{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:46:04Z","timestamp":1768567564773,"version":"3.49.0"},"posted":{"date-parts":[[2024,4,10]]},"group-title":"Epidemiology","reference-count":54,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Sex differences are related to both biological factors and the gendered environment. To untangle sex-related effects on health and disease it is important to model sex-related differences better.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data came from the baseline visit of the Hispanic Community Health Study\/Study of Latinos (HCHS\/SOL), a longitudinal cohort study following 16,415 individuals recruited at baseline from four study sites: Bronx NY, Miami FL, San Diego CA, and Chicago IL. We applied LASSO penalized logistic regression of male versus female sex over sociodemographic, acculturation, and psychological factors jointly. Two \u201cgendered indices\u201d, GISE and GIPSE, summarizing the sociodemographic environment (GISE, primary) and psychosocial and sociodemographic environment (GIPSE, secondary) associated with sex, were calculated by summing these variables, weighted by their regression coefficients. We examined the association of these indices with insomnia derived from self-reported symptoms assessed via the Women Health Initiative Insomnia Rating Scale (WHIIRS), a phenotype with strong sex differences, in sex-adjusted and sex-stratified analyses. All analyses were adjusted for age, Hispanic\/Latino background, and study center.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The distribution of GISE and GIPSE differed by sex with higher values in male individuals, even when constructing and validating them on separate, independent, subsets of HCHS\/SOL individuals. In an association model with insomnia, male sex was associated with lower likelihood of insomnia (odds ratio (OR)=0.60, 95% CI (0.53, 0.67)). Including GISE in the model, the association was slightly weaker (OR=0.63, 95% CI (0.56, 0.70)), and weaker when including instead GIPSE in the association model (OR=0.78, 95% CI (0.69, 0.88)). Higher values of GISE and of GIPSE, more common in male sex, were associated with lower likelihood of insomnia, in analyses adjusted for sex (per 1 standard deviation of the index, GISE OR= 0.92, 95% CI (0.87, 0.99), GIPSE OR=0.65, 95% CI (0.61, 0.70)).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>New measures such as GISE and GIPSE capture sex-related differences beyond binary sex and have the potential to better model and inform research studies of health. However, such indices do not account for gender identity and may not well capture the environment experienced by intersex and non-binary persons.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2024.04.09.24305555","type":"posted-content","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T13:55:17Z","timestamp":1712757317000},"source":"Crossref","is-referenced-by-count":0,"title":["A sociodemographic index identifies non-biological sex-related effects on insomnia in the Hispanic Community Health Study\/Study of Latinos"],"prefix":"10.64898","author":[{"given":"Natali","family":"Sorajja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmela","family":"Alc\u00e1ntara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Wassertheil-Smoller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank J","family":"Penedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto R","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista M","family":"Perreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha L","family":"Daviglus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shakira F","family":"Suglia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda C","family":"Gallo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Y","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Redline","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen R","family":"Isasi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8520-8860","authenticated-orcid":false,"given":"Tamar","family":"Sofer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2024041204451472000_2024.04.09.24305555v1.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03324754"},{"issue":"6","key":"2024041204451472000_2024.04.09.24305555v1.2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s11920-017-0784-8","article-title":"Sex differences in obesity and mental health","volume":"19","year":"2017","journal-title":"Curr Psychiatry Rep"},{"key":"2024041204451472000_2024.04.09.24305555v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308769"},{"key":"2024041204451472000_2024.04.09.24305555v1.4","doi-asserted-by":"publisher","DOI":"10.1037\/pag0000070"},{"key":"2024041204451472000_2024.04.09.24305555v1.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.tig.2014.08.006"},{"issue":"17","key":"2024041204451472000_2024.04.09.24305555v1.6","doi-asserted-by":"crossref","first-page":"2976","DOI":"10.1093\/hmg\/ddz090","article-title":"Tissue-specific sex differences in human gene expression","volume":"28","year":"2019","journal-title":"Hum Mol Genet"},{"key":"2024041204451472000_2024.04.09.24305555v1.