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Previous chapters have focussed on the broader picture of global health in the context of climate change, before examining why climatic conditions/acute weather events can influence an individual’s heart and broader cardiovascular health through the lens of ‘vulnerability to resilience’. In doing so, an argument for why and how we should alter our collective thinking around the role of climate and health (essentially embracing a new paradigm in providing clinical care) is urgently needed. However, such a radical change would be pointless, or at least a low priority, if there was little evidence that health outcomes are indeed—(1) Shaped and influenced by the weather/climatic conditions, thereby resulting in clinically significant variations in event rates and, (2) Climate change is likely to exacerbate the problem in terms of provoking more events that might be preventable. Thus, in the context of a growing body of research and published data (much of which is gravitating towards a more simplistic “heat is bad” mindset), this chapter provides hard evidence that the timing and frequency of concrete events such as hospital admissions and deaths linked to cardiovascular disease and the main subtypes of heart disease are not random. Instead, they ebb and flow according to both predictable climatic transitions (seasons) and unpredictable weather conditions (heatwaves and cold spells) in different ways.
Previous chapters have focussed on the broader picture of global health in the context of climate change, before examining why climatic conditions/acute weather events can influence an individual’s heart and broader cardiovascular health through the lens of ‘vulnerability to resilience’. In doing so, an argument for why and how we should alter our collective thinking around the role of climate and health (essentially embracing a new paradigm in providing clinical care) is urgently needed. However, such a radical change would be pointless, or at least a low priority, if there was little evidence that health outcomes are indeed—(1) Shaped and influenced by the weather/climatic conditions, thereby resulting in clinically significant variations in event rates and, (2) Climate change is likely to exacerbate the problem in terms of provoking more events that might be preventable. Thus, in the context of a growing body of research and published data (much of which is gravitating towards a more simplistic “heat is bad” mindset), this chapter provides hard evidence that the timing and frequency of concrete events such as hospital admissions and deaths linked to cardiovascular disease and the main subtypes of heart disease are not random. Instead, they ebb and flow according to both predictable climatic transitions (seasons) and unpredictable weather conditions (heatwaves and cold spells) in different ways.
Study Objectives To examine differences in the longitudinal prevalence of childhood insomnia symptoms across Black/African American, Hispanic/Latinx, and non-Hispanic White groups. Methods Participants were 519 children from the Penn State Child Cohort (baseline (V1) from 2000-2005) who were followed up 8 years later as adolescents (V2) and 15 years later as young adults (S3). Mean age at S3 was 24.1±2.7 years. Approximately, 76.5% identified as non-Hispanic White, 12.9% as Black/African American, 7.1% as Hispanic/Latinx, and 3.5% as “other” race/ethnicity. Insomnia symptoms were defined as parent-reported (childhood) or self-reported (adolescence, young adulthood) moderate-to-severe difficulties initiating/maintaining sleep. Longitudinal trajectories of insomnia symptoms were identified across three time-points and the odds of each trajectory were compared between racial/ethnic groups, adjusting for sex, age, overweight, sleep apnea, periodic limb movements, psychiatric/behavioral disorders and psychotropic medication use. Results Black/African Americans compared to non-Hispanic Whites were at significantly higher odds to have a childhood-onset persistent trajectory through young adulthood (OR = 2.58, 95% CI [1.29, 5.14]), while Hispanics/Latinx were at non-significantly higher odds to have the same trajectory (OR = 1.81, 95% CI [0.77, 4.25]). No significant racial/ethnic differences were observed for remitted and waxing-and-waning trajectories since childhood or incident/new-onset trajectories in young adulthood. Conclusions The results indicate that disparities in insomnia symptoms among Black/African American and, to a lesser extent, Hispanic/Latinx groups start early in childhood and persist into young adulthood. Identifying and intervening upon upstream determinants of racial/ethnic insomnia disparities are warranted to directly address these disparities and to prevent their adverse health sequelae.
Lifestyle Medicine emphasizes evidence-based lifestyle changes to address chronic conditions Yet, concerns have emerged regarding its ability to address broader social determinants of health (SDoH). This study examines how family physicians’ perceptions of SDoH relate to their use of lifestyle medicine competencies. This cross-sectional survey was administered to 5770 family physicians. Participants rated the importance of LM core competencies and the impact of community conditions on patient health. Data analysis involved descriptive statistics, factor analysis, regression models, and t-tests. This study encompassed 447 responses. The findings revealed that while respondents recognized the effect of certain SDoH, such as access to unhealthy food (89%), alcohol (86%), and tobacco (83%), they showed less awareness of factors like racism and discrimination (53%), and access to parks (56%) or education (60%). Gender and the level of social deprivation in their area were significant factors influencing respondents’ perception of SDoH impact. Additionally, those who valued and used lifestyle medicine core competencies were more likely to acknowledge the influence of SDoH on patient health. Our findings suggest that comprehensive education on SDoH, especially with a focus on community aspects, is crucial across all levels of medical training to address this gap and ensure equitable care.
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