Wu NQ, Xu RX, Dong Q, Dou KF, Qian J, Li JJ. Association of Triglyceride Glucose-Derived Indices with Recurrent Events Following Atherosclerotic Cardiovascular Disease. J Obes Metab Syndr 2024; 33:133-142. [PMID: 38714326 PMCID: PMC11224920 DOI: 10.7570/jomes23055] [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: 09/21/2023] [Revised: 10/15/2023] [Accepted: 02/28/2024] [Indexed: 05/09/2024] Open
Abstract
Background Triglyceride glucose (TyG) and TyG-body mass index (TyG-BMI) are reliable surrogate indices of insulin resistance and used for risk stratification and outcome prediction in patients with atherosclerotic cardiovascular disease (ASCVD). Here, we inserted estimated average glucose (eAG) into the TyG (TyAG) and TyG-BMI (TyAG-BMI) as derived parameters and explored their clinical significance in cardiovascular risk prediction. Methods This was a population-based cohort study of 9,944 Chinese patients with ASCVD. The baseline admission fasting glucose and A1C-derived eAG values were recorded. Cardiovascular events (CVEs) that occurred during an average of 38.5 months of follow-up were recorded. We stratified the patients into four groups by quartiles of the parameters. Baseline data and outcomes were analyzed. Results Distribution of the TyAG and TyAG-BMI indices shifted slightly toward higher values (the right side) compared with TyG and TyG-BMI, respectively. The baseline levels of cardiovascular risk factors and coronary severity increased with quartile of TyG, TyAG, TyG-BMI, and TyAG-BMI (all P<0.001). The multivariate-adjusted hazard ratios for CVEs when the highest and lowest quartiles were compared from low to high were 1.02 (95% confidence interval [CI], 0.77 to 1.36; TyG), 1.29 (95% CI, 0.97 to 1.73; TyAG), 1.59 (95% CI, 1.01 to 2.58; TyG-BMI), and 1.91 (95% CI, 1.16 to 3.15; TyAG-BMI). The latter two showed statistical significance. Conclusion This study suggests that TyAG and TyAG-BMI exhibit more information than TyG and TyG-BMI in disease progression among patients with ASCVD. The TyAG-BMI index provided better predictive performance for CVEs than other parameters.
Collapse
Affiliation(s)
- Sha Li
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hui-Hui Liu
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yan Zhang
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Meng Zhang
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Hui-Wen Zhang
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Cheng-Gang Zhu
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Yuan-Lin Guo
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Na-Qiong Wu
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Rui-Xia Xu
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Qian Dong
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Ke-Fei Dou
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jie Qian
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Jian-Jun Li
- Cardiometabolic Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| |
Collapse
|
7
|
Sandoval J, Aquino E, Piñeros-Leaño M, Domínguez J, Simonovich SD. Examining the Qualitative Experiences of Latinx Nurses During the First Wave of COVID-19. HISPANIC HEALTH CARE INTERNATIONAL 2024; 22:25-34. [PMID: 38009005 DOI: 10.1177/15404153231214726] [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: 11/28/2023]
Abstract
Introduction: The world has been impacted by the coronavirus disease 2019 (COVID-19) pandemic since March of 2020. Latinx nurses have been some of the most underrepresented in being studied during this time and have been greatly affected by it. To the best of our knowledge, there are no published studies that focus on the qualitative experiences of Latinx nurses during the first wave of the pandemic. Methods: Data analysis included thematic analysis to identify main themes experienced by Latinx nurses. A qualitative descriptive study design was employed to conduct a parent study with 100 nurses across the United States reflecting on their experiences during the first wave of the COVID-19 pandemic, data collected from May to September 2020. Formal coding of the interview data was conducted utilizing Dedoose cloud-based software. Results: Five main themes emerged, including (1) connection to patients' personal touch and empathy, (2) connection to Latinx nurses, (3) connection to family and friends, (4) connection to food as care, and (5) coping. Within the theme of coping, subthemes of (5.1) faith, (5.2) maladaptive behaviors, and (5.3) self-care activities emerged. Conclusion: These experiences can help shape the pathway to be better prepared for any emergency or future pandemic.
Collapse
Affiliation(s)
- Jennifer Sandoval
- School of Nursing, College of Science and Health, DePaul University, Chicago, IL, USA
| | - Elizabeth Aquino
- Department of Biobehavioral Nursing Science, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | |
Collapse
|
8
|
Chery MJ, Baral A, Rolle LD, Abdshah A, Bernard MJ, Poudel L, Francois L, Jones DL, Jean-Louis G, Blanc J. Depression, Sleep Health & Sociodemographic Correlates in a Nationwide Survey: Implications for Depression Treatment During the COVID-19. Nat Sci Sleep 2024; 16:17-31. [PMID: 38235481 PMCID: PMC10793117 DOI: 10.2147/nss.s434148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/04/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic. Methods We conducted a secondary analysis using self-reported data from the 2021 National Health Interview Survey (NHIS), focusing on adults aged 18 years and above (n=29,763). We utilized self-reported responses to questions about prescription medication and frequency of depressive feelings to determine participants' depression status. Appropriate weights were applied to account for the sampling design of the surveys. Our analysis involved descriptive statistics and chi-squared tests to compare sociodemographic, clinical, behavioral, and sleep-related characteristics between US adults with and without depression. Additionally, logistic regression was used to examine the associations between sleep duration, sleep quality and depression. Results The overall prevalence of depression in our sample was 44.4%. It were higher in certain demographic groups, including younger adults (18-39 years, 47.7%), non-Hispanic whites (47.9%), females (50.1%), those at the lower income bracket (52.2%), those with no college or degree (48.7%) uninsured individuals (45.2%), and those reporting poor general health (71.9%). Individuals with depression had a 12% increased odds of experiencing short sleep (aOR: 1.12, 95% CI:1.04-1.20, p<0.001), 34% increased odds of experiencing long sleep (aOR: 1.34, 95% CI: 1.20-1.50, p < 0.001) and more than 2.5 fold increased odds of reporting poor sleep quality (aOR:2.57, 95% CI: 2.40-2.78; p<0.0001). In the multivariate analysis, all variables (sex, race/ethnicity, education, health insurance coverage, marital status, general health status and use of sleep medications, smoking and alcohol use status) were significantly predictors of poor sleep quality, with the exceptions of age and family income. Conclusion The findings emphasize the need to address sleep health in treating depression, especially during times of public health crises.
Collapse
Affiliation(s)
- Maurice Junior Chery
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Amrit Baral
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - LaShae D Rolle
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Alireza Abdshah
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maritza J Bernard
- Anne Bates Leach Eye Hospital at Bascom Palmer Eye Institute, the University of Miami Miller School of Medicine, Miami, FL, USA
| | - Laxmi Poudel
- South Florida Integrative Medicine, Miami, FL, USA
| | - Laura Francois
- Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Girardin Jean-Louis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Judite Blanc
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
9
|
Buller-Peralta I, Gregory S, Low A, Dounavi ME, Bridgeman K, Ntailianis G, Lawlor B, Naci L, Koychev I, Malhotra P, O'Brien JT, Ritchie CW, Muniz-Terrera G. Comprehensive allostatic load risk index is associated with increased frontal and left parietal white matter hyperintensities in mid-life cognitively healthy adults. Sci Rep 2024; 14:573. [PMID: 38177228 PMCID: PMC10766612 DOI: 10.1038/s41598-023-49656-3] [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: 09/14/2023] [Accepted: 12/11/2023] [Indexed: 01/06/2024] Open
Abstract
To date, there is a considerable heterogeneity of methods to score Allostatic Load (AL). Here we propose a comprehensive algorithm (ALCS) that integrates commonly used approaches to generate AL risk categories and assess associations to brain structure deterioration. In a cohort of cognitively normal mid-life adults (n = 620, age 51.3 ± 5.48 years), we developed a comprehensive composite for AL scoring incorporating gender and age differences, high quartile approach, clinical reference values, and current medications, to then generate AL risk categories. Compared to the empirical approach (ALES), ALCS showed better model fit criteria and a strong association with age and sex. ALSC categories were regressed against brain and white matter hyperintensity (WMH) volumes. Higher AL risk categories were associated with increased total, periventricular, frontal, and left parietal WMH volumes, also showing better fit compared to ALES. When cardiovascular biomarkers were removed from the ALSC algorithm, only left-frontal WMHV remained associated with AL, revealing a strong vascular burden influencing the index. Our results agree with previous evidence and suggest that sustained stress exposure enhances brain deterioration in mid-life adults. Showing better fit than ALES, our comprehensive algorithm can provide a more accurate AL estimation to explore how stress exposure enhances age-related health decline.
Collapse
Affiliation(s)
- Ingrid Buller-Peralta
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK.
| | - Sarah Gregory
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Katie Bridgeman
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Georgios Ntailianis
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
| | - Brian Lawlor
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Lorina Naci
- Trinity College Institute of Neuroscience, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Ireland
- Global Brain Health Institute, Trinity College Dublin, GBHI Office Room 0.60, Lloyd Building Trinity College Dublin, Dublin 2, Ireland
| | - Ivan Koychev
- Department of Psychiatry, Warneford Hospital, Oxford University, Warneford Ln, Headington, Oxford, OX3 7JX, UK
| | - Paresh Malhotra
- Department of Brain Sciences, Imperial College London, Burlington Danes, The Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Level E4, Box 189, Cambridge, CB2 0QQ, UK
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Scottish Brain Sciences, Gyleview House, 3 Redheughs Rigg, South Gyle, Edinburgh, EH12 9DQ, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Outpatients Department Level 2 Western General Hospital, The University of Edinburgh, Crewe Rd S, Edinburgh, EH4 2XU, UK
- Ohio University Heritage College of Osteopathic Medicine, 191 W Union St, Athens, OH, 45701, USA
| |
Collapse
|
10
|
Humbyrd CJ. Virtue Ethics in a Value-Driven World: Pareto Meets PROMIS. Clin Orthop Relat Res 2023; 481:1886-1887. [PMID: 37624767 PMCID: PMC10499075 DOI: 10.1097/corr.0000000000002839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Casey Jo Humbyrd
- Chief, Penn Orthopaedics Foot and Ankle Service, The Hospitals of the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
11
|
Wen M, Shi L, Zhang D, Li Y, Chen Z, Chen B, Chen L, Zhang L, Li H, Li J, Han X, Su D. Racial-ethnic disparities in psychological distress during the COVID-19 pandemic in the United States: the role of experienced discrimination and perceived racial bias. BMC Public Health 2023; 23:957. [PMID: 37231401 PMCID: PMC10209952 DOI: 10.1186/s12889-023-15912-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 05/16/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Research on mental health disparities by race-ethnicity in the United States (US) during COVID-19 is limited and has generated mixed results. Few studies have included Asian Americans as a whole or by subgroups in the analysis. METHODS Data came from the 2020 Health, Ethnicity, and Pandemic Study, based on a nationally representative sample of 2,709 community-dwelling adults in the US with minorities oversampled. The outcome was psychological distress. The exposure variable was race-ethnicity, including four major racial-ethnic groups and several Asian ethnic subgroups in the US. The mediators included experienced discrimination and perceived racial bias toward one's racial-ethnic group. Weighted linear regressions and mediation analyses were performed. RESULTS Among the four major racial-ethnic groups, Hispanics (22%) had the highest prevalence of severe distress, followed by Asians (18%) and Blacks (16%), with Whites (14%) having the lowest prevalence. Hispanics' poorer mental health was largely due to their socioeconomic disadvantages. Within Asians, Southeast Asians (29%), Koreans (27%), and South Asians (22%) exhibited the highest prevalence of severe distress. Their worse mental health was mainly mediated by experienced discrimination and perceived racial bias. CONCLUSIONS Purposefully tackling racial prejudice and discrimination is necessary to alleviate the disproportionate psychological distress burden in racial-ethnic minority groups.