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2021.02.968"},{"issue":"8","key":"2024041204451472000_2024.04.09.24305555v1.8","doi-asserted-by":"crossref","first-page":"e0161045","DOI":"10.1371\/journal.pone.0161045","article-title":"Incidence of X and Y chromosomal aneuploidy in a large child bearing population","volume":"11","year":"2016","journal-title":"PLoS ONE"},{"issue":"5","key":"2024041204451472000_2024.04.09.24305555v1.9","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/s10038-021-01001-0","article-title":"Prevalence of common aneuploidy in twin pregnancies","volume":"67","year":"2022","journal-title":"J Hum Genet"},{"key":"2024041204451472000_2024.04.09.24305555v1.10","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001406"},{"key":"2024041204451472000_2024.04.09.24305555v1.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7320.1061"},{"issue":"1","key":"2024041204451472000_2024.04.09.24305555v1.12","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/tbm\/ibad014","article-title":"Gender as a social and structural variable: research perspectives from the National Institutes of Health (NIH)","volume":"14","year":"2024","journal-title":"Transl Behav Med"},{"issue":"5","key":"2024041204451472000_2024.04.09.24305555v1.13","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.cjca.2021.02.005","article-title":"The importance of gender to understand sex differences in cardiovascular disease","volume":"37","year":"2021","journal-title":"Can J Cardiol"},{"key":"2024041204451472000_2024.04.09.24305555v1.14","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00376.2005"},{"issue":"9","key":"2024041204451472000_2024.04.09.24305555v1.15","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1007\/s11883-022-01046-2","article-title":"Biology, bias, or both? the contribution of sex and gender to the disparity in cardiovascular outcomes between women and men","volume":"24","year":"2022","journal-title":"Curr Atheroscler Rep"},{"key":"2024041204451472000_2024.04.09.24305555v1.16","doi-asserted-by":"crossref","unstructured":"Baker FC , Y\u0171ksel D , de Zambotti M . Sex differences in sleep. In: Attarian H , Viola-Saltzman M , editors. Sleep disorders in women: A guide to practical management. Cham: Springer International Publishing; 2020. p. 55\u201364.","DOI":"10.1007\/978-3-030-40842-8_5"},{"key":"2024041204451472000_2024.04.09.24305555v1.17","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcp.0000245705.69440.6a"},{"key":"2024041204451472000_2024.04.09.24305555v1.18","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2015.0110"},{"issue":"12","key":"2024041204451472000_2024.04.09.24305555v1.19","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s11920-022-01393-6","article-title":"Socio-Ecological Context of Sleep: Gender Differences and Couples\u2019 Relationships as Exemplars","volume":"24","year":"2022","journal-title":"Curr Psychiatry Rep"},{"issue":"5","key":"2024041204451472000_2024.04.09.24305555v1.20","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5153\/sro.1609","article-title":"Gender roles and women\u2019s sleep in mid and later life: A quantitative approach","volume":"12","year":"2007","journal-title":"SOCIOL RES ONLINE"},{"key":"2024041204451472000_2024.04.09.24305555v1.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.07.059"},{"issue":"2","key":"2024041204451472000_2024.04.09.24305555v1.22","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1080\/15402002.2011.636112","article-title":"Objective and subjective socioeconomic gradients exist for sleep quality, sleep latency, sleep duration, weekend oversleep, and daytime sleepiness in adults","volume":"11","year":"2013","journal-title":"Behav Sleep Med"},{"key":"2024041204451472000_2024.04.09.24305555v1.23","first-page":"97","article-title":"Circadian and sleep-dependent regulation of hormone release in humans","volume":"54","year":"1999","journal-title":"Recent Prog Horm Res"},{"issue":"Suppl 1","key":"2024041204451472000_2024.04.09.24305555v1.24","first-page":"76","article-title":"Sleep and meal timing influence food intake and its hormonal regulation in healthy adults with overweight\/obesity","volume":"72","year":"2019","journal-title":"Eur J Clin Nutr"},{"key":"2024041204451472000_2024.04.09.24305555v1.25","doi-asserted-by":"crossref","unstructured":"Kelly MR , Yuen F , Satterfield BC , Auchus RJ , Gaddameedhi S , Van Dongen HPA , et al. Endogenous Diurnal Patterns of Adrenal and Gonadal Hormones During a 24-Hour Constant Routine After Simulated Shift Work. J Endocr Soc. 2022 Oct 26;6(12):bvac153.","DOI":"10.1210\/jendso\/bvac153"},{"key":"2024041204451472000_2024.04.09.24305555v1.26","doi-asserted-by":"crossref","unstructured":"Stewart EM , Landry S , Edwards BA , Drummond SPA . The bidirectional relationship between sleep and health. In: Paul RH , Salminen LE , Heaps J , Cohen LM , editors. The wiley encyclopedia of health psychology. Wiley; 2020. p. 165\u201388.","DOI":"10.1002\/9781119057840.ch200"},{"key":"2024041204451472000_2024.04.09.24305555v1.27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2016.10.012"},{"issue":"9","key":"2024041204451472000_2024.04.09.24305555v1.28","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s11920-018-0940-9","article-title":"Sex Differences in Insomnia: from Epidemiology and Etiology to Intervention","volume":"20","year":"2018","journal-title":"Curr Psychiatry Rep"},{"key":"2024041204451472000_2024.04.09.24305555v1.29","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/29.1.85"},{"key":"2024041204451472000_2024.04.09.24305555v1.