scholarly journals Multidimensional Sleep Health: Concepts, Advances, and Implications for Research and Intervention

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 338-338
Author(s):  
Joon Chung ◽  
Matthew Goodman ◽  
Tianyi Huang ◽  
Suzanne Bertisch ◽  
Susan Redline
Keyword(s):  
Ethnic Disparities ◽  
Sleep Health ◽  
Multiple Components ◽  
Multiple Dimensions ◽  
Complex Process ◽  
Measurement Tools ◽  
Health Concepts ◽  
Aging Adults ◽  
Racial Ethnic ◽  
Multiple Health

Abstract Sleep is a complex process, sensitive to aging, with theoretical and evidentiary basis for influence on multiple health outcomes. Recent scholarship has argued for a ‘multi-dimensional’ approach to sleep health, that is, a recognition that healthy sleep consists of more than its quantity (duration) and is more than the absence of sleep disorders. This new conception of sleep health acknowledges sleep’s complexity yet presents challenges for methodological treatment. How do we operationalize/analyze multiple dimensions of sleep, some of which are correlated due to physiological reasons, common measurement tools, or sensitivity to common stressors? Is it sensible to talk about ‘sleep health’ as a single, composite entity with multiple components, akin to a dietary pattern rather than a collection of individual nutrients? Exemplar data from a racial-ethnic disparities project in aging adults suggest the utility of a composite approach, and the value of considering inter-correlations among sleep metrics.

scholarly journals Racial/ethnic disparities in sleep health and health care: importance of the sociocultural context

Sleep Health ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Natasha J. Williams ◽  
Michael A. Grandner ◽  
Shedra A. Snipes ◽  
April Rogers ◽  
Olajide Williams ◽  
...  
Keyword(s):  
Health Care ◽  
Ethnic Disparities ◽  
Sociocultural Context ◽  
Sleep Health ◽  
Racial Ethnic

scholarly journals Racial/Ethnic Disparities in Sleep Health and Potential Interventions Among Women in the United States

2020 ◽  
Vol 29 (3) ◽  
pp. 435-442 ◽  
Author(s):  
Chandra L. Jackson ◽  
Tiffany M. Powell-Wiley ◽  
Symielle A. Gaston ◽  
Marcus R. Andrews ◽  
Kosuke Tamura ◽  
...  
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
The United States ◽  
Sleep Health ◽  
Racial Ethnic

Exposure to Discrimination and Sleep

2019 ◽  
pp. 257-324
Author(s):  
Tené T. Lewis, PhD ◽  
Izraelle I. McKinnon
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Social Determinant ◽  
Future Research ◽  
Sleep Health ◽  
Strong Focus ◽  
The Relationship ◽  
Racial Ethnic ◽  
Important Measurement

This chapter focuses on how discrimination can impact sleep health, with an emphasis on stress as a mediator in the relationship. Given that the vast majority of sleep research on discrimination focuses on racial discrimination, this type of discrimination is the focus of the chapter. Measurement of discrimination is a strong focus of the chapter as well as mechanisms linking discrimination to sleep health, including psychosocial stress. The chapter begins by highlighting discrimination as an important social determinant in the lives of racial/ethnic minority groups in the United States, followed by key findings linking experiences of discrimination to both self-reported and objective indices of sleep and important measurement issues relevant to the study of discrimination and sleep. How studies of discrimination and sleep have contributed to the understanding of racial/ethnic disparities in sleep is also considered. The chapter closes by discussing critical gaps in knowledge and potential directions for future research.

Race as a Social Determinant of Sleep Health

2019 ◽  
pp. 167-186
Author(s):  
Rebecca Robbins ◽  
Azizi Seixas ◽  
Natasha Williams ◽  
Byoungjun Kim ◽  
Judite Blanc ◽  
...  
Keyword(s):  
Ethnic Disparities ◽  
Social Determinant ◽  
Data Sets ◽  
Social Categories ◽  
Sleep Health ◽  
Intersectionality Theory ◽  
Nationally Representative ◽  
Using Data ◽  
Measurement Artifact ◽  
Racial Ethnic

This chapter focuses on racial/ethnic disparities in sleep, including Black–White differences in sleep health using data from nationally representative data sets. It also examines reasons for racial/ethnic disparities in sleep, including measurement artifact, biological/genetic differences, and the social and economic influences that influence sleep health in racial and ethnic minorities. Some of the factors that may contribute to racial/ethnic differences in sleep health include genetic, biological, physiological, psychological, behavioral, cultural, and environmental differences across these populations The chapter draws upon intersectionality theory, a framework that acknowledges how multiple social categories (e.g., race, ethnicity, employment, socioeconomic status) intersect with macro-level phenomena and reflect multiple interlocking systems of privilege that present real consequences for sleep and health.

