How Cumulative Risks Warrant A Shift In Our Approach To Racial Health Disparities: The Case Of Lead, Stress, And Hypertension

Hicken, Margaret T.; Gragg, Richard; Hu, Howard

doi:10.1377/hlthaff.2010.1241

Cited by 26 publications

(18 citation statements)

References 34 publications

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“…Despite the attention given to characterizing these disparities, less is known about their causes (Williams, Mohammed et al 2010). Many researchers theorize that racial/ethnic disparities in social stressors and psychosocial/biosocial stress 2 may contribute to these health disparities (Turner 2009; Geronimus, Hicken et al 2010; Jackson, Knight et al 2010; Williams, Mohammed et al 2010; Hicken, Gragg et al 2011). In particular, some argue that racial discrimination is an important source of stress for non-White compared to White Americans (Clark, Anderson et al 1999; Williams 1999; Wyatt, Williams et al 2003; Davis, Liu et al 2005; Harrell, Burford et al 2011).…”

Section: Introductionmentioning

confidence: 99%

“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

et al. 2013

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Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress – “racism-related vigilance” – and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.

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Section: Introductionmentioning

confidence: 99%

“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

et al. 2013

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“…First, single social or psychosocial measures may not adequately capture vulnerability to environmental hazards. Rather, researchers note the importance of examining the cumulative effects of numerous social and psychosocial factors when investigating vulnerability to environmental health (12, 13). Neighborhood measures like racial/ethnic residential segregation may capture the accumulation of multiple adverse social and psychosocial exposures.…”

Section: Introductionmentioning

confidence: 99%

Air Pollution, Cardiovascular Outcomes, and Social Disadvantage

et al. 2016

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Background Social factors may enhance health effects of air pollution, yet empirical support is inconsistent. The interaction of social and environmental factors may only be evident with long-term exposures and outcomes that reflect long-term disease development Methods We used cardiac magnetic resonance imaging data from the Multi-Ethnic Study of Atherosclerosis to assess left-ventricular mass index (LVMI) and left-ventricular ejection fraction (LVEF). We assigned residential concentrations of fine particulate matter (PM2.5), oxides of nitrogen (NOx), and nitrogen dioxide (NO2) in the year 2000 to each participant in 2000 using prediction models. We examined modifying roles of four measures of adversity: race/ethnicity, racial/ethnic residential segregation, and socioeconomic status (SES) and psychosocial adversity as composite indices on the association between air pollution and LVMI or LVEF. Results Compared to whites, blacks showed a stronger adjusted association between air pollution and LVMI. For example, for each 5 μg/m3 greater PM2.5 level, whites showed a 1.0 g/m2 greater LVMI (95%CI: -1.3, 3.1) while blacks showed an additional 4.0 g/m2 greater LVMI (95%CI: 0.3, 8.2). Results were similar for NOx and NO2 with regard to black race and LVMI. However, we found no evidence of a modifying role of other social factors or ethnic groups. Furthermore, we found no evidence of a modifying role for any social factors or racial/ethnic groups on the association between air pollution and LVEF. Conclusions Our results suggest that racial group membership may modify the association between air pollution and cardiovascular disease.

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“…Interest has been driven by environmental justice concerns of heightened chemical exposures among lower-SEP populations [75,76], and the EPA authority to protect susceptible populations and improve population health [77]. Some reviews have proposed screening methods incorporating SEP indicators and environmental factors [78].…”

Section: Implications For Cumulative Risk Assessmentmentioning

confidence: 99%

The Role of Non-Chemical Stressors in Mediating Socioeconomic Susceptibility to Environmental Chemicals

Clougherty

Shmool

Kubzansky

2014

Curr Envir Health Rpt

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Growing evidence suggests that lower socioeconomic position (SEP) communities may be more susceptible to environmental exposures. SEP, however, represents a complex mix of social and environmental exposures accumulating over the lifecourse, and those components that most impact susceptibility remain undetermined. One plausible hypothesis is that the chronic psychological stress associated with stressors in many lower-SEP communities (e.g., housing instability, food insecurity, fear of violence) may lead to altered immune, endocrine, and metabolic function. These alterations, together with environmental exposures, may ultimately contribute to increased risk of developing a variety of chronic diseases.Clearer insight into which specific components of SEP may magnify susceptibility to toxic environmental exposures is needed to improve epidemiologic analyses, and to design more effective environmental health policies and interventions. Here, we compile recent evidence published since 2009, when we conducted a similar review of this topic, towards developing a better understanding of chronic stress as a possible mediator of SEP-related pollution susceptibility. We discuss recent findings on common patterning (i.e., spatial correlation) between these exposures and methodological needs to facilitate disentangling health effects of nonchemical and chemical stressors. Finally, we briefly discuss the implications of disentangling SEP-and stress-related susceptibility for cumulative risk assessment.

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How Cumulative Risks Warrant A Shift In Our Approach To Racial Health Disparities: The Case Of Lead, Stress, And Hypertension

Cited by 26 publications

References 34 publications

“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

Air Pollution, Cardiovascular Outcomes, and Social Disadvantage

The Role of Non-Chemical Stressors in Mediating Socioeconomic Susceptibility to Environmental Chemicals

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