Collapse
Affiliation(s)
- Ming Wen
- Faculty of Social Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
- Department of Sociology, University of Utah, Salt Lake City, UT, 84112, USA
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA
| | - Donglan Zhang
- Division of Health Services Research, Department of Foundations of Medicine, New York University Long Island School of Medicine, Mineola, NY, 11501, USA
| | - Yan Li
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Zhuo Chen
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, 30602, USA
| | - Baojiang Chen
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, 1616 Guadalupe, Suite 6.300, Austin, TX, 78701, USA
| | - Liwei Chen
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Lu Zhang
- Department of Public Health Sciences, Clemson University, Clemson, SC, 29634, USA
| | - Hongmei Li
- Department of Media, Journalism and Film, Miami University, Oxford, OH, 45056, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, 90095, USA
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, 30303, USA
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, USA.
| |
Collapse
|
12
|
de Oliveira C, Sabbah W, Bernabé E. Allostatic load and depressive symptoms in older adults: An analysis of 12-year panel data. Psychoneuroendocrinology 2023; 152:106100. [PMID: 36989564 DOI: 10.1016/j.psyneuen.2023.106100] [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: 02/01/2023] [Revised: 03/08/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Whether changes in allostatic load (AL) and depressive symptoms relate over time has not been yet fully explored. This study evaluated the association between AL and depressive symptoms over 12 years among community-dwelling older adults. METHODS Panel data from 8291 participants in the English Longitudinal Study of Ageing were analysed. Depressive symptoms were assessed with the 8-item Centre for Epidemiologic Studies Depression Scale (CES-D). The AL score was derived from nine metabolic, cardiovascular and immune biomarkers. The association between AL and depressive symptoms was modelled in a linear hybrid model adjusting for time-invariant (sex, ethnicity) and time-variant confounders (age, marital status, education, wealth, physical activity, smoking status, alcohol intake, limitations in daily living, comorbidities). RESULTS The mean AL score was 3.1 (SD: 2.1), 3.5 (2.3), 3.2 (2.3) and 3.3 (2.5) whereas the mean CES-D score was 1.4 (SD: 1.8), 1.2 (1.8), 1.2 (1.8) and 1.2 (1.7) in waves 2, 4, 6 and 8, respectively. In the adjusted model, the between-person differences (coefficient: 0.02, 95% CI: 0.01, 0.04) but not the within-individual differences (0.01; 95% CI: -0.01, 0.03) in the AL score were associated with CES-D score. The between-person coefficient indicates that participants with greater AL scores also had slightly higher CES-D scores. The within-person coefficient indicates that changes in the AL score were not associated with changes in the CES-D score. CONCLUSION AL was associated with depressive symptoms. However, most of the association was driven by differences in AL between individuals rather than changes in AL over time.
Collapse
Affiliation(s)
- Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, Torrington Place, London W1CE 6BT, United Kingdom.
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Bessemer Road, London SE5 9RS, United Kingdom.
| | - Eduardo Bernabé
- Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London E1 2AD, United Kingdom.
| |
Collapse
|
13
|
Bashir T, Obeng-Gyasi E. The Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Allostatic Load Using Bayesian Kernel Machine Regression. Diseases 2023; 11:diseases11010052. [PMID: 36975601 PMCID: PMC10047702 DOI: 10.3390/diseases11010052] [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: 01/28/2023] [Revised: 03/01/2023] [Accepted: 03/19/2023] [Indexed: 03/29/2023] Open
Abstract
Background/Objective: This study aimed to investigate the effect of exposure to per- and polyfluoroalkyl substances (PFAS), a class of organic compounds utilized in commercial and industrial applications, on allostatic load (AL), a measure of chronic stress. PFAS, such as perfluorodecanoic acid (PFDE), perfluorononanoic acid (PFNA), perfluorooctane sulfonic acid (PFOS), perfluoroundecanoic acid (PFUA), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHS), and metals, such as mercury (Hg), barium (Ba), cadmium (Cd), cobalt (Co), cesium (Cs), molybdenum (Mo), lead (Pb), antimony (Sb), thallium (TI), tungsten (W), and uranium (U) were investigated. This research was performed to explore the effects of combined exposure to PFAS and metals on AL, which may be a disease mediator. Methods: Data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2014 were used to conduct this study on persons aged 20 years and older. A cumulative index of 10 biomarkers from the cardiovascular, inflammatory, and metabolic systems was used to calculate AL out of 10. If the overall index was ≥ 3, an individual was considered to be chronically stressed (in a state of AL). In order to assess the dose-response connections between mixtures and outcomes and to limit the effects of multicollinearity and other potential interaction effects between exposures, Bayesian kernel machine regression (BKMR) was used. Results: The most significant positive trend between mixed PFAS and metal exposure and AL was revealed by combined exposure to cesium, molybdenum, PFHS, PFNA, and mercury (posterior inclusion probabilities, PIP = 1, 1, 0.854, 0.824, and 0.807, respectively). Conclusions: Combined exposure to metals and PFAS increases the likelihood of being in a state of AL.
Collapse
Affiliation(s)
- Tahir Bashir
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| |
Collapse
|
14
|
Hoggard LS, Volpe VV, Hatton VL, Jones SJ, Tikhonov AA, Davis SE. "Now I just need something sweet": Racism, emotional eating, and health among African Americans. Soc Sci Med 2023; 316:114947. [PMID: 35410763 DOI: 10.1016/j.socscimed.2022.114947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/21/2022] [Accepted: 03/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Environmental Affordances Model theorizes that systemic racism disproportionately exposes African Americans in the United States to chronic everyday stressors (e.g., individual racism) while simultaneously shaping the availability of coping resources (e.g., fast food outlets) and engagement in self-regulatory strategies (e.g., emotional eating). Greater engagement in self-regulatory strategies is theorized to preserve mental health while contributing to medical morbidities and mortality. OBJECTIVE However, few studies have tested the Environmental Affordances Model, limiting our understanding of how the proposed pathways operate in the lives of African Americans. METHODS In the present study, the associations between systemic racism (institutional racism, cultural racism, neighborhood disadvantage), chronic everyday stressors (exposure to individual racism), emotional eating, and mental (anxiety symptomatology) and physical (self-rated overall physical health) health are assessed in a sample of 751 African Americans aged 18 to 88. RESULTS The path analysis reveals that institutional and cultural racism are both positively associated with individual racism. Neighborhood disadvantage is inversely associated with individual racism. Individual racism is significantly associated with greater anxiety symptomatology but is unrelated to self-rated overall physical health. Institutional and cultural racism are associated with emotional eating although individual racism and neighborhood disadvantage are not. Moreover, engagement in emotional eating exacerbates, rather than mitigates, the impacts of individual racism on anxiety symptomatology. CONCLUSIONS We conclude that institutional and cultural racism contribute to individual racism experiences and emotional eating whereas emotional eating exacerbates associations among individual racism and anxiety symptomatology.
Collapse
|
15
|
Beese S, Postma J, Graves JM. Allostatic Load Measurement: A Systematic Review of Reviews, Database Inventory, and Considerations for Neighborhood Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192417006. [PMID: 36554888 PMCID: PMC9779615 DOI: 10.3390/ijerph192417006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Neighborhoods are critical to understanding how environments influence health outcomes. Prolonged environmental stressors, such as a lack of green spaces and neighborhood socioeconomic disadvantage, have been associated with higher allostatic load levels. Since allostatic load levels experienced earlier in life have stronger associations with mortality risk, neighborhoods may be uniquely suited to monitor and mitigate the impacts of environmental stressors. Researchers often study allostatic load in neighborhoods by utilizing administrative boundaries within publicly accessible databases as proxies for neighborhoods. METHODS This systematic review of reviews aims to identify commonly used biomarkers in the measurement of allostatic load, compare measurement approaches, inventory databases to study allostatic load, and spotlight considerations referenced in the literature where allostatic load is studied in neighborhoods. The review was conducted using the search term "allostatic load" in the MEDLINE, CINAHL, and PsychINFO databases. The search results were filtered to include reviews. RESULTS The search returned 499 articles after deduplication. Overall, 18 synthesis reviews met the inclusion criteria and were retained for extraction. The synthesis reviews analyzed represented 238 studies published from 1995 to 2020. The original ten biomarkers were most often used to measure allostatic load. More recently, body mass index and C-reactive protein have additionally been frequently used to measure allostatic load burden. CONCLUSIONS The scientific contributions of this study are that we have identified a clear gap in geographic considerations when studying allostatic load. The implication of this study is that we have highlighted geographic concepts when conducting neighborhood-level research using administrative databases as a neighborhood proxy and outlined emerging future trends that can enable future study of allostatic load in the neighborhood context.
Collapse
Affiliation(s)
- Shawna Beese
- College of Agricultural, Human, and Natural Resources Sciences, Washington State University, Pullman, WA 99164, USA
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Julie Postma
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| | - Janessa M. Graves
- College of Nursing, Washington State University, Spokane, WA 99202, USA
| |
Collapse
|
16
|
Carter S, Mekawi Y, Sheikh I, Sanders AS, Packard G, Harnett NG, Metzger IW. Approaching Mental Health Equity in Neuroscience for Black Women Across the Lifespan: Biological Embedding of Racism From Black Feminist Conceptual Frameworks. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1235-1241. [PMID: 36038046 DOI: 10.1016/j.bpsc.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 12/24/2022]
Abstract
Black women in the United States are faced with unrelenting chronic stressors that are often driven by racism and oppression and that result in mental health inequities. Similar to common U.S. societal views of Black women, ideological values about Black women's lives also permeate psychiatry and neuroscience research to prevent likely impactful research that fully examines the role of social power structures in the biological embedding of racism. This article's overall aim is to highlight the most urgent areas to address in mental health inequities utilizing a Black feminist lens that include 1) culturally grounded and contextually relevant considerations for the biological embedding of racism on mental health outcomes for Black women across the lifespan and 2) intersectional frameworks that address mental health inequities ingrained in multiple marginalization. We conclude with a call to action informed by Black feminist thought for the field of neuroscience to make a concerted effort to address mental health inequities among Black women and other disenfranchised groups from a frame of compassion, cultural humility, and a continuous pursuit of social justice.