Study finds racial/ethnic disparities in depressive trajectories among middle-aged or older adults

2012 ◽  
Author(s):  
J. Liang ◽  
X. Xu ◽  
A. R. Quinones ◽  
J. M. Bennett ◽  
W. Ye
Keyword(s):  
Older Adults ◽  
Ethnic Disparities ◽  
Middle Aged ◽  
Racial Ethnic

1489-P: Racial/Ethnic Disparities in Deaths Due to Diabetes, Diabetes Ketoacidosis, and Diabetic Coma among Those Aged 1-44 Years: 1999-2017, United States

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1489-P
Author(s):  
SHARON SHAYDAH ◽  
GIUSEPPINA IMPERATORE ◽  
CARLA MERCADO ◽  
KAI M. BULLARD ◽  
STEPHEN R. BENOIT
Keyword(s):  
United States ◽  
Ethnic Disparities ◽  
Diabetic Coma ◽  
Racial Ethnic

scholarly journals Association Between Out-Of-Pocket Costs, Race/Ethnicity, and Adjuvant Endocrine Therapy Adherence Among Medicare Patients With Breast Cancer

2017 ◽  
Vol 35 (1) ◽  
pp. 86-95 ◽  
Author(s):  
Albert J. Farias ◽  
Xianglin L. Du
Keyword(s):  
Breast Cancer ◽  
Endocrine Therapy ◽  
Ethnic Disparities ◽  
Medication Possession Ratio ◽  
Adjuvant Endocrine Therapy ◽  
Hormone Receptor Positive ◽  
Medication Costs ◽  
Poverty Status ◽  
Racial Ethnic ◽  
Out Of Pocket Costs

Purpose Previous studies suggest that adherence to adjuvant endocrine therapy (AET) for patients with breast cancer is suboptimal, especially among minorities, and is associated with out-of-pocket medication costs. This study aimed to determine whether there are racial/ethnic differences in 1-year adherence to AET and whether out-of-pocket costs explain the racial/ethnic disparities in adherence. Methods This retrospective cohort study used the SEER-Medicare linked database to identify patients ≥ 65 years of age with hormone receptor–positive breast cancer who were enrolled in Medicare Part D from 2007 to 2009. The cohort included non-Hispanic whites, blacks, Hispanics, and Asians. Out-of-pocket costs for AET medications were standardized for a 30-day supply. Adherence to tamoxifen, aromatase inhibitors (AIs), and overall AET (tamoxifen or AIs) was assessed using the medication possession ratio (≥ 80%) during the 12-month period. Results Of 8,688 patients, 3,197 (36.8%) were nonadherent to AET. Out-of-pocket costs for AET medication were associated with lower adjusted odds of adherence for all four cost categories compared with the lowest category of ≤ $2.65 ( P < .01). In the univariable analysis, Hispanics had higher odds of adherence to any AET at initiation (OR, 1.30; 95% CI, 1.07 to 1.57), and blacks had higher odds of adherence to AIs at initiation (OR, 1.27; 95% CI, 1.04 to 1.54) compared with non-Hispanic whites. After adjusting for copayments, poverty status, and comorbidities, the association was no longer significant for Hispanics (OR, 0.95; 95% CI, 0.78 to 1.17) or blacks (OR, 0.96; 95% CI, 0.77 to 1.19). Blacks had significantly lower adjusted odds of adherence than non-Hispanic whites when they initiated AET therapy with tamoxifen (OR, 0.54; 95% CI, 0.31 to 0.93) after adjusting for socioeconomic, clinic, and prognostic factors. Conclusion Racial/ethnic disparities in AET adherence were largely explained by women's differences in socioeconomic status and out-of-pocket medication costs.

scholarly journals Geographic Regional Variation in Patterns of Racial and Ethnic Disparities in Late-Life Depression

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Chirag Vyas ◽  
Charles Reynolds ◽  
David Mischoulon ◽  
Grace Chang ◽  
Olivia Okereke
Keyword(s):  
Native American ◽  
Ethnic Differences ◽  
Ethnic Disparities ◽  
Late Life ◽  
Geographic Region ◽  
Omega 3 ◽  
Late Life Depression ◽  
Item Level ◽  
Racial Ethnic ◽  
Hispanic White

Abstract There is evidence of racial/ethnic disparities in late-life depression (LLD) burden and treatment in the US. Geographic region may be a novel social determinant; yet, limited data exist regarding the interplay of geographic region with racial/ethnic differences in LLD severity, item-level symptom burden and treatment. We conducted a cross-sectional study among 25,503 men aged 50+ years and women aged 55+ years in VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary study to the VITAL trial. Racial/ethnic groups included Non-Hispanic White, Black, Hispanic, Asian, and other groups (Native American/Alaskan Native and other/multiple/unspecified-race/ethnicity). We assessed depression status using: the Patient Health Questionnaire-8 (PHQ-8); self-reported clinician/physician diagnosis of depression; medication and/or counseling treatment for depression. In the full sample, Midwest region was significantly associated with 12% lower severity of LLD, compared to Northeast region (rate ratio (RR) (95% confidence interval (CI)): 0.88 (0.83-0.93)). However, racial/ethnic differences in LLD varied by region. For example, in the Midwest, Blacks and Hispanics had significantly higher depression severity compared to non-Hispanic Whites (RR (95% CI): for Black, 1.16 (1.02-1.31); for Hispanic, 2.03 (1.38-3.00)). Furthermore, in multivariable-adjusted logistic regression models, minority vs. non-Hispanic White adults had 2- to 3-fold significantly higher odds of several item-level symptoms across all regions, especially in the Midwest and Southwest. Finally, among those endorsing PHQ-8≥10, Blacks had 60-80% significantly lower odds of depression treatment, compared to non-Hispanic Whites, in all regions. In summary, we observed significant geographic variation in patterns of racial/ethnic disparities in LLD outcomes. This requires further longitudinal investigation.

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