Interplay of race and neighborhood deprivation on resting and ambulatory blood pressure in young adults.

Nighttime blood pressure (BP) and BP dipping (daytime-nighttime BP) are prognostic for cardiovascular disease. When compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping. Neighborhood deprivation may contribute to disparities in cardiovascular health, but its effects on resting and ambulatory BP patterns in young adults are unclear. Therefore, we examined associations between neighborhood deprivation with resting and nighttime BP and BP dipping in young Black and White adults. We recruited 19 Black and 28 White participants (23 males/24 females, 21 ± 1 yr, body mass index: 26 ± 4 kg/m2) for 24-h ambulatory BP monitoring. We assessed resting BP, nighttime BP, and BP dipping (absolute dip and nighttime:daytime BP ratio). We used the area deprivation index (ADI) to assess average neighborhood deprivation during early and mid-childhood and adolescence. When compared with White participants, Black participants exhibited higher resting systolic and diastolic BP (Ps ≤ 0.029), nighttime systolic BP (114 ± 9 vs. 108 ± 9 mmHg, P = 0.049), diastolic BP (63 ± 8 vs. 57 ± 7 mmHg, P = 0.010), and attenuated absolute systolic BP dipping (12 ± 5 vs. 9 ± 7 mmHg, P = 0.050). Black participants experienced greater average ADI scores compared with White participants [110 (10) vs. 97 (22), P = 0.002], and select ADI scores correlated with resting BP and some ambulatory BP measures. Within each race, select ADI scores correlated with some BP measures for Black participants, but there were no ADI and BP correlations for White participants. In conclusion, our findings suggest that neighborhood deprivation may contribute to higher resting BP and impaired ambulatory BP patterns in young adults warranting further investigation in larger cohorts.NEW & NOTEWORTHY We demonstrate that young Black adults exhibit higher resting blood pressure, nighttime blood pressure, and attenuated systolic blood pressure dipping compared with young White adults. Black adults were exposed to greater neighborhood deprivation, which demonstrated some associations with resting and ambulatory blood pressure. Our findings add to a growing body of literature indicating that neighborhood deprivation may contribute to increased blood pressure.

Interplay of Race and Neighborhood Deprivation on Ambulatory Blood Pressure in Young Adults.

Background: Ambulatory blood pressure (BP) monitoring measures nighttime BP and BP dipping, which are superior to in-clinic BP for predicting cardiovascular disease (CVD), the leading cause of death in America. Compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping, including in young adulthood. Social determinants of health contribute to disparities in CVD risk, but the contribution of neighborhood deprivation on nighttime BP is unclear. Therefore, we examined associations between neighborhood deprivation with nighttime BP and BP dipping in young Black and White adults. Methods: We recruited 21 Black and 26 White participants (20 M/27 F, mean age: 21 years, body mass index: 25±4 kg/m2) for 24-hour ambulatory BP monitoring. We assessed nighttime BP and BP dipping (nighttime:daytime BP ratio). The area deprivation index (ADI) was used to measure neighborhood deprivation. Associations between ADI and ambulatory BP were examined. Results: Black participants exhibited higher nighttime diastolic BP compared with White participants (63±8 mmHg vs 58±7 mmHg, p=0.003), and attenuated BP dipping ratios for both systolic (0.92±0.06 vs 0.86±0.05, p=0.001) and diastolic BP (0.86±0.09 vs 0.78±0.08, p=0.007). Black participants experienced greater neighborhood deprivation compared with White participants (ADI scores: 110±8 vs 97±21, p<0.001), and ADI was associated with attenuated systolic BP dipping (ρ=0.342, p=0.019). Conclusions: Our findings suggest neighborhood deprivation may contribute to higher nighttime BP and attenuated BP dipping, which are prognostic of CVD, and more prevalent in Black adults. Targeted interventions to mitigate the effects of neighborhood deprivation may help to improve nighttime BP. Clinical Trial Registry: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04576338.

Cross-sectional analysis of racial differences in hydration and neighborhood deprivation in young adults.

