Health risk behaviours and allostatic load: A systematic review

Suvarna, Beena; Suvarna, Aditya; Phillips, Riana; Juster, Robert‐Paul; McDermott, Brett; Sarnyai, Zoltán

doi:10.1016/j.neubiorev.2019.12.020

Cited by 104 publications

(71 citation statements)

References 176 publications

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“…12 13 A recent review of empirical studies provided a somewhat discordant picture, reporting some null results for the association between smoking and AL, and divergent directions for the association between alcohol intake and AL. 29 Methodological differences across studies, including early life versus adult populations, and cross-sectional versus longitudinal study designs, should be acknowledged. In a longitudinal assessment of 35-year-old individuals, Robertson et al found a significant mediator role for smoking, but not for alcohol, affecting the social gradient in AL.…”

Section: Discussionmentioning

confidence: 99%

Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

Veronesi

Kee

Hicks

et al. 2020

J Epidemiol Community Health

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BackgroundWe investigate whether socially disadvantaged individuals are more susceptible to the detrimental effects of smoking and alcohol intake on allostatic load (AL), a marker of physiological ‘wear and tear’, resulting from adaptation to chronic stress.MethodsIn a cross-sectional analysis, 27 019 men and 26 738 women aged 35–74 years were identified from 21 European cohorts in the BiomarCaRE consortium. We defined three educational classes (EDs) according to years of schooling and an AL score as the sum of z-scores of eight selected biomarkers from the cardiovascular, metabolic and inflammatory systems. We used the Oaxaca-Blinder decomposition to disentangle the ED gradient in AL score into the differential exposure (DE, attributable to different distribution of smoking and alcohol intake across EDs) and the differential susceptibility (DS, attributable to a different effect of risk factors on AL across EDs) components.ResultsLess-educated men (mean AL difference: 0.68, 95% CI 0.57 to 0.79) and women (1.52, 95% CI 1.40 to 1.64) had higher AL scores. DE accounted for 7% and 6% of the gradient in men and women, respectively. In men, combining smoking and alcohol intake, DS accounted for 42% of the gradient (smoking DS coefficient=0.177, 26% of the gradient; alcohol DS coefficient=0.109; 16%, not statistically significant). DS contribution increased to 69% in metabolic markers. DS estimates were consistent across age groups, irrespective of comorbidities and robust to unmeasured confounding. No DS was observed in women.ConclusionsIn men, a DS mechanism substantially contributes to the educational class gradient in allostatic load.

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Section: Discussionmentioning

confidence: 99%

Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

Veronesi

Kee

Hicks

et al. 2020

J Epidemiol Community Health

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“…One such mechanism is chronic exposure to stress resulting in the accumulation of allostatic load, which undermines the physical health and reproductive potential of BWBP (Lu et al 2010 ). Moreover, even in the presence of social and structural supports, chronic exposure to unique stressors related to pervasive gendered racism may contribute to diminished mental well-being and coping behaviors that elevate risk for or exacerbate chronic health conditions (Suvarna et al 2019 ) and exacerbate maternal morbidity and mortality risks. Another key mechanism is the impact of healthcare actions or inactions, rooted in systemic racism endemic to healthcare systems, on maternal morbidity and mortality (Hall et al 2015 ).…”

Section: Endemic Vulnerabilities and Disparities Among Black Women Anmentioning

confidence: 99%

Syndemic Perspectives to Guide Black Maternal Health Research and Prevention During the COVID-19 Pandemic

Lemke

Brown

2020

Matern Child Health J

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The coronavirus 2019 (COVID-19) pandemic and related policies have led to an unequal distribution of morbidity and mortality in the U.S. For Black women and birthing people, endemic vulnerabilities and disparities may exacerbate deleterious COVID-19 impacts. Historical and ongoing macro-level policies and forces over time have induced disproportionately higher rates of maternal morbidity and mortality among Black women and birthing people, and contemporary macroeconomic and healthcare policies and factors continue to hold particular consequence. These factors induce detrimental psychological, health, and behavioral responses that contribute to maternal health disparities. The COVID-19 pandemic is likely to disproportionately impact Black women and birthing people, as policy responses have failed to account for the their unique socioeconomic and healthcare contexts. The resulting consequences may form a 'vicious cycle', with upstream impacts that exacerbate upstream macro-level policies and forces that can further perpetuate the clustering of maternal morbidity and mortality in this population. Understanding the impacts of COVID-19 among Black women and birthing people requires theoretical frameworks that can sufficiently conceptualize their multi-level, interacting, and dynamic nature. Thus, we advocate for the proliferation of syndemic perspectives to guide maternal disparities research and prevention during the COVID-19 pandemic. These perspectives can enable a holistic and nuanced understanding of the intersection of endemic and COVID-19-specific vulnerabilities and disparities experienced by Black women and birthing people. Syndemic-informed research can then lead to impactful multi-level prevention strategies that simultaneously tackle both endemic and COVID-19-specific factors and outcomes that lead to the clustering of vulnerabilities and disparities over time.

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“…With this in mind it is not surprising to see that Native Americans were two to three times more likely to have psychological distress comorbidity with diabetes, stroke, and angina in unadjusted results, given how this group has been historically and currently treated in the Unites States (Findling et al, 2019). Stress arising from discrimination is shown to have a direct impact on both physical and mental health through physiological pathways (Carter et al, 2017;Suvarna et al, 2020). Some researchers have theorized that individuals exposed to chronic stressors (like discrimination stress) are more likely to engage in poor health behaviors, including smoking, drinking, drug use, and overeating as these are accessible coping strategies for dealing with stress (Boateng-Poku et al, 2020;Jackson et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Medical and Mental Health Comorbidities Among Minority Racial/Ethnic Groups in the United States

Nadeem

Conway

2020

JSBHS

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Objective. To examine the prevalence of and the association between comorbid disorders and race/ethnicity in the United States. Methods. Using cross-sectional data from the 2012 National Behavioral Risk Factor Surveillance System [N=45,207,844], we examined comorbidity of psychological distress with self-reported diagnosis of diabetes, angina, and with history of heart attack and stroke. Logistic regression was used to examine between group differences by race/ethnicity. Results. Unadjusted results indicate that American Indian [OR 4.01, 95%CI: 1.78, 9.04] and Hispanic [OR 1.55, 95%CI: 1.04, 2.33] participants were more likely to have psychological distress and history of heart attack in comparison to Whites. American Indians were more likely to have psychological distress with angina [OR 3.82, 95%CI: 1.92, 7.63], and with history of stroke [OR 4.25, 95%CI: 2.16-8.26] in unadjusted results when compared to White participants. Conclusions. Our results suggest that racial/ethnic minority groups are more likely to suffer from comorbid mental health and medical conditions, which may be a result of stress arising from discrimination and historical oppression of these populations.

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Health risk behaviours and allostatic load: A systematic review

Cited by 104 publications

References 176 publications

Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

Syndemic Perspectives to Guide Black Maternal Health Research and Prevention During the COVID-19 Pandemic

Medical and Mental Health Comorbidities Among Minority Racial/Ethnic Groups in the United States

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