Social determinants of incidence, outcomes, and interventions of cardiovascular disease risk factors in American Indians and Alaska Natives

Leung, Eric; Parker, Tassy; Allyson, Kelley; Blankenship, James C.

doi:10.1002/wmh3.556

Cited by 6 publications

(3 citation statements)

References 99 publications

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“…Urban American Indian and Alaska Native adolescents are a population that is rarely included in research, despite facing a disproportionate burden of chronic health conditions. 4 , 50 It is important to understand how sleep may be associated with health disparities among American Indian and Alaska Native adolescents to help inform prevention and intervention programming to increase health equity for this population.…”

Section: Discussionmentioning

confidence: 99%

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents

Troxel,

Klein,

Dong

et al. 2024

JAMA Netw Open

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ImportanceAdolescent sleep problems are prevalent, particularly among racial and ethnic minority groups, and can increase morbidity. Despite the numerous strengths of their racial and ethnic group, urban American Indian and Alaska Native adolescents face significant health disparities but are rarely included in health research. Understanding how sleep problems are associated with health outcomes among American Indian and Alaska Native adolescents may elucidate novel targets for interventions to promote health equity.ObjectiveTo assess whether baseline sleep problems are associated with changes in behavioral and cardiometabolic health outcomes among urban American Indian and Alaska Native adolescents 2 years later.Design, Setting, and ParticipantsAmerican Indian and Alaska Native adolescents were recruited via flyers and community events for an observational cohort study in California. Baseline assessments were conducted among 142 adolescents from March 1, 2018, to March 31, 2020, and follow-ups were conducted among 114 adolescents from December 1, 2020, to June 30, 2022.ExposuresBaseline actigraphy-assessed sleep duration and efficiency and self-reported sleep disturbances and social jet lag (absolute value of the difference in sleep midpoint on weekends vs weekdays; indicator of circadian misalignment).Main Outcomes and MeasuresMain outcome measures included self-reported depression (measured using the Patient Health Questionnaire), anxiety (measured using the Generalized Anxiety Disorder 7-item scale), past year alcohol and cannabis use, body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), waist circumference, and glycosylated hemoglobin (HbA1c). Analyses examined whether baseline sleep was associated with health outcomes at follow-up, controlling for age, sex, and baseline outcome measures.ResultsThe baseline sample included 142 urban American Indian and Alaska Native adolescents (mean [SD] age, 14.0 [1.4] years; 84 girls [59%]), 80% of whom (n = 114; mean [SD] age, 14.1 [1.3] years; 71 girls [62%]) completed follow-ups. Linear or logistic regressions showed significant negative associations between shorter sleep duration and depression (β = −1.21 [95% CI, −2.19 to −0.24]), anxiety (β = −0.89 [95% CI, −1.76 to −0.03]), DBP (β = −2.03 [95% CI, −3.79 to −0.28]), and HbA1c level (β = −0.15 [95% CI, −0.26 to −0.04]) and likelihood of alcohol (odds ratio [OR], 0.57 [95% CI, 0.36-0.91]) and cannabis use (full week: OR, 0.59 [95% CI, 0.35-0.99]) at follow-up. Greater social jet lag was associated with significantly higher SBP (β = 0.06 [95% CI, 0.01-0.11]) at follow-up.Conclusions and RelevanceThis cohort study found significant associations between poor sleep and adverse changes in health outcomes. Findings highlight the importance of developing culturally responsive interventions that target sleep as a key modifiable risk factor to improve the health of American Indian and Alaska Native adolescents.

