Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents
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Community Violence Exposure, Sleep Disruption, and Insulin Resistance in Low-Income Urban Adolescents Wendy Kliewer 1
&
Jo Lynne Robins 2 & Alicia Borre 3
# International Society of Behavioral Medicine 2019
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. Keywords Insulin resistance . Sleep problems . Violence exposure . Gender differences . African-American . Adolescents
Introduction
* Wendy Kliewer [email protected] Jo Lynne Robins [email protected] Alicia Borre [email protected] 1
Department of Psychology, Virginia Commonwealth University, Box 842018, Richmond, VA 23284-2018, USA
2
Department of Family and Community Health, School of Nursing Box 980567, Virginia Commonwealth University, Richmond, VA 23298-0567, USA
3
Psychology Department, Hampton University, MLK Building, Room 238, Hampton, VA 23668, USA
Evidence suggests that exposure to violence during adolescence increases cardiovascular risk into adulthood [1]. A recent study that examined racial disparities in violent victimization, and health consequences associated with violence exposure during childhood by black youth and young adults, found that black adolescents and young adults were at risk for the most physically harmful forms of violence compared with whites [2]. Mounting evidence suggests that this exposure to violence contribut
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