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Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents

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Abstract

Background

Exposure to violence, which is experienced at disproportionally higher levels by black versus white youth, is associated with disruptions in sleep and elevated cardiovascular risk. Further, poor sleep hygiene is associated with insulin resistance. However, research to date examining disruptions in sleep and cardiovascular risk in African-American adolescents has not taken the impact of exposure to violence into account, nor considered how gender might affect patterns of association. The present study addressed this gap by testing a path model linking exposure to community violence, sleep disruption, and insulin resistance in a sample of African-American adolescents and evaluating model fit across gender.

Method

African-American adolescents (N = 107; 56% female; Mage = 14.29, SD = 1.17) completed structured interviews at home and provided a blood sample after fasting overnight.

Results

The model fit connecting exposure to violence with sleep disruption and insulin resistance, adjusting for depressive symptoms and body mass index z score, was excellent. Multiple group analysis indicated gender differences in model fit. Path analysis revealed significant positive associations between exposure to violence and sleep disruption and sleep disruption and insulin resistance for females but not males.

Conclusion

These data indicate that low-income, urban African-American female adolescents who witness violence and experience sleep disruptions may already be at elevated risk for health problems compared with their male counterparts. Additional research should attempt to replicate and explicate the underlying reasons for the gender differences observed here, with the goal of improving health and disrupting the path leading to health disparities.

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Acknowledgements

Alicia Borre is now at Hampton University. The authors also thank their dedicated research teams and the research participants; this work would not have been possible without each of them.

Funding

The authors acknowledge the Virginia Commonwealth University Presidential Research Quest Fund, which provided funding for this study.

Author information

Authors and Affiliations

  1. Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA, 23284-2018, USA

    Wendy Kliewer

  2. Department of Family and Community Health, School of Nursing Box 980567, Virginia Commonwealth University, Richmond, VA, 23298-0567, USA

    Jo Lynne Robins

  3. Psychology Department, Hampton University, MLK Building, Room 238, Hampton, VA, 23668, USA

    Alicia Borre

Authors
  1. Wendy Kliewer
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  2. Jo Lynne Robins
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  3. Alicia Borre
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Corresponding author

Correspondence to Wendy Kliewer.

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Ethical Approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval to conduct the study was obtained from the authors’ university.

Informed Consent

Written informed consent or assent (as appropriate) was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflicts of interest.

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Kliewer, W., Robins, J.L. & Borre, A. Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents. Int.J. Behav. Med. 26, 437–442 (2019). https://doi.org/10.1007/s12529-019-09801-7

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  • DOI: https://doi.org/10.1007/s12529-019-09801-7

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