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Section: Discussionmentioning

confidence: 99%

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents

Troxel,

Klein,

Dong

et al. 2024

JAMA Netw Open

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“…While providers did not specify issues, these could be associated with structural determinants stemming from colonization including exclusion, oppression, discrimination, and loss of control. 26 These translate to a broken health system, staffing issues, poor surveillance, limited prevention, and ultimately premature death from cardiovascular diseases. 1 …”

Section: Discussionmentioning

confidence: 99%

Tribal Perspectives on Hypertension: Results From the Center for Native American Health Native-CHART Needs Assessment

Parker

Kelley

Cooeyate

et al. 2022

J Prim Care Community Health

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Purpose and Objectives: American Indian/Alaska Native (AI/AN) hypertension contributes to cardiovascular disease, the leading cause of premature death in this population. The purpose of this article is to document strategies, concerns, and barriers related to hypertension and cardiovascular disease from Native-Controlling Hypertension and Risks through Technology (Native-CHART) symposiums facilitated by the Center for Native American Health (CNAH). The objectives of this evaluation were to combine Health Needs Assessment (HNA) data and explore barriers and strategies related to hypertension while assessing changes in participants’ perspectives over time (2017-2021). Approach: CNAH followed an iterative process each year for planning the HNA, facilitating the HNA, and refining and reflecting on HNA findings over time. This involved 3 interconnected steps: (1) developing a shared understanding for the HNA, “Why are we here?,” (2) facilitating the HNA during annual symposiums “What do we do?,” and (3) reflecting on “What did we learn?”. Evaluation Methods: Data were collected using a culturally centered HNA co-created by the CNAH team and tribal partners. Qualitative data analysis utilized a culturally centered thematic approach and NVivo software version 12.0. Quantitative data analysis included summarizing frequency counts and descriptive statistics using Microsoft Excel. Results: Over the 5-year period, 212 Native-CHART symposium participants completed HNAs. Data collected from HNAs show persistent barriers and concerns and illuminate potential strategies to address AI/AN hypertension. Future efforts must explore effective strategies that build on community strengths, culture and traditions, and existing resources. This is the path forward. Implications for Public Health: CNAH’s culturally centered and unique HNA approach helped assess participant perspectives over time. CNAH facilitated symposiums over multiple years, even amid a global pandemic. This demonstrates resilience and continuity of community outreach when it is needed the most. Other universities and tribal partners could benefit from this iterative approach as they work to design HNAs with tribal populations.

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“…Coal miners in southern West Virginia (WV) face additional barriers, including limited access to primary care and advanced health care in their communities [ 12 ]. West Virginia’s rural patterns and economic challenges have led to unequal access to care and “healthcare deserts” [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Coal Mining on Health Outcomes Between Male and Female Miners in Southern West Virginia: A Brief Report

Annie,

Crews,

Drabish

et al. 2023

Cureus

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Purpose: There is evidence of an association between coal mining and an increased prevalence of respiratory and cardiovascular disease (CVD). Mining is significantly associated with elevated chronic CVD mortality rates. Research is limited and looks at the differences between specific health outcomes between male and female coal miners. The aim of this study was to compare the long-term health outcomes of male and female coal miners in southern West Virginia. Methods: We used the Charleston Area Medical Center (CAMC) data registry to look at specific health outcomes of coal miners. We queried the data warehouse from September 1, 2016, to January 1, 2023, to identify any coal miners coming to CAMC for any treatment. We identified adult patients aged 18-90 years with at least one visit to a clinic in the CAMC system. Findings: We identified (n=2,460) cases of coal miners, comprising of 2,280 males and 180 females. Overall, we found higher mortality rates as well as higher rates of ischemic heart disease, heart failure, cancer, and mental health disorders among male coal miners. Conclusions: Additional research is needed to further examine possible contributing factors that explain the differences in health outcomes between male and female coal miners. Clinicians and policymakers need to address health disparities and occupational hazards that impact the health outcomes of coal miners living in southern West Virginia.

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Social determinants of incidence, outcomes, and interventions of cardiovascular disease risk factors in American Indians and Alaska Natives

Cited by 6 publications

References 99 publications

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents

Sleep Problems and Health Outcomes Among Urban American Indian and Alaska Native Adolescents

Tribal Perspectives on Hypertension: Results From the Center for Native American Health Native-CHART Needs Assessment

Effect of Coal Mining on Health Outcomes Between Male and Female Miners in Southern West Virginia: A Brief Report

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