Collapse
Affiliation(s)
- Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, Georgia.
| | - Yara Mekawi
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky
| | - Ifrah Sheikh
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | | | - Grace Packard
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Isha W Metzger
- Department of Psychology, Georgia State University, Atlanta, Georgia
| |
Collapse
|
17
|
Barrett M, Wilcox NS, Huang A, Levy R, Demissei B, Narayan V, Ky B. Bearing allostatic load: insights into a more equitable future within cardio-oncology. Trends Mol Med 2022; 28:1040-1049. [PMID: 36207229 DOI: 10.1016/j.molmed.2022.09.006] [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: 06/15/2022] [Revised: 08/23/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022]
Abstract
Chronic stress is often regarded as a significant cause of morbidity and mortality; however, the mechanistic link between stress and various disease states has not yet been fully characterized. We explore the concept of allostatic load, a measurement of the physiological burden of chronic stress, as well as its potential role in disease pathogenesis as it relates to cardiovascular disease, cancer, and health-related disparities. Building from this framework, we then posit the potential implications of allostatic load on patient care and research in cardio-oncology. We identify allostatic load as a potential clinically actionable tool to improve health equity in cardio-oncology.
Collapse
Affiliation(s)
- Matthew Barrett
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nicholas S Wilcox
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Anran Huang
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard Levy
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Biniyam Demissei
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivek Narayan
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Bonnie Ky
- Division of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
18
|
More, less, or the same: A scoping review of studies that compare depression between Black and White U.S. adult populations. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
|
19
|
Robbins PA, Bentley-Edwards KL, Blackman Carr LT, Conde E, Van Vliet R, Darity WA. Shades of Black: Gendered Denominational Variation in Depression Symptoms Among Black Christians. PSYCHOLOGY OF RELIGION AND SPIRITUALITY 2022; 14:425-435. [PMID: 36861032 PMCID: PMC9970286 DOI: 10.1037/rel0000398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Religion and spirituality (R/S) play a central role in shaping the contextual experiences of many Black people in the United States. Blacks are among the most religiously engaged groups in the country. Levels and types of religious engagement, however, can vary by subcategories such as gender or denominational affiliation. Although R/S involvement has been linked to improved mental health outcomes for Black people in general, it is unclear whether these benefits extend to all Black people who claim R/S affiliation irrespective of denomination and gender. Data from the National Survey of American Life (NSAL) sought to determine whether there are differences in the odds of reporting elevated depressive symptomology among African American and Black Caribbean Christian adults across denominational affiliation and gender. Initial logistic regression analysis found similar odds of elevated depressive symptoms across gender and denominational affiliation, but further analysis revealed the presence of a denomination by gender interaction. Specifically, there was a significantly larger gender gap in the odds of reporting elevated depression symptoms for Methodists than for Baptists and Catholics. In addition, Presbyterian women had lower odds of reporting elevated symptoms than Methodist women. This study's findings highlight the importance of examining denominational disparities among Black Christians, and suggest that denomination and gender may work in tandem to shape the R/S experiences and mental health outcomes of Black people in the United States.
Collapse
Affiliation(s)
- Paul A. Robbins
- The Samuel DuBois Cook Center on Social Equity, Duke University
| | | | | | - Eugenia Conde
- The Samuel DuBois Cook Center on Social Equity, Duke University
| | | | | |
Collapse
|
20
|
Powell DS, Betz JF, Yaffe K, Kritchevsky S, Strotmeyer E, Simonsick EM, Rubin S, Houston DK, Pratt SR, Purchase Helzner E, Brewster KK, Lin FR, Gross AL, Deal JA. Hearing loss and risk of depressive symptoms in older adults in the Health ABC study. FRONTIERS IN EPIDEMIOLOGY 2022; 2:980476. [PMID: 38455326 PMCID: PMC10910912 DOI: 10.3389/fepid.2022.980476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/21/2022] [Indexed: 03/09/2024]
Abstract
Objective Hearing loss (HL) is highly prevalent among older adults and may lead to increased risk of depressive symptoms. In both cross-sectional and longitudinal analysis, we quantified the association between HL and depressive symptoms, incorporating the variable nature of depressive symptoms and characterizing by race and gender. Methods Data were from the Health, Aging, and Body Composition study. Depressive symptoms were measured using the Center for Epidemiologic Study Depression Scale short form (CES-D 10), defined as CES-D 10 score ≥10 or treatment for depression. Hearing was defined via four-frequency pure-tone average (PTA) decibel hearing level (dB HL), categorized as normal hearing (PTA ≤25 dB HL), mild HL (PTA26-40 dB HL), and ≥moderate HL (PTA > 40 dB HL). Associations at baseline were quantified using logistic regression, incident depressive symptoms using Cox proportional hazard models, and change in depressive symptoms over time using growth mixture models and multinomial logistic regression. Results Among 2,089 older adults (1,082 women, 793 Black; mean age 74.0 SD: 2.8), moderate or greater HL was associated with greater odds of concurrent [Odds Ratio (OR):2.45, 95% CI:1.33, 4.51] and incident depressive symptoms [Hazard Ratio (HR):1.26, 95% CI:1.00, 1.58]. Three depressive symptom trajectory patterns were identified from growth mixture models: low, moderate increasing, and borderline high depressive symptom levels. Those with moderate or greater HL were more likely to be in the borderline high depressive-symptom trajectory class than the low trajectory class [Relative Risk Ratio (RRR):1.16, 95% CI:1.01, 1.32]. Conclusions HL was associated with greater depressive symptoms. Although findings were not statistically significantly different by gender and race, estimates were generally stronger for women and Black participants. Investigation of psychosocial factors and amelioration by hearing aid use could have significant benefit for older adults' quality of life.
Collapse
Affiliation(s)
- Danielle S. Powell
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Joshua F. Betz
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Stephen Kritchevsky
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Elsa Strotmeyer
- Department of Epidemiology, Center for Aging and Population Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eleanor M. Simonsick
- Intramural Research Program, National Institute of Aging, Baltimore, MD, United States
| | - Susan Rubin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Denise K. Houston
- Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Sheila R. Pratt
- Department of Communication Sciences and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
- Veterans Affairs (VA) Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Elizabeth Purchase Helzner
- Department of Epidemiology and Biostatistics, State University of New York (SUNY) Downstate Health Sciences University, Brooklyn, NY, United States
| | - Katharine K. Brewster
- New York State Psychiatric Institute, New York, NY, United States
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Frank R. Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jennifer A. Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins University, Baltimore, MD, United States
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of Otolaryngology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| |
Collapse
|
21
|
McClain AC, Xiao RS, Tucker KL, Falcón LM, Mattei J. Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults. Psychol Med 2022; 52:3073-3085. [PMID: 33443008 PMCID: PMC8277900 DOI: 10.1017/s0033291720005139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively. METHODS Data were from baseline, 2-year, and 5-year visits of 620 adults (45-75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0-60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8-15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0-2), moderate (3-5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score. RESULTS Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5-5.2)], but not depression-likely symptoms [4.5 (4.2-4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9-4.7)]. Baseline high AL [19.4 (17.6-21.2)], but not low AL [18.5 (16.5-20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3-18.5)]. CONCLUSIONS Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
Collapse
Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Rui S. Xiao
- IQVIA, Real-World Evidence, Cambridge, MA, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Luis M. Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
22
|
Concomitant use of relative telomere length, biological health score and physical/social statuses in the biological aging evaluation of mustard-chemical veterans. Int Immunopharmacol 2022; 109:108785. [DOI: 10.1016/j.intimp.2022.108785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/15/2022] [Accepted: 04/15/2022] [Indexed: 11/23/2022]
|
23
|
Finlay S, Roth C, Zimsen T, Bridson TL, Sarnyai Z, McDermott B. Adverse childhood experiences and allostatic load: A systematic review. Neurosci Biobehav Rev 2022; 136:104605. [PMID: 35278597 DOI: 10.1016/j.neubiorev.2022.104605] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 02/23/2022] [Accepted: 03/06/2022] [Indexed: 12/21/2022]
Abstract
Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences associated with an increased lifetime risk of negative health outcomes. The Allostatic Load (AL) is a measure of multisystem dysregulation, resulted by chronic stress. We systematically reviewed the English language literature on the association between ACEs and AL to identify the clinical risk profile, with the exclusion of reviews and preclinical studies. Searches covered the publication period up to the 1st of February 2022 and identified 25 studies in which ACEs such as maltreatment, abuse, poverty, psychological abuse, and discrimination were investigated in the context of AL. The selected studies used different sets of AL biomarkers resulting in substantial heterogenicity of calculating the AL index. Overall, we found that ACEs are associated with elevated AL and poorer health outcomes in adulthood. Furthermore, health risk behaviors, social support, and coping resources either moderate or mediate this association. These findings suggest that targeting individuals at risk and starting interventions early might reduce AL and its deleterious health consequences.
