Discrimination, Sleep, and Stress Reactivity: Pathways to African American-White Cardiometabolic Risk Inequities
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This review provides a model explicating two related physiologic and behavioral pathways through which the chronic daily stress of the expectation and experience of discrimination exposure can shape life course cardiometabolic risk trajectories: sleep and stress reactivity. We argue that these two pathways work together jointly to shape African American-White disparities in cardiometabolic morbidities. The body’s ongoing anticipation of experiencing racism-related stressors disrupts sleep, a behavior highly responsive to stress reactivity, which is also elevated during stressful conditions. The constant feedback between sleep disruption and the body’s stress response can lead to higher allostatic load and disproportionate exposure to stress-related illness among African Americans earlier in their life course.
KeywordsDiscrimination Sleep Stress Racial inequities Cardiometabolic
The authors would like to thank participants of the National Institute of Child Health and Human Development and European Research Council (United Kingdom) “How Social Environments Get Under the Skin” workgroup and Thom McDade for their helpful feedback on earlier drafts of this manuscript. This research was funded by a University of Nebraska Minority Health Disparities Award and is part of a larger study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K01 HD 064537, Bridget Goosby, PI).
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