The widening gap in all-cause and CVD-mortality and morbidity rates in rural and urban America is at an all- time high. Latino/as, the largest minority ethnic group in the U.S., appear to be most affected by rural-urban divide in CVD outcomes, as they are disproportionately burdened by CVD risk (overweight/obesity, hypertension, dyslipidemia, diabetes) and CVD mortality (20%, 2nd leading cause of death among Latino/as) relative to other racial/ethnic groups. Unlike other groups where individuals in rural and urban areas have differing CVD risk, rural and urban Latino/as have similarly high rates of CVD risk. Although, healthy diets/ nutrition, smoking cessation, and regular physical activity are linked to CVD risk, they have not been very effective in reducing the CVD burden among racial/ethnic groups, specifically among Latino/as. Several studies indicate that insufficient sleep (<7hrs./day) explains a significant amount of the CVD burden among Latino/as. Preliminary evidence indicates that insufficient sleep may contribute to the observed CVD burden among Latino/as, as Latino/as have greater odds of experiencing insufficient sleep compared with non-Hispanic whites. Evidence also shows that insufficient sleep, which is associated with potentially life-threatening CVD, is a key modifiable risk factor with great potential to reduce health disparities. However, it is unclear what factors contribute to insufficient sleep (IS) disparities and IS-related CVD burden among rural and urban Latino/as. To address these gaps, we will enroll 525 Latino/as in rural and urban communities to participate in home-based studies using novel mHealth devices. The multidisciplinary team will: 1) identify behavioral, genetic, psychosocial, and environmental factors that are associated with insufficient sleep and IS-related CVD and 2) assess effects of insufficient sleep on CVD risk markers (obesity, blood pressure, lipid profile, and fasting plasma glucose/ HbA1C) and inflammatory risk markers (IL-6, IL-10, and TNF-?). This study will provide multi-level evidence supporting epidemiological findings of greater rates of insufficient sleep among Latino/as, which may explain their disproportionate burden of CVD risk. It will also assess whether and why rural and urban differences in IS exist among Latino/as and how that may lead to IS-related CVD outcomes. These data will provide: 1) the foundation for interventions to mitigate adverse effects of insufficient sleep on CVD health outcomes, 2) evidence to delineate factors underlying insufficient sleep and CVD burden among Latino/as in rural and urban settings, and 3) a possible explanation of behavioral, genetic, environmental and psychosocial determinants of insufficient sleep and related CVD risk factors in rural and urban Latino/as. Findings can lead to actionable clinical, lifestyle, and policy interventions to improve Latino health.

Public Health Relevance

This proposal is predicated upon compelling data that Latino/as exhibit a greater risk of insufficient sleep (<7 hours) compared with whites, and that insufficient sleep is associated with increased risk of cardiovascular disease and inflammation. It will provide multi-level evidence on behavioral, genetic, psychosocial and environmental determinants of insufficient sleep and sleep-related CVD risk and inflammation markers among rural and urban Latino/as. These data will provide the foundation for interventions to mitigate adverse effects of insufficient sleep on health outcomes.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Special Emphasis Panel (ZRG1)
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Brown, Marishka
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New York University
Internal Medicine/Medicine
Schools of Medicine
New York
United States
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