Collapse
Affiliation(s)
- Sabine Finlay
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia.
| | - Cody Roth
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia
| | - Tiansha Zimsen
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Tahnee Lee Bridson
- North-West Mental Health, The Royal Melbourne Hospital, Victoria, Australia; Fireside Research, Woodbridge Tasmania, Australia
| | - Zoltan Sarnyai
- Laboratory of Psychiatric Neuroscience, Centre for Molecular Therapeutics, James Cook University, Townsville, Queensland, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; College of Public Health, Medical & Veterinary Sciences, James Cook University, Queensland, Australia
| | - Brett McDermott
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| |
Collapse
|
24
|
Bashir T, Obeng-Gyasi E. The Association between Multiple Per- and Polyfluoroalkyl Substances' Serum Levels and Allostatic Load. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5455. [PMID: 35564852 PMCID: PMC9104853 DOI: 10.3390/ijerph19095455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 01/27/2023]
Abstract
Background/Objective: This study aimed to explore the association between allostatic load (AL), an index of chronic stress, with nine per- and polyfluoroalkyl substances (PFASs), a group of organic compounds used in commercial and industrial applications. The PFASs explored were perfluorohexane sulfonic acid (PFHS), perfluorodecanoic acid (PFDE), perfluorobutane sulfonic acid (PFBS), perfluoroheptanoic acid (PFHP), perflurododecanoic acid (PFDO), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUA), perfluorooctanoic acid (PFOA), and perfluorooctane sulfonic acid (PFOS). This study was performed to better understand the association between PFASs and AL, which may be a mediator of several diseases. Methods: This study was performed on adults aged 20 and older, using the National Health and Nutrition Examination Survey (NHANES) 2007−2014 data. AL was calculated as a cumulative index of ten biomarkers from the cardiovascular, inflammatory, and metabolic system, which was dichotomized into high risk (assigned a value of 1) or low risk (assigned a value 0) depending on if the index value was ≥3 (chronic physiological stress) or <3 (less stressed). In this study, PFASs and covariates such as age, gender, ethnicity, alcohol consumption, smoking, and physical activity were explored using descriptive statistics and logistic regression modeling. Results: The results indicated that in adults, AL was more elevated in men as compared to women, in those aged ≥60 years, and varied by ethnicity. For instance, non-Hispanic Blacks had higher AL levels (mean of 3.92) compared to other ethnicities. A significant number of the participants tested for PFBS, PFHP, PFDO were below the LOD and thus these PFASs were excluded from the analysis. Our analysis demonstrated multicollinearities between variables such as PFNA, PFOS, and PFOA with variance inflation factor (VIF) values of 6.197, 6.212, and 5.139, respectively. Thus, PFASs were analyzed individually and adjusted for age, gender, ethnicity, physical activity, smoking, and alcohol consumption. The results indicated a statistically significant positive association between AL and most of the PFASs, except PFUA which was not statistically significant with a p value of 0.531. Conclusions: The findings of this study suggest that exposure to PFDE, PFNA, PFOS, PFOA, and PFHS are associated with AL when adjusted for age, gender, ethnicity, alcohol consumption, smoking, and physical activity. Future studies looking to model the effects of these factors together must consider their relationship with each other and choose different analytical approaches.
Collapse
Affiliation(s)
- Tahir Bashir
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA;
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA;
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| |
Collapse
|
25
|
Nishimi K, Borsari B, Marx BP, Rosen RC, Cohen BE, Woodward E, Maven D, Tripp P, Jiha A, Woolley JD, Neylan TC, O'Donovan A. Clusters of COVID-19 protective and risky behaviors and their associations with pandemic, socio-demographic, and mental health factors in the United States. Prev Med Rep 2021; 25:101671. [PMID: 34926133 PMCID: PMC8669937 DOI: 10.1016/j.pmedr.2021.101671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/02/2021] [Accepted: 12/12/2021] [Indexed: 11/11/2022] Open
Abstract
Protective and risky behaviors for COVID-19 cluster in a U.S.-based sample. Behavior classes had differing patterns of socio-demographics and pandemic exposure. Posttraumatic stress and anxiety were elevated among protective and risky classes.
Individual behaviors are critical for preventing the spread of coronavirus disease 2019 (COVID-19) infection. Given that both protective and risky behaviors influence risk of infection, it is critical that we understand how such behaviors cluster together and in whom. Using a data-driven approach, we identified clusters of COVID-19-related protective and risky behaviors and examined associations with socio-demographic, pandemic, and mental health factors. Data came from a cross-sectional online U.S. nationwide study of 832 adults with high levels of pre-pandemic trauma. Latent class analysis was performed with ten protective (e.g., washing hands, wearing masks) and eight risky (e.g., attending indoor restaurants, taking a flight) behaviors for COVID-19. Then, we examined distributions of socio-demographic and pandemic factors across behavior classes using ANOVA or Chi-square tests, and associations between mental health factors (depressive, anxiety, posttraumatic stress symptoms) and behavior classes using multinomial logistic regression. We identified four classes, including three classes with relatively low risky but high (28.8%), moderate (33.5%) and minimal (25.5%) protective behaviors and one high risky behaviors class with associated moderate protective behaviors (12.1%). Age, sexual orientation, political preference, and most pandemic factors differed significantly across behavior classes. Anxiety and posttraumatic stress symptoms, but not depression, were higher in the High Risk, but also Highly and Moderately Protective classes, relative to Minimally Protective. Prevention and intervention efforts should examine constellations of protective and risky behaviors to comprehensively understand risk, and consider current anxiety and posttraumatic stress symptoms as potential risk indicators.
Collapse
Key Words
- ANOVA, analysis of variance
- AWE, Approximate Weight of Evidence Criterion
- AvePP, average posterior class probability
- BF, Bayes Factors
- BIC, Bayesian Information Criterion
- COVID-19
- COVID-19, coronavirus disease 2019
- DASS, Depression Anxiety Stress Scale
- LCA, latent class analysis
- Latent class analysis
- Mental health
- OCC, odds of correct classification
- PTSD Checklist-5, PCL-5
- PTSD, posttraumatic stress disorder
- Protective behaviors
- Risky behaviors
- cAIC, consistent Akaike's Information Criterion
- mcaP, modal class assignment proportion
Collapse
Affiliation(s)
- Kristen Nishimi
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brian Borsari
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Brian P Marx
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Raymond C Rosen
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Beth E Cohen
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA.,Medical Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA
| | - Eleanor Woodward
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - David Maven
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Paige Tripp
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Ahmad Jiha
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Joshua D Woolley
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Thomas C Neylan
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Aoife O'Donovan
- Mental Health Service, San Francisco Veterans Affairs Healthcare System, San Francisco, CA, USA.,Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
26
|
Memiah P, Biadgilign S, Kuhlman J, Cook C, Mburia P, Kingori C, Sarpong D, Buluku G, Hawkins M. Allostatic Load, Single, and Dual Chronic Conditions: Evidence from the National Health and Nutrition Examination Survey. Metab Syndr Relat Disord 2021; 20:104-113. [PMID: 34910882 PMCID: PMC8972020 DOI: 10.1089/met.2021.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Allostatic load (AL) is defined as a cumulative burden of chronic stress and life events, which involves the interaction of different physiological systems at varying degrees of activity. AL is suspected of contributing to health disparities among different populations. Suppressed or overactive physiological systems can interrupt AL affecting proper tissue and organ function leading to disease. The objective of our study was to determine the association of AL with dual chronic conditions. Methods: We used data from the National Health and Nutrition Examination Survey (NHANES). For the current analysis, we used the data cycles of 2007–2010, which is the most recent data that collected comprehensive measures of the composite AL outcome variable. Descriptive, bivariate, and multivariable logistic regression, with stepwise forward variable selection method (P < 0.05), were conducted using STATA/IC 15.0. Results: AL levels were high among 20% of the respondents (n = 2179). Having a lower income to poverty ratio, being married, physical inactivity, experiencing sleep problems, and a history of smoking were significantly associated with high AL (P < 0.05). Non-Hispanic blacks [odds ratio (OR): 1.8; 95% confidence interval (CI): 1.6–2.4] and Mexicans and other Hispanics (OR: 1.4; 95% CI: 1.1–1.7) had higher AL compared to Caucasians. Having cardiovascular disease (CVD) (OR: 1.7; 95% CI: 1.4–2.2) and diabetes (OR: 4.7; 95% CI: 3.8–5.7) independently, as well as both CVD and diabetes (OR: 3.1; 95% CI 2.7–3.6), were associated with higher odds of AL. We conducted an age-adjusted regression model that indicated higher odds of elevated AL among females with diabetes independently (OR: 1.4; 95% CI: 1.2–1.9) and with both CVD and diabetes (OR: 1.6; 95% CI: 1.2–2.1) compared to men. Conclusions: Despite the significant impact and association of AL with overall health, there is minimal evidence of its risk factors and linkage to disease burden. Modifiable lifestyle factors were associated with a higher AL. There is a critical need to support ethnic and gender contextual interventions to reduce the burden of AL on chronic conditions.
Collapse
Affiliation(s)
- Peter Memiah
- Division of Epidemiology and Prevention, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sibhatu Biadgilign
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Jamie Kuhlman
- College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Courtney Cook
- Department of Nursing, Fortis Institute, Pensacola, Florida, USA
| | - Piera Mburia
- Department of Public Health, University of Reno, Reno, Arizona, USA
| | - Carol Kingori
- College of Health Sciences and Professions, Ohio University, Athens, Ohio, USA
| | - Daniel Sarpong
- Centre of for Minority Health and Health Disparities Research and Education, Xavier University of Louisiana, New Orleans, Louisiana, USA
| | - Gabriel Buluku
- Department of Medicine, University of Maryland School of Medicine Midtown Campus, Baltimore, Maryland, USA
| | - Marquis Hawkins
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
27
|
Pabayo R, Benny C, Liu SY, Grinshteyn E, Muennig P. Financial Barriers to Mental Healthcare Services and Depressive Symptoms among Residents of Washington Heights, New York City. HISPANIC HEALTH CARE INTERNATIONAL 2021; 20:184-194. [PMID: 34894792 PMCID: PMC9315193 DOI: 10.1177/15404153211057563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives: In the United States, Hispanics are more likely to
experience financial barriers to mental health care than non-Hispanics. We used
a unique survey to study the effect of these financial barriers on the severity
of depressive symptoms among Hispanics who had previously been diagnosed as
having depression. Methods: This cross-sectional study used data
from the 2015 Washington Heights Community Survey, administered to 2,489
households in Manhattan, New York City. Multiple regression models and
propensity score matching were used to estimate the association between
financial barriers to mental health care and depressive symptoms and the
likelihood of being clinically depressed. Results: Among those
diagnosed with depression, those with financial barriers to mental health
services or counseling had significantly higher (β = 0.36, 95% CI = 0.03, 0.70)
depressive symptoms. When propensity score matching was utilized, those with
financial barriers to mental health services had significantly greater
depressive symptoms (β = 0.63, 95% CI = 0.37, 0.89) and were significantly more
likely to be currently depressed (OR = 2.38, 95% CI = 1.46, 3.89), in comparison
to those who had access. Conclusions: Making mental health care
more affordable and therefore more accessible to Hispanics is one step toward
mitigating the burden on mental illness and decreasing health disparities.
Collapse
Affiliation(s)
- Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Claire Benny
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Sze Yan Liu
- 8087Montclair State University, Public Health Department, Montclair, NJ, USA
| | - Erin Grinshteyn
- 16152University of San Francisco, Health Professions Department, San Francisco, CA, USA
| | - Peter Muennig
- 33638Columbia Mailman School of Public Health, New York City, NY, USA
| |
Collapse
|
28
|
Sulfur mustard and biological ageing: A multisystem biological health score approach as an extension of the allostatic load in Sardasht chemical veterans. Int Immunopharmacol 2021; 101:108375. [PMID: 34810125 DOI: 10.1016/j.intimp.2021.108375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Mustard gas as a chemical weapon has been used in wars and its long-term side effects are substantial in the human body. This study was aimed to apply an extension of allostatic load, known as synthetic biological health score (BHS), including the wear-and-tear of four physiological systems (endocrine, inflammatory, cardiovascular and metabolic systems) and two organs (liver and kidney) to estimate biological aging caused by sulfur mustard (SM) gas poisoning. METHODS The plasma samples were prepared from two following groups of people; 1) 446 individuals exposed to SM gas in 1987. 2) 115 healthy members, at the same range of age and residence, as the non-exposed group. These people were chosen from the same patients' families and have not had any exposure to SM or pulmonary dysfunction. To estimate BHS, 18 blood-derived biomarkers of the mentioned systems and organs were measured and the relative contribution of many social and body parameters across the age groups was explored. RESULTS It was revealed, in BHS calculation, the cardiovascular system had the most effect. Also, in the SM group, BHS was significantly higher than in the control group. This feature has a positive correlation with physical parameter (BMI) and a negative correlation with social parameters (salary and educational levels). CONCLUSION The multisystem BHS could be useful in the evaluation of biological aging due to SM exposure. Social (education, good-paying job) and physical (BMI) parameters could influence BHS and the higher BHS indicates the progress of biological aging due to mustard gas.
