Neighborhood features and physiological risk: An examination of allostatic load

Robinette, Jennifer W.; Charles, Susan T.; Almeida, David M.; Gruenewald, Tara L.

doi:10.1016/j.healthplace.2016.08.003

Cited by 84 publications

(72 citation statements)

References 65 publications

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“…That household income did not significantly predict allostatic load is consistent with the findings of Barber et al ( 13 ). Our findings contrast with those of several studies of neighborhood poverty and cumulative biological risk; these studies found household income to be an independent and significant predictor among women ( 7 , 8 , 12 ). However, the association of higher household income with lower allostatic load in our study, although not significant, suggests that women may weather both individual and neighborhood socioeconomic disadvantage.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies of African American women also showed that women residing in areas of greater neighborhood poverty had higher cumulative biological risk than women living in less impoverished neighborhoods (8). Conversely, individuals living in high-income neighborhoods had lower cumulative biological risk than those who live in low-income neighborhoods ( 12 ). Our study adds to this research by evaluating health behaviors and individual socioeconomic factors as mediators in the relationship between neighborhood disadvantage and allostatic load exclusively in African American women who are at risk for obesity-related diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Neighborhood disadvantage in the context of allostatic load may be a proxy for exposure to multiple, chronic, stressful events; perceived safety; and access to health resources ( 9 – 11 ). One study of African American men and women found that health behaviors (diet, exercise, and smoking) partially mediated the relationship between neighborhood poverty and allostatic load ( 12 ). Another study of African Americans suggested that educational attainment, a component of individual SES, differentially affects the relationship between allostatic load and neighborhood disadvantage ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases

et al. 2017

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IntroductionAfrican American women have higher rates of obesity and related chronic disease than other demographic groups. The poorer health of African American women compared with other groups may be explained by allostatic load, or cumulative physiologic stress, due to chronic socioeconomic disadvantage. The objective of this study was to evaluate neighborhood and individual factors contributing to allostatic load in African American women at risk for obesity-related diseases.MethodsThis study evaluated the relationship of allostatic load with neighborhood disadvantage, individual socioeconomic determinants, and synergism between neighborhood and socioeconomic disadvantage, along with health behaviors and other factors as mediators in African American women. Our sample consisted of 220 African American women at risk of obesity-related diseases enrolled in the Better Me Within program (mean [standard deviation] age, 50.1 [11.2] y; mean [standard deviation] body mass index,36.7 [8.4] kg/m2). Allostatic load score for each participant was calculated by summing the number of biomarkers (of 9 biomarkers) that were determined to be in the high-risk quartile.ResultsPoisson regression of neighborhood disadvantage and individual socioeconomic determinants found that neighborhood disadvantage, but not education level or household income, was significantly associated with allostatic load (β = 0.22, SE, 0.10, P = .04). Tests for mediators showed that household income and alcohol consumption partially mediated the relationship between allostatic load score and neighborhood disadvantage but were not significant.ConclusionMore research is necessary to determine the mechanisms by which neighborhoods can exacerbate and attenuate cumulative disadvantage among African American women. Policies and interventions that focus on neighborhood health may improve the outcomes of individual-level health interventions among women who reside in disadvantaged communities.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases

et al. 2017

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“…Multiple mechanisms contribute to differential health as a function of neighborhood SES: differential access to material resources, the cost of available resources, access to medical care, the availability and quality of municipal services, the quality of education, environmental exposures (e.g., noise, lead), crime, crowding, and the availability of tobacco, fast food, and recreational resources, among others. At the biological level, there are also several pathways that link SES at the neighborhood level to the etiology and pathogenesis of cardiovascular disease, including elevated inflammation, greater cardiovascular responses to stress, and greater allostatic load (Bird et al, 2010; Brody et al, 2014; Finch et al, 2010; Merkin et al, 2009; Mujahid et al, 2017; Nazmi, Diez Roux, Ranjit, Seeman, & Jenny, 2010; Petersen et al, 2008; Pollitt, Rose, & Kaufman, 2005; Purser et al, 2008; Robinette et al, 2016; Theall et al, 2012). Although it is clear that, independent of individual SES, higher neighborhood SES is generally associated with better health, it is not yet clear if this association is stronger or weaker depending on a person’s own SES.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood SES is particularly important to the cardiovascular health of low SES individuals

