Document text
Principal Investigator: ALEXANDER C TSAI
Organization: MASSACHUSETTS GENERAL HOSPITAL
Fiscal Year: 2024
Award: $411,136
Funding agency: National Institute on Minority Health and Health Disparities
ABSTRACT
Numerous studies have documented racial & ethnic disparities in sleep deficiency among adolescents &
adults. These disparities are thought to be explained partially by experiences of interpersonal racial
discrimination. What remains lacking is knowledge of the causal mechanisms linking structural racism to poor
sleep health. The long-term goal is to reduce racial disparities in health. The scientific objective of this
application is to determine the extent to which structural racism, as manifested in racial disparities in police use
of deadly force, leads to racial disparities in sleep health. This application focuses on police use of deadly force
on unarmed black Americans as a cardinal manifestation of structural racism. The central hypothesis is that
police use of deadly force on unarmed black Americans leads to unhealthy sleep among other black
Americans in the general U.S. population. This hypothesis has been formulated on the basis of strong
preliminary data showing that police use of deadly force on unarmed black Americans leads to poor mental
health among other black Americans in the general U.S. population. The rationale for this application is that
detailed understanding of the causal mechanisms linking structural racism to poor sleep health is likely to offer
a strong scientific framework for developing and targeting structural and psychosocial interventions to reduce
racial disparities in sleep, cardiometabolic, and other health outcomes. The central hypothesis will be tested by
pursuing three specific aims: 1) Estimate the extent to which police use of deadly force on unarmed black
Americans is causally associated with poor sleep health among other adult black Americans in the general
U.S. population. 2) Estimate the extent to which police use of deadly force on unarmed black Americans is
causally associated with poor sleep health among other children and adolescent black Americans in the
general U.S. population. 3) Elaborate a conceptual framework identifying the mechanisms that link racial
disparities in police use of deadly force to racial disparities in sleep health. In Aims 1 & 2, population-based
survey data from 2013-18 will be merged with novel, high-resolution geocoded data on police killings and
analyzed using quasi-experimental regression models. In Aim 3, qualitative interviews will be conducted in 5
U.S. cities to build a grounded theory about structural racism and sleep health. Potential mediating pathways,
and effect modification by age and sex, will be explored in all aims. The key innovation of the proposed
research is to pair quasi-experimental, population-based studies with qualitative research to investigate a novel
contributor to racial disparities in sleep health. The findings will have significant public health impact because
they will provide proof of principle for development and targeting of structural and psychosocial interventions to
reduce racial disparities in sleep health.
Terms: <0-11 years old><21+ years old><Address><Adolescent><Adolescent Youth><Adult><Adult Human><Affect><Age><Black American><Boston><Chicago><Child><Child Youth><Children (0-21)><Cities><Coping Skills><Data><Data Set><Development><Disparities><Disparity><Funding Opportunities><General Population><General Public><Goals><Health><Health behavior><Intervention><Intervention Strategies><Interview><Knowledge><Lead><Life Cycle><Life Cycle Stages><Link><Los Angeles><Maps><Measures><Mediating><Mental Health><Mental Hygiene><Mission><Modeling><Modification><NIH><National Institutes of Health><Outcome><Pathway interactions><Pb element><Philadelphia><Police><Population><Population Study><Procedures><Psychological Health><Public Health><Qualitative Research><Quasi-experiment><Quasi-experimental analysis><Quasi-experimental approach><Quasi-experimental design><Quasi-experimental methods><Quasi-experimental research><Quasi-experimental study><Quasi-experimental technique><Research><Resolution><Scientific Advances and Accomplishments><Sleep><Sleep Deprivation><Structural Racism><Survey Instrument><Surveys><Testing><Transcript><Translating><United States National Institutes of Health><Violence><adulthood><ages><cardiometabolic><cardiometabolism><coping strategy><deficient sleep><developmental><discrimination based on race><discrimination due to race><disparities in race><disparity due to race><disparity in ethnic><disparity in health><ethnic based disparity><ethnic disadvantage><ethnic disparity><ethnic inequality><ethnic inequity><ethnicity disparity><experience><experienced discrimination><health disparity><health disparity community><health disparity group><health disparity populations><health related behavior><heavy metal Pb><heavy metal lead><improve minority health><improvement of minority health><inadequate sleep><inequality due to race><inequity due to race><innovate><innovation><innovative><insufficient sleep><interventional strategy><juvenile><juvenile human><kids><killings><life course><mortality><novel><pathway><perceived discrimination><perception of discrimination><poor sleep><population based><population-based study><population-level study><psychosocial><race based disparity><race based inequality><race based inequity><race discrimination><race disparity><race related disparity><race related inequality><race related inequity><race-based discrimination><race-related discrimination><racial discrimination><racial disparities in health><racial disparity><racial health disparity><racial inequality><racial inequity><racially unequal><resolutions><scientific accomplishments><scientific advances><self-reported discrimination><sex><sleep debt><sleep deficiency><sleep deficit><sleep health><sleep hygiene><sleep insufficiency><sleep loss><studies of populations><study of the population><theories><violent><violent behavior><youngster>