Collapse
|
29
|
Litz BT, Cummings MH, Grunthal B, McLean CL. A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:519-531. [PMID: 34629840 PMCID: PMC8488184 DOI: 10.1016/j.cbpra.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/21/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic has universally threatened the building blocks of mental health, well-being, and quality of life, namely, expectations of safety, connectedness, hope, and individual and societal efficacy. Consequently, unprecedently large numbers of individuals are significantly stressed and many are at risk for relapse of mental health problems, exacerbations of existing mental and behavioral health problems, and new onset clinical problems. Because of the scope of the problem, a population-based public health perspective is needed, which in the context of disasters has well-established theories and prevention approaches. Public health approaches to disasters and pandemics focus on preventing subclinical problems from becoming clinical disorders, in comparison to clinical care approaches that focus on treating established disorders. Fortunately, specialty care clinicians who typically think about assessing and treating established disorders have the training and clinical competencies to deliver prevention-focused interventions. This paper is designed to help specialty care clinicians who use cognitive-behavioral strategies to understand the biopsychosocial impacts and resource deficits associated with COVID-19-related stressors and the public health perspective to address them. We also provide ways clinicians can help people who are suffering from significant stress and resource deficits bounce back and regain functioning. We describe psychological first aid, stress management, repeated ecological assessment, writing about stressors, problem-solving, and behavioral activation approaches to assist individuals at risk for enduring stress-linked problems.
Collapse
Affiliation(s)
- Brett T Litz
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System
- Boston University School of Medicine
| | - Mackenzie H Cummings
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System
| | - Breanna Grunthal
- Massachusetts Veterans Epidemiological Research and Information Center, VA Boston Healthcare System
| | - Caitlin L McLean
- VA San Diego Healthcare System
- University of California San Diego
| |
Collapse
|
30
|
Guidi J, Lucente M, Sonino N, Fava GA. Allostatic Load and Its Impact on Health: A Systematic Review. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:11-27. [PMID: 32799204 DOI: 10.1159/000510696] [Citation(s) in RCA: 411] [Impact Index Per Article: 137.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Allostatic load refers to the cumulative burden of chronic stress and life events. It involves the interaction of different physiological systems at varying degrees of activity. When environmental challenges exceed the individual ability to cope, then allostatic overload ensues. Allostatic load is identified by the use of biomarkers and clinical criteria. OBJECTIVE To summarize the current knowledge on allostatic load and overload and its clinical implications based on a systematic review of the literature. METHODS PubMed, PsycINFO, Web of Science, and the Cochrane Library were searched from inception to December 2019. A manual search of the literature was also performed, and reference lists of the retrieved articles were examined.We considered only studies in which allostatic load or overload were adequately described and assessed in either clinical or non-clinical adult populations. RESULTS A total of 267 original investigations were included. They encompassed general population studies, as well as clinical studies on consequences of allostatic load/overload on both physical and mental health across a variety of settings. CONCLUSIONS The findings indicate that allostatic load and overload are associated with poorer health outcomes. Assessment of allostatic load provides support to the understanding of psychosocial determinants of health and lifestyle medicine. An integrated approach that includes both biological markers and clinimetric criteria is recommended.
Collapse
Affiliation(s)
- Jenny Guidi
- Department of Psychology, University of Bologna, Bologna, Italy,
| | | | - Nicoletta Sonino
- Department of Statistical Sciences, University of Padova, Padova, Italy.,Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| | - Giovanni A Fava
- Department of Psychiatry, State University of New York at Buffalo, Buffalo, New York, USA
| |
Collapse
|
31
|
Pamplin JR, Kezios KL, Hayes-Larson E, Keyes KM, Susser ES, Factor-Litvak P, Link BG, Bates LM. Response to: "Theory and empiricism: A comment on 'Interrogating the environmental affordances model' by Pamplin and colleagues". Soc Sci Med 2021; 287:114368. [PMID: 34534778 PMCID: PMC10478759 DOI: 10.1016/j.socscimed.2021.114368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Affiliation(s)
- John R Pamplin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Center for Urban Science and Progress, New York University, New York, NY, USA.
| | - Katrina L Kezios
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ezra S Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bruce G Link
- Department of Sociology, University of California Riverside, Riverside, CA, USA; School of Public Policy, University of California Riverside, Riverside, CA, USA
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
32
|
Rodriquez EJ, Coreas SI, Gallo LC, Isasi CR, Salazar CR, Bandiera FC, Suglia SF, Perreira KM, Hernandez R, Penedo F, Talavera GA, Daviglus ML, Pérez-Stable EJ. Allostatic load, unhealthy behaviors, and depressive symptoms in the Hispanic Community Health Study/Study of Latinos. SSM Popul Health 2021; 16:100917. [PMID: 34660875 PMCID: PMC8502772 DOI: 10.1016/j.ssmph.2021.100917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 09/02/2021] [Accepted: 09/05/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Environmental Affordances Model (EAM) proposes that the effects of chronic stress on depression are moderated by unhealthy behaviors and race/ethnicity. The unique social structures and contexts of Hispanics/Latinos in the U.S. may influence such relationships. This study evaluated whether unhealthy behaviors weakened the relationship between allostatic load, a measure of chronic stress, and future elevated depressive symptoms among Hispanic Community Health Study/Study of Latinos participants. METHODS Longitudinal data (2008-2011 and 2014-2017) from 11,623 participants were analyzed. The exposure was allostatic load, an index of twelve established biomarkers categorized using clinically relevant cut points, at Visit 1. Elevated depressive symptoms were operationalized as a score of ≥10 (out of 30) on the CES-D 10 at Visit 2. An index of unhealthy behaviors, with one point each for cigarette smoking, excessive/binge drinking, sedentary behavior, and poor diet quality at Visit 1, was examined as an effect modifier. Multivariable logistic regression, in the overall sample and among Mexicans specifically and adjusted for demographic characteristics and elevated depressive symptoms at Visit 1, was used to model allostatic load, unhealthy behavior index (range: 0-4), and their interaction in relation to elevated depressive symptoms at Visit 2. RESULTS Overall, greater allostatic load was associated with higher odds of elevated depressive symptoms after at least 6 years (aOR = 1.06, 95% CI = 1.01, 1.10). Overall, individuals with greater allostatic load and an unhealthy behavior index = 1, compared to those with an unhealthy behavior index = 0, had lower odds of elevated depressive symptoms at follow-up (aβ = -0.065, 95% CI = -0.12, -0.007). CONCLUSIONS The relationship between chronic stress and depression was partially moderated among Hispanics/Latinos who engaged in unhealthy behavior, which may have reduced their risk of elevated depressive symptoms given more chronic stress.
Collapse
Affiliation(s)
- Erik J. Rodriquez
- Division of Intramural Research; National Heart, Lung, And Blood Institute; 3 Center Drive, Bethesda, MD, 20892-0311, USA
| | - Saida I. Coreas
- Division of Intramural Research; National Heart, Lung, And Blood Institute; 3 Center Drive, Bethesda, MD, 20892-0311, USA
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, 780 Bay Boulevard Suite 200, Chula Vista, CA, 91910, USA
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Christian R. Salazar
- UC Irvine Institute for Memory Impairment and Neurological Disorders, University of California, Irvine, 3227 Biological Sciences III, Irvine, CA, 92697, USA
| | - Frank C. Bandiera
- Division of Behavioral and Social Research, National Institute on Aging, 31 Center Drive, Bethesda, MD, 20892-2292, USA
| | - Shakira F. Suglia
- Rollins School of Public Health, Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA
| | - Krista M. Perreira
- School of Medicine, University of North Carolina, 333 South Columbia Street, Chapel Hill, NC, 27599-7240, USA
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, 1010 West Nevada Street, Urbana, IL, 61801, USA
| | - Frank Penedo
- Department of Psychology, University of Miami, Flipse Building, 5th Floor, 5665 Ponce de Leon Blvd, Coral Gables, Florida, 33146, USA
| | - Gregory A. Talavera
- Division of Health Promotion and Behavioral Science, Graduate School of Public Health, San Diego State University, 9245 Sky Park Court, Suite 100 / HH 138, San Diego, CA, 92123-4311, USA
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, 1819 West Polk Street Suite 246, Chicago, IL, 60612, USA
| | - Eliseo J. Pérez-Stable
- Division of Intramural Research; National Heart, Lung, And Blood Institute; 3 Center Drive, Bethesda, MD, 20892-0311, USA,Corresponding author. Division of Intramural Research; National Heart, Lung, And Blood Institute; 3 Center Drive, Bethesda, MD, 20892-0311, USA.
| |
Collapse
|
33
|
Wang Y, Liu Y, Waldron M, Houston-Ludlam AN, McCutcheon VV, Lynskey MT, Madden PAF, Bucholz KK, Heath AC, Lian M. Temporal trends in smoking and nicotine dependence in relation to co-occurring substance use in the United States, 2005-2016. Drug Alcohol Depend 2021; 226:108903. [PMID: 34304125 PMCID: PMC8878578 DOI: 10.1016/j.drugalcdep.2021.108903] [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: 01/18/2021] [Revised: 05/09/2021] [Accepted: 05/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite an overall decline in tobacco use in the United States, secular trends of smoking and nicotine dependence with co-occurring substance use are not well characterized. METHODS We examined self-reported tobacco and other substance use in 22,245 participants age 21-59 in the United States from six waves of the National Health and Nutrition Examination Survey (NHANES). Using Joinpoint regression, we assessed secular trends of smoking and nicotine dependence as a function of co-occurring use of alcohol, prescription opioids, marijuana/hashish, cocaine/heroin/methamphetamine, or other injection drug use. Multivariable logistic regressions were fitted to identify the potential risk factors. RESULTS During 2005-2016, the prevalence of current smoking decreased (without co-occurring substance use: 17.0 %-12.7 %; with co-occurring use of one substance: 35.3 % to 24.6 %; with co-occurring use of two or more substances: 53.8 %-42.2 %), and moderate-to-severe nicotine dependence decreased as well (8.0 %-4.2 %, 16.0 %-8.8 %, and 23.9 %-15.7 %, respectively). Smoking and nicotine dependence were more likely in those with co-occurring use of one substance (current smoking: odds ratio [OR] = 2.22, 95 % confidence interval [CI] = 2.01-2.45); nicotine dependence: OR = 1.88, 95 % CI = 1.63-2.17) and in those with co-occurring use of two or more substances (current smoking: OR = 5.25, 95 % CI = 4.63-5.95; nicotine dependence: OR = 3.24, 95 % CI = 2.72-3.87). CONCLUSIONS Co-occurring substance use was associated with smaller reductions in tobacco use, over time, and with increased odds of nicotine dependence. This suggests that co-occurring substance users should be regarded as a tobacco-related disparity group and prioritized for tobacco control interventions.