Boylan

Robert

2017

Social Science & Medicine

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Rationale Health disparities defined by neighborhood socioeconomic status (SES) are well established; it is less well understood whether neighborhood SES is differentially associated with health depending on one’s own SES. Objective The double jeopardy hypothesis, collective resources model, fundamental cause theory, and relative deprivation hypothesis, support differential patterns of association between neighborhood and individual SES with health. The first three models suggest that higher neighborhood SES predicts health more strongly among lower, as compared to higher, SES individuals. The relative deprivation hypothesis suggests that higher SES neighborhoods bring no extra health benefit to low SES individuals and could even bring a health deficit. This study examined competing hypotheses with prospective associations between cardiovascular (CV) health and individual SES, neighborhood SES, and their interaction. Method Data were from two waves of the Midlife in the United States (MIDUS) Study (N=1,012), a national survey of adults ages 25 and older at baseline. Neighborhood SES was a composite of five census tract-level SES indicators from the 1990 census. Individual SES was a composite of educational attainment and household income at wave one (1995–1996). CV health at wave two (2004–2008), was computed as a composite based on smoking status, body mass index, physical activity, diet, total cholesterol, blood pressure, and glucose. Results Individual and neighborhood SES were each associated with CV health net of baseline health status and other covariates. Interactions between individual and neighborhood SES showed that higher neighborhood SES was associated with better CV health for those of lower, not higher, individual SES. Conclusion Results are consistent with the double jeopardy hypothesis, the collective resources model, and the fundamental cause theory, but not with a relative deprivation hypothesis. Results suggest that additional attention to the neighborhood socioeconomic context of lower SES individuals may reduce SES disparities in cardiovascular health.

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“…One item measuring restless sleep was removed from the computation of the total score to reduce conflation between sleep and depression, and the revised scale had high reliability (α = 0.89). Habits relating to physical activity, diet, and cigarette smoking were also assessed (36,62). Physical activity was reported on nightly sleep logs by the answer to the question "How many minutes of moderate or vigorous exercise did you get today?"…”

Section: Methodsmentioning

confidence: 99%

Habitual sleep as a contributor to racial differences in cardiometabolic risk

Curtis

Fuller‐Rowell

El‐Sheikh

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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Insufficient and disrupted sleep is linked with cardiovascular and metabolic dysregulation and morbidity. The current study examines the degree to which differences in sleep between black/African American (AA) and white/European American (EA) adults explain racial differences in cardiometabolic (CMB) disease risk. Total sleep time and sleep efficiency (percent of time in bed asleep) were assessed via seven nights of wrist actigraphy among 426 participants in the Midlife in the United States Study (31% AA; 69% EA; 61% female; mean age = 56.8 y). CMB risk was indexed as a composite of seven biomarkers [blood pressure, waist circumference, hemoglobin A1c (HbA), insulin resistance, triglycerides, HDL cholesterol (HDL-C), and C-reactive protein]. Covariates included sociodemographic characteristics and relevant health behaviors. Results indicated that AAs relative to EAs obtained less sleep (341 vs. 381 min) and had lower sleep efficiency (72.3 vs. 82.2%) ( values < 0.001). Further, 41% and 58% of the racial difference in CMB risk was explained by sleep time and sleep efficiency, respectively. In models stratified by sex, race was indirectly associated with CMB risk via sleep time and efficiency only among females (explaining 33% and 65% of the race difference, respectively). Indirect effects were robust to alternative model specifications that excluded participants with diabetes or heart disease. Consideration of sleep determinants and sleep health is therefore needed in efforts to reduce racial differences in CMB disease.

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Neighborhood features and physiological risk: An examination of allostatic load

Cited by 84 publications

References 65 publications

Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases

Neighborhood Disadvantage and Allostatic Load in African American Women at Risk for Obesity-Related Diseases

Neighborhood SES is particularly important to the cardiovascular health of low SES individuals

Habitual sleep as a contributor to racial differences in cardiometabolic risk

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