BACKGROUND: Inadequate hydration is associated with cardiovascular and kidney disease morbidity and all-cause mortality. Compared with White individuals, Black individuals exhibit a higher prevalence of inadequate hydration, which may contribute to racial health disparities. However, the underlying reasons for these differences in hydration remain unclear. OBJECTIVE: This cross-sectional study aimed to investigate whether neighborhood deprivation contributes to racial differences in hydration status. METHODS: We assessed 24 Black and 30 White college students, measuring 24-hour urine osmolality, urine flow rate, urine specific gravity, and plasma copeptin concentration. Participants recorded their food and fluid intake for 3 d to assess total water intake from food and beverages. Neighborhood socioeconomic deprivation was measured using a tract-level Area Deprivation Index. RESULTS: Black participants exhibited higher urine osmolality (640 [314] compared with 440 [283] mOsm/kg H2O, respectively, P = 0.006) and lower urine flow rate (1.06 [0.65] compared with 1.71 [0.89] ml/min, respectively, P = 0.009) compared with White participants, indicating greater hypohydration among Black participants. Black participants reported lower total water intake from food and beverages than White participants (2.3 ± 0.7 compared with 3.5 ± 1.1 L/day, respectively, P < 0.01). Black participants exhibited higher copeptin than White participants (6.3 [3.1] compared with 4.5 [2.3] pmol/L, P = 0.046), and urine osmolality mediated 67% of the difference (P = 0.027). Black participants reported greater cumulative exposure to neighborhood deprivation during childhood (ages 0-18 y). Furthermore, neighborhood deprivation during childhood was associated with urine specific gravity (P = 0.031) and total water intake from food and beverages (P = 0.042) but did not mediate the racial differences in these measures. CONCLUSION: Our data suggest that compared with White young adults, Black young adults are hypohydrated and exhibit higher plasma copeptin concentration, and that greater neighborhood deprivation is associated with chronic underhydration irrespective of race. This trial was registered at clinicaltrials.gov as NCT04576338.

The pandemic and social experience: For whom did discrimination and social isolation increase?

OBJECTIVE: The objective of this study was to examine whether experiences of discrimination have increased during the pandemic, particularly among negatively stigmatized racial/ethnic groups, and whether such experiences have exacerbated feelings of social isolation. METHOD: Discrimination and social isolation were assessed before and during the pandemic in a sample of 263 Black and White young adults attending a large, predominantly White 4-year research university in the Southeastern region of the United States (52% Black, 48% White, 53% female, mean age = 19.2). RESULTS: Increases in discrimination were evident among Black but not White participants. Black participants also reported greater increases in social isolation than White participants, and changes in discrimination partially mediated the emergent racial disparity in social isolation. CONCLUSIONS: Findings are consistent with theoretical perspectives on discrimination during times of stress and suggest the need for broader attention to the impact of the pandemic on unfair treatment of stigmatized groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Neighborhood Socioeconomic Deprivation in Early Childhood Mediates Racial Disparities in Blood Pressure in a College Student Sample.

The influence of childhood contexts on adult blood pressure is an important yet understudied topic. Using a developmental perspective, this study examines the association between neighborhood socioeconomic disadvantage in early childhood (0-5 yrs), middle childhood (6-12 yrs) and adolescence (13-18 yrs) on subsequent blood pressure in young adulthood. Data were from 263 college students (52% Black; Mage = 19.21 years) and neighborhood socioeconomic disadvantage was measured using a tract-level Area Deprivation Index. Neighborhood disadvantage in early childhood was significantly associated with diastolic blood pressure and explained 22% of the race difference between Black and White adults. The findings are consistent with the notion that early childhood may be a sensitive period for the effects of neighborhood disadvantage on blood pressure.

Racial disparities in sleep health between Black and White young adults: The role of neighborhood safety in childhood.

OBJECTIVES: Black adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep. METHODS: Data were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from eight nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed. RESULTS: Black participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use. CONCLUSIONS: Findings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.

A Changing Landscape of Health Opportunity in the United States: Increases in the Strength of Association Between Childhood Socioeconomic Disadvantage and Adult Health Between the 1990s and the 2010s.

Understanding the changing health consequences of childhood socioeconomic disadvantage (SED) is highly relevant to policy debates on inequality and national and state goals to improve population health. However, changes in the strength of association between childhood SED and adult health over historic time are largely unexamined in the United States. The present study begins to address this knowledge gap. Data were from 2 national samples of adults collected in 1995 (n = 7,108) and 2012 (n = 3,577) as part of the Midlife in the United States study. Three measures of childhood SED (parents' occupational prestige, childhood poverty exposure, and parents' education) were combined into an aggregate index and examined separately. The association between childhood SED (aggregate index) and 5 health outcomes (body mass index, waist circumference, chronic conditions, functional limitations, and self-rated health) was stronger in the 2012 sample than the 1995 sample, with the magnitude of associations being approximately twice as large in the more recent sample. Results persisted after adjusting for age, sex, race, marital status, and number of children, and were similar across all 3 measures of childhood SED. The findings suggest that the socioeconomic circumstances of childhood might have become a stronger predictor of adult health in recent decades.