Collapse
Affiliation(s)
- Yun Wang
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;,Current Institution: Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, California
| | - Ying Liu
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri;,Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri
| | - Mary Waldron
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, Indiana;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri
| | | | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Michael T. Lynskey
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, UK
| | - Pamela A. F. Madden
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Kathleen K. Bucholz
- Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Andrew C. Heath
- Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, Missouri;,Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, Missouri;,Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Min Lian
- Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States; Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, United States.
| |
Collapse
|
34
|
Dawes DE, Dunlap NJ, Johnson SM. The Surgeon's Role in Addressing Racism and Achieving Health Equity. Am Surg 2021; 87:1704-1712. [PMID: 34412516 DOI: 10.1177/00031348211038562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In the United States, the nation's health is not an organic outcome. It is not a coincidence that certain groups of people living in the United States experience higher premature death rates or poorer health outcomes than others. For centuries, racial and ethnic as well as geographic differences in health outcomes have been part of the American landscape, so entrenched in society that many people fail to recognize that health inequities were intentionally derived. A national crisis tends to magnify inequities in our society, but even more alarming is the fact that as the country becomes more racially and ethnically diverse in the coming years, the health inequities are projected to worsen if we do not proactively and immediately address them. As we continue to grapple with the lasting impact of the pandemic, it is of vital importance that we utilize this time to acknowledge, understand, and seriously address the health inequities that have historically plagued the country for over 400 years. As the United States works overtime to stem the tide of the COVID-19 pandemic, it must also work equally hard to move in a more equitable, inclusive, and healthier direction, not only because of the more than 83 000 Americans dying prematurely each year but also because of the economic and national security toll it will have if not effectively addressed.
Collapse
Affiliation(s)
- Daniel E Dawes
- Satcher Health Leadership Institute, 1374Morehouse School of Medicine, Atlanta, GA, USA
| | - Nelson J Dunlap
- Satcher Health Leadership Institute, 1374Morehouse School of Medicine, Atlanta, GA, USA
| | - Shaneeta M Johnson
- Satcher Health Leadership Institute, 1374Morehouse School of Medicine, Atlanta, GA, USA.,Department of Surgery, 1374Morehouse School of Medicine, Atlanta, GA, USA
| |
Collapse
|
35
|
Perez NB, Lanier Y, Squires A. Inequities along the Depression Care Cascade in African American Women: An Integrative Review. Issues Ment Health Nurs 2021; 42:720-729. [PMID: 33306426 DOI: 10.1080/01612840.2020.1853289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Depression represents a growing health problem and African American women (AAW) disproportionally experience increased risk and broad disparities in health care. This integrative review examines what is known about the equity of depression care provided to AAW. PubMed, PsychINFO, and Web of Science were searched through April 2020 for studies in peer-reviewed journals from 2015 to 2020. Across the studies (n = 7), AAW received inequitable care across a depression care cascade including lower rates of screening, treatment initiation, and guideline-concordant care. Here we explore individual-, relational-, and structural-level factors related to these disparities and implications for research, practice, and education.
Collapse
Affiliation(s)
| | - Yzette Lanier
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| |
Collapse
|
36
|
Pamplin JR, Bates LM. Evaluating hypothesized explanations for the Black-white depression paradox: A critical review of the extant evidence. Soc Sci Med 2021; 281:114085. [PMID: 34090157 PMCID: PMC8238891 DOI: 10.1016/j.socscimed.2021.114085] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/26/2022]
Abstract
The Black-white Depression paradox, the lower prevalence of major depression among non-Hispanic Black (relative to non-Hispanic white) individuals despite their greater exposure to major life stressors, is a phenomenon that remains unexplained. Despite a decade plus of research, there is little clarity as to whether the paradoxical observations are an invalid finding, spuriously produced by selection bias, information bias, or confounding, or are a valid finding, representative of a true racial patterning of depression in the population. Though both artefactual and etiologic mechanisms have been tested, a lack of synthesis of the extant evidence has contributed towards an unclear picture of the validity of the paradox and produced challenges for researchers in determining which proposed mechanisms show promise, which have been debunked, and which require further study. The objective of this critical review is to assess the state of the literature regarding explanations for the Black-white depression paradox by examining some of the more prominent hypothesized explanatory mechanisms that have been proposed and assessing the state of the evidence in support of them. Included mechanisms were selected for their perceived dominance in the literature and the existence of at least one, direct empirical test using DSM major depression as the outcome. This review highlights the very limited evidence in support of any of the extant putative mechanisms, suggesting that investigators should redirect efforts towards identifying novel mechanisms, and/or empirically testing those which show promise but to date have been relatively understudied. We conclude with a discussion of the broader implications of the evidence for well-accepted social theories and raise questions regarding the use of DSM major depression to assess mental health burden in Black communities.
Collapse
Affiliation(s)
- John R Pamplin
- Center for Urban Science and Progress, New York University, New York, NY, USA; Center for Opioid Epidemiology and Policy, Department of Population Health, Grossman School of Medicine, New York University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
37
|
Okosun IS, Airhihenbuwa C, Henry TL. Allostatic load, metabolic syndrome and self-rated health in overweight/obese Non-Hispanic White, non-Hispanic Black and Mexican American adults. Diabetes Metab Syndr 2021; 15:102154. [PMID: 34186341 DOI: 10.1016/j.dsx.2021.05.027] [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: 03/20/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 11/21/2022]
Abstract
AIM This study examined the associations of high allostatic load (h_ALS) and metabolic syndrome (MetS) with and self-rated poor health (SRPH) in overweight/obese non-Hispanic White (NHW), non-Hispanic Black (NHB), and Mexican American (MA) adults. METHODS The 2015-16 and 2017-18 US National Health and Nutrition Examination Survey data (n = 4403) were used for this study. RESULTS Rates of h_ALS in overweight/obese NHW, NHW, and MA participants were 56.9%, 58.8%, and 51.9%, respectively (P < .05). The corresponding rates for MetS were 26.9%, 31.9%, and 46.5%, respectively. High ALS was associated with 2.19 (95% CI: 1.87-4.59), 1.82 (1.42-2.58), and 1.47 (95% CI: 1.08-1.64) increased odds of SRPH in overweight/obese NHW, NHB, and MA, respectively, after adjusting for age, education, gender, income, lifestyle behaviors, and marital status. The corresponding values for MetS were 1.86 (95% CI: 1.54-2.40), 2.77 (95% CI: 1.36-5.63), and 1.22 (95% CI: 1.06-2.32), respectively. CONCLUSIONS The effect of h_ALS on SRPH was much stronger in NHW, while the effect of MetS was strongest among NHB overweight/obese adults. The result of this study provides further evidence in favor of race/ethnic-tailored interventions, including education and weight control to reduced risks of bodywear and tear and SRPH.
Collapse
Affiliation(s)
- Ike S Okosun
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA.
| | - Collins Airhihenbuwa
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Tracey L Henry
- Division of General Medicine and Geriatrics. Emory University School of Medicine, Atlanta, GA, 30303, USA
| |
Collapse
|
38
|
Obeng-Gyasi E, Ferguson AC, Stamatakis KA, Province MA. Combined Effect of Lead Exposure and Allostatic Load on Cardiovascular Disease Mortality-A Preliminary Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6879. [PMID: 34206881 PMCID: PMC8297236 DOI: 10.3390/ijerph18136879] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022]
Abstract
This study explores the combined effect of lead (Pb) exposure and an index of chronic physiological stress on cardiovascular disease mortality using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2008 linked to 1999-2014 National Death Index data. Chronic physiological stress was measured using the allostatic load (AL) index, which was formed by analyzing markers from the cardiovascular, inflammatory, and metabolic systems, with Pb levels, assessed using blood lead levels (BLL). The dataset was analyzed with statistical techniques to explore (a) the relationship between Pb exposure and AL, and (b) the combined role of Pb and AL on cardiovascular disease mortality. Results indicated that AL was more elevated in those with BLLs above the 50th percentile in the US population and that those with elevated AL were more likely to have high BLL. Finally, the interaction of AL and BLL significantly increased the likelihood of cardiovascular disease mortality. These findings highlight the need for considering the totality of exposures experienced by populations to build holistic programs to prevent Pb exposure and reduce stressors to promote optimal health outcomes and reduce cardiovascular mortality risk.
Collapse
Affiliation(s)
- Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA;
- Environmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA
| | - Alesia C. Ferguson
- Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USA;
| | - Katherine A. Stamatakis
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO 63103, USA;
| | - Michael A. Province
- Department of Genetics, Washington University School of Medicine St. Louis, St. Louis, MO 63130, USA;
| |
Collapse
|
39
|
Rojas LM, Sanchez M, Westrick A, Vazquez V, Cano MA, De La Rosa MR. Socio-Cultural Subgroups of Latina/o Immigrants: A Latent Profile Analysis. INTERNATIONAL JOURNAL OF INTERCULTURAL RELATIONS : IJIR 2021; 82:185-196. [PMID: 33967359 PMCID: PMC8098717 DOI: 10.1016/j.ijintrel.2021.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Socio-cultural factors, such as familismo, social support, machismo, and multigroup ethnic identity, are strongly associated with Latina/o immigrants' alcohol misuse and depressive symptoms. However, research has rarely explored whether unobserved groups of Latina/o immigrants with similar socio-cultural factors exist. Latent Profile analysis can illuminate which subgroups to target, or which socio-cultural factors need to be supported, to have an impact on the prevention and treatment of alcohol use and/or depression in the Latina/o immigrant population. Cross sectional data from on ongoing longitudinal investigation was utilized (N= 518 Latina/o adults living in Miami-Dade County, Florida and have immigrated to the US within one year prior to assessment). Latent Profile Analyses (LPA) were conducted utilizing validated measures of familismo, social support, neighborhood collective efficacy, ethnic identity, machismo, caballerismo, and marianismo. The LPA revealed three, significantly different profiles: (1) low socio-cultural protection (n=155, 29.98%), (2) high socio-cultural protection (n=21, 4.06%), and (3) high socio-, low-cultural protection (n=341, 65.96%). Profile membership was associated significantly with immigrant documentation status, education level, and past family history of substance use. Results indicate that Latina/o immigrants in the low socio-cultural protection group had significantly higher alcohol use compared to high socio-, low cultural protection group. No significant differences were found for depressive symptoms. We discuss implications of our findings and encourage researchers to continue to unpack the complexities associated with socio-cultural factors and Latina/o mental and behavioral health. Specifically, research should focus on socio-cultural factors can provide protection from negative health outcomes and increase resiliency among this population.
