Worse mental health (β=0.59, p<0.05), disruptive sleep environment (β=0.59, p<0.05), and neighborhood crime (β=0.59, p<0.05) were directly associated with cardiometabolic risk among Black adults.
Cross-Sectional (n=623)
Yes
Are psychosocial and environmental stressors associated with cardiometabolic risk and insomnia severity, and does insomnia mediate this relationship in Black adults?
Psychosocial and environmental stressors are directly associated with cardiometabolic risk in Black adults, but this relationship does not appear to be mediated by insomnia severity.
Abstract Introduction Adequate sleep is a key determinant of cardiometabolic health, but epidemiologic evidence among Black adults (BA) remains limited. Psychosocial and neighborhood-level stressors may influence cardiometabolic risk (CMR) directly and through the presence of insomnia. We examined associations of psychosocial and environmental stressors with CMR, associations with insomnia severity, and whether the presence of insomnia mediates these relationships. Methods Cross-sectional data from the ESSENTIAL study were analyzed from 623 BA residing in Miami and New York City (66% female; Mage=40.3, SD= 13.2 range 18-75 years old). Insomnia severity was measured with the Insomnia Severity Index (ISI). Psychosocial determinants included social support (Multidimensional Scale of Perceived Social Support), discrimination (Everyday Discrimination Scale), life stressors (Holmes and Rahe Stress Scale), and mental health (SF-12, history of anxiety/depression). Environmental determinants were assessed with the Assessment of Sleep Environment (ASE) and the Neighborhood Environment Walkability Scale–Abbreviated (NEWS-A) indices (residential density .01), a more disruptive sleep environment (ASE; β=0.10, p 0.01), higher neighborhood crime, and greater residential density (NEWS-A; β=0.59, p.05 and β=0.0030, p 0.05) were independently associated with higher ISI. Older age (β=0.09, p 0.001) and female sex (β=1.15, p 0.05) were also independently associated with higher ISI. For CMR, mental health (β=0.59, p 0.05), sleep environment (β=0.59, p.05), and neighborhood crime (β=0.59, p 0.05) showed significant direct associations with CMR. We found no significant indirect effects of ISI in the model. Conclusion These findings underscore the need for culturally tailored precision medicine-based interventions that target key factors such as mental health, sleep and environments to mitigate CMR among BA. Future studies should employ longitudinal methods with larger sample sizes to establish causal relationships with these determinants of sleep and CMR outcomes in Black communities and other populations experiencing similar neighborhood disadvantage. Support (if any) R01HL142066
Thompson et al. (Fri,) conducted a cross-sectional in Cardiometabolic risk (n=623). Psychosocial and environmental stressors was evaluated on Insomnia severity (ISI) and cardiometabolic risk (CMR). Worse mental health (β=0.59, p<0.05), disruptive sleep environment (β=0.59, p<0.05), and neighborhood crime (β=0.59, p<0.05) were directly associated with cardiometabolic risk among Black adults.
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