Changes in Depressive Symptoms, Physical Symptoms, and Sleep-Wake Problems from before to during the COVID-19 Pandemic among Emerging Adults: Inequalities by Gender, Socioeconomic Position, and Race.

The impact of the COVID-19 pandemic on emerging adults is of global concern. We examine changes in depressive symptoms, physical symptoms, and sleep-wake problems from before to during the pandemic among college students, and examine inequalities by gender, socioeconomic status (SES), and race (N=263, 52% Black, 48% White, 53% female). As compared to pre-pandemic levels, increases were evident in depressive symptoms, physical symptoms, and sleep problems. Females had greater increases than males in depressive symptoms, sleep problems, and physical symptoms. Students from disadvantaged SES backgrounds had greater increases in physical symptoms. Among White students, those from disadvantaged backgrounds also had greater increases in sleep problems. Lastly, daytime sleepiness increased more among Black male than White male students. Overall, findings suggest notable shifts in sleep and health during the early phase of the pandemic among emerging adults, and that attention to inequality by gender, SES, and race is warranted.

Day-to-day fluctuations in experiences of discrimination: Associations with sleep and the moderating role of internalized racism among African American college students.

OBJECTIVES: Studies of discrimination and sleep have largely focused on between-person differences in discrimination as a correlate of sleep outcomes. A common criticism of this research is that standard questionnaire measures of discrimination may be confounded by personality and identity and are subject to recall bias. Partially addressing these limitations, the current study examined within-person, day-to-day fluctuations in perceived discrimination as a predictor of day-to-day fluctuations in sleep. The role of internalized racism as a moderator of the within-person association between discrimination and sleep was also considered. METHOD: Participants were African American college students attending a predominantly White institution (N = 124, 26% male, Mage = 20.1, SD = 1.6). Each student was asked to complete a baseline questionnaire and a 9-day diary. Experiences of discrimination were assessed in the questionnaire and daily diary format. Sleep problems were measured each day using self-report measures focusing on sleep quality. Internalized racism was assessed with the miseducation scale, which captures the degree to which individuals associate negative characteristics such as laziness and criminality with their racial/ethnic group. Established measures of racial identity were considered as covariates. RESULTS: Multilevel analyses indicated that on days when participants experienced more discrimination, subsequent sleep problems increased (B = .037, SE = .017, p = .034). Furthermore, this within-person association was moderated by internalized racism such that the effects of daily discrimination on sleep were stronger among those who scored higher on miseducation (B = .046, SE = .021, p = .033). CONCLUSIONS: Overall, results suggest that ongoing efforts to reduce discrimination, support the adjustment of racial/ethnic minority students, and address internalized racism are warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Assessing and quantifying the secure base script from narratives produced by preschool age children: justification and validation tests.

Building on aframework presented by Bretherton and associates, Waters and associates argued that interaction sequences relevant to children's access to and use of asecure base for exploration during infancy/toddlerhood become internalized as script-like representations. For adults, these scripted representations are readily assessed using word-prompt lists d to elicit attachment relevant narratives. However, this method is not appropriate during early childhood. Waters and associates used stories from Bretherton's Attachment Story Completion Task for this purpose. However, the method they used to score secure base script use is not efficient for larger samples (e.g. over 50), and new approaches for scoring have been designed. We describe two approaches to story selection and scoring for access to and use of the secure base script. The two scoring methods show substantial and significant overlap and also have significant associations with other methods of measuring attachment security during early childhood.

Preschoolers' secure base script representations predict teachers' ratings of social competence in two independent samples.

Associations between attachment security, assessed as a secure base script (SBS), and teachers' social competence ratings were examined in two samples (one from the Midwest region and the other from the Southern region of the United States). Consistent with previous reports, significant associations between domains were obtained in both samples and after combining the two samples, r = .33, p < .001. The associations remained significant when child sex, age, and verbal intelligence were controlled. Findings are discussed with reference to relations between SBS scores and the covariates. Regarding sex differences, an existing literature suggests that girls, compared with boys, may be advantaged with respect to skills that could support higher scores on the task used to assess secure base scripts. In both samples, teachers rated girls as somewhat higher on scales of social competence and controlling for sex reduced the magnitude of associations between SBS and social competence, but the results remained significant in all tests.