Collapse
Affiliation(s)
- Lourdes M. Rojas
- 1575 San Ignacio Ave, Penthouse, Coral Gables, Florida, 33146, Center for Advanced Analytics, Baptist Health South Florida
| | - Mariana Sanchez
- 11200 SW 8 Street, AHC5-423, Miami, Florida, 33199, Florida International University, Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA)
| | - Ashly Westrick
- 11200 SW 8 Street, AHC5-423, Miami, Florida, 33199, Florida International University, Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA)
| | - Vicky Vazquez
- 11200 SW 8 Street, AHC5-423, Miami, Florida, 33199, Florida International University, Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA)
| | - Miguel A. Cano
- 11200 SW 8 Street, AHC5-423, Miami, Florida, 33199, Florida International University, Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA)
| | - Mario R. De La Rosa
- 11200 SW 8 Street, AHC5-423, Miami, Florida, 33199, Florida International University, Center for Research on US Latino HIV/AIDS and Drug Abuse (CRUSADA)
| |
Collapse
|
40
|
Pamplin JR, Kezios KL, Hayes-Larson E, Keyes KM, Susser ES, Factor-Litvak P, Link BG, Bates LM. Explaining the Black-white depression paradox: Interrogating the Environmental Affordances Model. Soc Sci Med 2021; 277:113869. [PMID: 33892418 PMCID: PMC8119386 DOI: 10.1016/j.socscimed.2021.113869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 01/06/2023]
Abstract
The Environmental Affordances (EA) model posits that Black Americans' engagement with unhealthy behaviors (i.e. smoking, alcohol use, eating calorie-dense foods) to cope with stressor exposure may simultaneously account for their observed greater risk of chronic physical illness, and their observed equal or lesser prevalence of depression, relative to white Americans - the so-called "Black-white depression paradox." However, the specific mechanisms through which such effects might arise have been theorized and analyzed inconsistently across studies, raising concerns regarding the appropriateness of existing empirical tests of the model as well as the validity of the conclusions. We specify the two mechanisms most consistent with the EA model - 'Mediation-only' and 'Mediation and Modification' - and derive a priori predictions based on each. We systematically test these pathways using a subset of 559 participants of the Child Health and Development Study who were included in an adult follow-up study between 2010 and 2012 and self-identified as Black or white. Results failed to support either of the two mechanisms derived from the EA model, challenging the validity and utility of the model for explaining racial differences in depression; efforts to develop alternative hypotheses to explain the paradox are needed.
Collapse
Affiliation(s)
- John R Pamplin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Center for Urban Science and Progress, New York University, New York, NY, USA.
| | - Katrina L Kezios
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ezra S Susser
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Bruce G Link
- Department of Sociology, University of California Riverside, Riverside, CA, USA; School of Public Policy, University of California Riverside, Riverside, CA, USA
| | - Lisa M Bates
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| |
Collapse
|
41
|
Depressive symptoms, childhood maltreatment, and allostatic load: The importance of sex differences. Psychoneuroendocrinology 2021; 126:105130. [PMID: 33493752 DOI: 10.1016/j.psyneuen.2021.105130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Roughly half the individuals who experience childhood maltreatment also experience depressive symptoms in adulthood; however, many current treatments are ineffective. Allostatic load (AL) offers a method of exploring this relationship through the lens of biometric dysregulation that may explain these increased odds for depressive symptoms in adulthood. We attempted to expand the limited research base on AL, depressive symptoms, and childhood maltreatment by examining how these variables are associated in a U.S. community sample. METHOD Data were acquired through secondary analysis of the Midlife in the United States Refresher biomarker survey (n = 691). Depression severity, measured by the Center for Epidemiologic Studies Depression Scale, served as the dependent variable, while summed scores for the Childhood Trauma Questionnaire, and a 16 measure AL index served as independent variables. All analyses were stratified by sex (n male = 347, n female = 344). The Perceived Stress Scale was included to control for recent stress. An OLS regression was used to understand the relationship between depression and predictor variables before then being tested for the possible mediating role of AL. RESULTS Comparison of OLS models yielded notable differences in predicting depressive symptoms between males and females, namely that while maltreatment was significant for both groups, AL was only significant for females. Mediation by allostatic load was not significant for males or females. CONCLUSION We explored the possible mediation of childhood maltreatment and adulthood depressive symptoms by AL. While our study did not confirm mediation, this was the first known study to explore these relationships in a U.S., community sample. Sex stratification reveals a clear need for accounting for sex differences in predictor variables for future studies.
Collapse
|
42
|
Cartujano-Barrera F, Lee D’Abundo M, Arana-Chicas E, Chock S, Valera P, Kamen CS, Cupertino AP. Barriers and Facilitators of Smoking Cessation among Latinos Living with HIV: Perspectives from Key Leaders of Community-Based Organizations and Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073437. [PMID: 33810269 PMCID: PMC8036939 DOI: 10.3390/ijerph18073437] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to identify the perspectives from key leaders of community-based organizations (CBOs) and clinics serving people living with HIV on barriers and facilitators of smoking cessation among Latino smokers living with HIV. Semi-structured interviews were conducted in English and Spanish with 10 key leaders. Using a social ecological model, qualitative theoretical analysis was used to analyze the results. Participants identified barriers at the individual (e.g., low education level, HIV, and financial stress), interpersonal (e.g., language barriers, low social support), organizational (e.g., lack of smoking cessation resources and targeted interventions), community (e.g., HIV and mental health stigma), and policy (e.g., paperwork for insurance) level. Participants identified facilitators at the individual (e.g., high participation in trials, good medication adherence), interpersonal (e.g., no smoking in social circles), organizational (e.g., bilingual staff, culturally competent care), community (e.g., providing transportation, the coronavirus disease 2019 as an opportunity for smoking cessation), and policy level (e.g., existence of funding, comprehensive insurance programs). These results provide operational strategies to address smoking disparities among Latino smokers living with HIV. Further research is needed on how to integrate these perspectives into effective smoking cessation interventions.
Collapse
Affiliation(s)
- Francisco Cartujano-Barrera
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
- Correspondence: ; Tel.: +1-585-353-0035
| | - Michelle Lee D’Abundo
- Department of Interprofessional Health Sciences and Health Administration, Seton Hall University, Nutley, NJ 07110, USA;
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Surina Chock
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Pamela Valera
- Department of Urban-Global Public Health, Rutgers University, Newark, NJ 07102, USA;
| | - Charles S. Kamen
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA; (E.A.-C.); (S.C.); (C.S.K.); (A.P.C.)
| |
Collapse
|
43
|
Yu X, Quante M, Rueschman M, Ash T, Kaplan ER, Guo N, Horan CM, Haneuse S, Davison K, Taveras EM, Redline S. Emergence of racial/ethnic and socioeconomic differences in objectively measured sleep-wake patterns in early infancy: results of the Rise & SHINE study. Sleep 2021; 44:zsaa193. [PMID: 33057653 PMCID: PMC7953214 DOI: 10.1093/sleep/zsaa193] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/30/2020] [Indexed: 01/20/2023] Open
Abstract
STUDY OBJECTIVES To characterize objectively assessed sleep-wake patterns in infants at approximately 1 month and 6 months and examine the differences among infants with different racial/ethnic backgrounds and household socioeconomic status (SES). METHODS Full-term healthy singletons wore an ankle-placed actigraph at approximately 1 month and 6 months and parents completed sleep diaries. Associations of racial/ethnic and socioeconomic indices with sleep outcomes were examined using multivariable analyses. Covariates included sex, birth weight for gestational age z-score, age at assessment, maternal education, household income, bed-sharing, and breastfeeding. RESULTS The sample included 306 infants, of whom 51% were female, 42.5% non-Hispanic white, 32.7% Hispanic, 17.3% Asian, and 7.5% black. Between 1 month and 6 months, night sleep duration increased by 65.7 minutes (95% CI: 55.4, 76.0), night awakenings decreased by 2.2 episodes (2.0, 2.4), and daytime sleep duration decreased by 73.3 minutes (66.4, 80.2). Compared to change in night sleep duration over this development period for white infants (82.3 minutes [66.5, 98.0]), night sleep increased less for Hispanic (48.9 minutes [30.8, 66.9]) and black infants (31.6 minutes [-5.9, 69.1]). Night sleep duration also increased less for infants with lower maternal education and household income. Asian infants had more frequent night awakenings. Adjustment for maternal education and household income attenuated all observed day and night sleep duration differences other than in Asians, where persistently reduced nighttime sleep at 6 months was observed. CONCLUSIONS Racial/ethnic differences in sleep emerge in early infancy. Night and 24-hour sleep durations increase less in Hispanic and black infants compared to white infants, with differences largely explained by SES.
Collapse
Affiliation(s)
- Xinting Yu
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- School of Social Work, Boston College, Chestnut Hill, MA
| | - Mirja Quante
- Department of Neonatology, University of Tuebingen, Tuebingen, Germany
| | - Michael Rueschman
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Tayla Ash
- Center for Health Equity Research, Brown University School of Public Health, Providence, RI
- Department of Behavioral & Social Sciences, Brown University School of Public Health, Providence, RI
| | - Emily R Kaplan
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Na Guo
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | - Christine M Horan
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Kirsten Davison
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
- School of Social Work, Boston College, Chestnut Hill, MA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA
| | - Susan Redline
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| |
Collapse
|
44
|
Langellier BA, Fleming PJ, Kemmick Pintor JB, Stimpson JP. Allostatic Load Among U.S.- and Foreign-Born Whites, Blacks, and Latinx. Am J Prev Med 2021; 60:159-168. [PMID: 33339663 DOI: 10.1016/j.amepre.2020.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/16/2020] [Accepted: 08/05/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The objective of this study is to examine how allostatic load, a multidimensional measure of the body's cumulative response to stressors experienced throughout the life course, has changed over time and by age among U.S.- and foreign-born Whites, Blacks, and Latinx. METHODS Data were from 26,818 adult participants in the 2005-2018 National Health and Nutrition Examination Survey, a national repeated cross-sectional study. Allostatic load was measured based on 10 indicators of cardiovascular, metabolic, and immunologic risk. The analyses were conducted in March 2020. RESULTS Allostatic load increased over time across all groups. The difference between the first and last survey cycle was greatest among U.S.-born Black women (from 2.74 in 2005-2006 to 3.02 in 2017-2018), U.S.-born Latino men (from 2.69 to 3.09) and foreign-born Latino men (from 2.58 to 2.87). Aging gradients in allostatic load were steepest among foreign-born Blacks of both genders and foreign-born Latina women and flattest among U.S.-born and foreign-born Whites. CONCLUSIONS Chronic exposure to stressors leads to an erosion of health that is particularly severe among foreign-born Blacks and Latinx. Policies should seek to reduce exposure to structural and environmental risks and to ensure equitable opportunities to achieve optimal health among racial/ethnic minorities and immigrants.
