Black men suffer disproportionately from premature mortality and cardiovascular disease (CVD) compared to their white counterparts, perhaps in part due to blacks'greater exposure to social and economic adversity across the life span as suggested by the weathering hypothesis. This application suggests that (a) black-white differences in CVD in adulthood stem from cumulative adversity correlated with race much earlier in life;and (b) early life exposures at the individual, family, and neighborhood level mus be considered simultaneously. Not emphasized in the weathering hypothesis is that intra- and inter-personal and cultural resources also may accumulate over the life course (labeled reserve capacity) and moderate effects of early life adversity;and that there may also be a critical perio exposure to adverse life events. Sleep may be an important factor here because of its likely relation to race and socioeconomic status (SES), and possibly to CVD events. This application focuses on the developmental antecedents of sleep, optimal cardiovascular (CV) health (defined by AHA criteria), and CVD risk in a population-based study of middle-aged black and white men who have been followed since they were enrolled in the first grade. They have been assessed repeatedly for health behaviors and academic and social competence;parent health behaviors, parenting practices, and household SES;and neighborhood characteristics, including census track SES, violence exposure, and community cohesiveness and involvement;these measures have been summarized into developmentally appropriate periods. In 300 men now in their late thirties, we propose to collect measures of CV biomarkers and psychosocial risk factors and sleep to test the following: 1) the extent of black/white differences in sleep, optimal CV health, and CVD risk, and sleep;2) whether early adverse family and neighborhood environments, particularly during adolescence, predict adult optimal CV health, CVD risk, and sleep;and 3) if reserve capacity reduces the impact of early adverse environments. Knowledge gained from this project may identify the early life experiences and their timing that render black men particularly vulnerable to later CVD.
Understanding the developmental antecedents of poor sleep and cardiovascular risk in black and white men will facilitate the design and timing of interventions to prevent adverse health consequences of early life experiences. This project will facilitate reaching two overarching goals of Healthy People 2020: a) achieving health equity and eliminating health disparities;and b) promoting healthy development and healthy behaviors across all life stages.
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