Collapse
Affiliation(s)
- Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Paul J Fleming
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jessie B Kemmick Pintor
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Jim P Stimpson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| |
Collapse
|
45
|
Hughes JL, Morrow KE, Spears SK, Gentzler AL. Mothers' and children's depression is linked through children's perceptions of attachment security. INFANT AND CHILD DEVELOPMENT 2020. [DOI: 10.1002/icd.2208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Jeffrey L. Hughes
- Department of Psychology, West Virginia University Morgantown West Virginia USA
| | - Kayley E. Morrow
- Department of Psychology, West Virginia University Morgantown West Virginia USA
| | - Shantel K. Spears
- Department of Psychology, West Virginia University Morgantown West Virginia USA
| | - Amy L. Gentzler
- Department of Psychology, West Virginia University Morgantown West Virginia USA
| |
Collapse
|
46
|
Kerr P, Kheloui S, Rossi M, Désilets M, Juster RP. Allostatic load and women's brain health: A systematic review. Front Neuroendocrinol 2020; 59:100858. [PMID: 32758482 DOI: 10.1016/j.yfrne.2020.100858] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023]
Abstract
Allostatic load represents the 'wear and tear' of chronic stress on the brain and body that may differ between men and women. A small but growing number of studies are assessing allostatic load in relation to mental health. The objective of this systematic review was to (1) assess sex differences in allostatic load and (2) identify allostatic load associations that are specific to women. We systematically searched for allostatic load studies that included psychosocial causes and/or psychiatric consequences. Our search focused on allostatic load studies that disaggregated by sex and that include women. Sixty-two studies were included in this systematic review. First, men appear to have higher allostatic load than women. Second, women show gender-specific variation for numerous factors such as age, race/ethnicity, adversities, social support, and health behaviors that influence associations between allostatic load and mental health. Recommendations are made to guide researchers advance sex and gender approaches.
Collapse
Affiliation(s)
- Philippe Kerr
- Center on Sex*Gender, Allostasis and Resilience, Canada; Center for Studies on Human Stress, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Sarah Kheloui
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Mathias Rossi
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada
| | - Marie Désilets
- Research Center of the Montreal Mental Health University Institute, Canada
| | - Robert-Paul Juster
- Center on Sex*Gender, Allostasis and Resilience, Canada; Research Center of the Montreal Mental Health University Institute, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Canada.
| |
Collapse
|
47
|
Allen JO, Watkins DC, Mezuk B, Chatters L, Johnson-Lawrence V. Mechanisms of Racial Health Disparities: Relationships between Coping and Psychological and Physiological Stress Responses. Ethn Dis 2020; 30:563-574. [PMID: 32989356 PMCID: PMC7518539 DOI: 10.18865/ed.30.4.563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective Psychological distress and physiological dysregulation represent two stress response pathways linked to poor health and are implicated in racial disparities in aging-related health outcomes among US men. Less is known about how coping relates to these stress responses. The purpose of this exploratory study was to examine whether midlife and older men's coping strategies and behaviors accounted, in part, for Black-White disparities in men's psychological and physiological stress responses. Methods We examined racial differences in 12 coping strategies (COPE Inventory subscales, religious/spiritual coping, and behaviors such as stress eating and substance use) and their relationships with psychological distress (Negative Affect scale) and physiological dysregulation (blunted diurnal cortisol slopes) using regression models and cross-sectional data from 696 Black and White male participants aged 35-85 years in the National Survey of Midlife Development in the United States (MIDUS) II, 2004-2006. Results Black men exhibited more psychological distress and physiological dysregulation than White men. Black and White men reported comparable use of most coping strategies, none of which demonstrated similar relationships with both stress responses. Coping strategies explained variations in psychological distress consistent with conventional protective-harmful categorizations. Coping accounted for racial disparities in men's psychological distress, as Black men reported using harmful strategies more often and were more susceptible to their negative effects. Neither differential use of coping strategies nor differing relationships accounted for racial disparities in physiological dysregulation. Conclusions Findings revealed complex relationships between coping and psychological and physiological stress responses and suggest the importance of differing approaches to reducing associated racial health disparities among men.
Collapse
Affiliation(s)
- Julie Ober Allen
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, MI
| | | | - Briana Mezuk
- School of Public Health, University of Michigan, Ann Arbor, MI
| | - Linda Chatters
- Schools of Social Work and Public Health, University of Michigan, Ann Arbor, MI
| | - Vicki Johnson-Lawrence
- College of Human Medicine, Family Medicine, Division of Public Health, Michigan State University, Flint, MI
| |
Collapse
|
48
|
Pre-diagnostic allostatic load and health-related quality of life in a cohort of Black breast cancer survivors. Breast Cancer Res Treat 2020; 184:901-914. [PMID: 32914357 DOI: 10.1007/s10549-020-05901-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 08/29/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To determine the association of pre-diagnostic allostatic load (AL) with health-related quality of life (HRQOL) among Black women with breast cancer. METHODS In a sample of 409 Black women with non-metastatic breast cancer enrolled in the Women's Circle of Health Follow-Up Study (WCHFS), two pre-diagnostic AL measures were estimated using medical records data from up to 12 months prior to breast cancer diagnosis: AL-lipid/metabolic profile-based measure and AL-inflammatory profile-based measure. HRQOL was assessed approximately 24 months post diagnosis, using the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) instrument, including 5 subscale scores [presented by physical well-being (PWB), social & family well-being (SFWB), emotional well-being (EWB), functional well-being (FWB), and breast cancer-specific scale (BCS)] and 3 derived total scores [presented by trial outcome index (TOI), Functional Assessment of Cancer Therapy-General (FACT-G) and FACT-B]. We used multivariable logistic regression models, using dichotomized AL scores (lower AL: 0-3 points, higher AL: 4-8 points), to assess the associations between the two pre-diagnostic AL measures and HRQOL. RESULTS Higher pre-diagnostic AL was associated with poorer FWB and lower FACT-G, but these associations were statistically significant for the AL-inflammatory profile-based measure (FWB: OR 1.63, 95% CI 1.04, 2.56; FACT-G: OR 1.62, 95% CI 1.04, 2.54), but not the AL-lipid/metabolic profile-based measure (FWB: OR 1.45, 95% CI 0.81, 2.59; FACT-G: OR 1.33, 95% CI 0.75, 2.37). CONCLUSION These findings suggest that higher AL, particularly when measured using the inflammatory profile-based measure, was associated with poorer HRQOL, namely FWB and FACT-G, among Black breast cancer survivors.
Collapse
|
49
|
Still CH, Tahir S, Yarandi HN, Hassan M, Gary FA. Association of Psychosocial Symptoms, Blood Pressure, and Menopausal Status in African-American Women. West J Nurs Res 2020; 42:784-794. [PMID: 32590927 DOI: 10.1177/0193945919898477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
African-American women have disproportionate rates of hypertension that can be further complicated as they transition through menopause. Stress, coupled with depression and hypertension in perimenopausal African-American women has not been fully explored. This study examines the associations of stress, depression, and social support on systolic blood pressure (SBP) among a sample of 184 perimenopausal African-American women. We used descriptive statistics, Pearson's correlation, and logistic regression to analyze data stratified by menopausal status (perimenopausal or menopausal) and SBP status (<130 mmHg vs. >130 mmHg). Women classified as menopausal reported higher levels of stress and depressive symptoms, and lower levels of social support. Age, body mass index (BMI), health insurance, and perceived health status were significant predictors of SBP in menopausal women. Stress, depression, and social support did not play a role in SBP. It is necessary that future research focus on reducing cardiovascular risk include addressing menopausal health.
Collapse
Affiliation(s)
- Carolyn H Still
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Sadia Tahir
- College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, USA
| | - Hossein N Yarandi
- College of Nursing, Office of Health Research, Wayne State University, Detroit, MI, USA
| | - Mona Hassan
- College of Nursing, Prairie View A&M University, Houston, TX, USA
| | - Faye A Gary
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
50
|
Scheuermann TS, Onge JMS, Ramaswamy M, Cox LS, Ahluwalia JS, Nollen NL. The Role of Neighborhood Experiences in Psychological Distress among African American and White Smokers. RACE AND SOCIAL PROBLEMS 2020; 12:133-144. [PMID: 34084252 PMCID: PMC8172079 DOI: 10.1007/s12552-020-09281-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Residential area characteristics and discrimination have been associated with psychological distress. Differences in these relationships across racial groups are not well understood. We examined the relative role of perceived discrimination, neighborhood problems and neighborhood cohesion/trust in explaining differences in psychological distress (indicated by anxiety and depressive symptoms) between 224 African American and 225 White smokers (income ≤ 400% federal poverty level) in a smoking cessation intervention study. Surveys were linked to US census-tract data. We conducted random intercept Poisson multi-level regression models and examined interactions between race and neighborhood experiences. African Americans had greater risk of anxiety and depressive symptoms and greater individual and neighborhood disadvantage than Whites. Controlling for objective neighborhood characteristics, when perceived discrimination and perceived neighborhood characteristics were added to the regression models the association between anxiety symptoms and race were no longer statistically significant; the association between depressive symptoms and race decreased but remained statistically significant. Lower neighborhood social cohesion/trust and greater neighborhood problems increased depressive symptoms for African Americans, but not for Whites. Perceived discrimination and neighborhood social cohesion/trust outweighed the importance of race in explaining anxiety symptoms. These findings underscore the need for multi-level interventions addressing social and environmental contexts.
Collapse
Affiliation(s)
- Taneisha S. Scheuermann
- Department of Population Health, University of Kansas
School of Medicine, Kansas City, KS, USA
| | - Jarron M. Saint Onge
- Department of Population Health, University of Kansas
School of Medicine, Kansas City, KS, USA
- Department of Sociology, University of Kansas, Lawrence,
USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas
School of Medicine, Kansas City, KS, USA
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas
School of Medicine, Kansas City, KS, USA
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown
University School of Public Health, Providence, RI, USA
| | - Nicole L. Nollen
- Department of Population Health, University of Kansas
School of Medicine, Kansas City, KS, USA
| |
Collapse
|