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2009.05.011"},{"key":"2024041204451472000_2024.04.09.24305555v1.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2010.05.006"},{"key":"2024041204451472000_2024.04.09.24305555v1.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2010.03.015"},{"issue":"11","key":"2024041204451472000_2024.04.09.24305555v1.33","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1007\/s11883-023-01152-9","article-title":"Risk Factors for Cardiovascular Disease: Knowledge Gained from the Hispanic Community Health Study\/Study of Latinos","volume":"25","year":"2023","journal-title":"Curr Atheroscler Rep"},{"issue":"5","key":"2024041204451472000_2024.04.09.24305555v1.34","doi-asserted-by":"crossref","first-page":"e28997","DOI":"10.2196\/28997","article-title":"Influence of stress, gender, and minority status on cardiovascular disease risk in the hispanic\/latino community: protocol for a longitudinal observational cohort study","volume":"10","year":"2021","journal-title":"JMIR Res Protoc"},{"key":"2024041204451472000_2024.04.09.24305555v1.35","doi-asserted-by":"publisher","DOI":"10.1177\/07399863870092005"},{"key":"2024041204451472000_2024.04.09.24305555v1.36","unstructured":"Spielberger CD . State-Trait Anxiety Inventory for Adults. American Psychological Association (APA). 2012;"},{"key":"2024041204451472000_2024.04.09.24305555v1.37","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"2024041204451472000_2024.04.09.24305555v1.38","doi-asserted-by":"crossref","unstructured":"Lumley T. Complex surveys: a guide to analysis using R. 2011;","DOI":"10.1002\/9780470580066"},{"key":"2024041204451472000_2024.04.09.24305555v1.39","doi-asserted-by":"publisher","DOI":"10.1037\/1040-3590.15.2.137"},{"issue":"4","key":"2024041204451472000_2024.04.09.24305555v1.40","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1002\/ase.2002","article-title":"Beyond the sex binary: toward the inclusive anatomical sciences education","volume":"14","year":"2021","journal-title":"Anat Sci Educ"},{"key":"2024041204451472000_2024.04.09.24305555v1.41","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.1998.7.1247"},{"key":"2024041204451472000_2024.04.09.24305555v1.42","doi-asserted-by":"crossref","unstructured":"Gurvich C , Hoy K , Thomas N , Kulkarni J . Sex Differences and the Influence of Sex Hormones on Cognition through Adulthood and the Aging Process. Brain Sci. 2018 Aug 28;8(9).","DOI":"10.3390\/brainsci8090163"},{"key":"2024041204451472000_2024.04.09.24305555v1.43","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1257\/pandp.20221083","article-title":"Continuous gender identity and economics","volume":"112","year":"2022","journal-title":"AEA Papers and Proceedings"},{"key":"2024041204451472000_2024.04.09.24305555v1.44","doi-asserted-by":"crossref","unstructured":"Lindqvist A , Send\u00e9n MG , Renstr\u00f6m EA . What is gender, anyway: a review of the options for operationalising gender. Psychology & Sexuality. 2020 Feb 18;1\u201313.","DOI":"10.1080\/19419899.2020.1729844"},{"key":"2024041204451472000_2024.04.09.24305555v1.45","doi-asserted-by":"crossref","unstructured":"Smiler AP , Epstein M . Measuring gender: options and issues. In: Chrisler JC , McCreary DR , editors. Handbook of gender research in psychology. New York, NY: Springer New York; 2010. p. 133\u201357.","DOI":"10.1007\/978-1-4419-1465-1_7"},{"key":"2024041204451472000_2024.04.09.24305555v1.46","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.socscimed.2018.12.038","article-title":"Perceived discrimination and physical health-related quality of life: The Hispanic Community Health Study\/Study of Latinos (HCHS\/SOL) Sociocultural Ancillary Study","volume":"222","year":"2019","journal-title":"Soc Sci Med"},{"issue":"4","key":"2024041204451472000_2024.04.09.24305555v1.47","first-page":"202","article-title":"and Negative Cognitive-Emotional Factors: Findings From the Hispanic Community Health Study\/Study of Latinos Sociocultural Ancillary Study","volume":"4","year":"2016","journal-title":"J Lat Psychol"},{"issue":"3","key":"2024041204451472000_2024.04.09.24305555v1.48","first-page":"160","article-title":"Prevalence and correlates of perceived ethnic discrimination in the hispanic community health study\/study of latinos sociocultural ancillary study","volume":"3","year":"2015","journal-title":"J Lat Psychol"},{"key":"2024041204451472000_2024.04.09.24305555v1.49","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201309-1735OC"},{"issue":"7","key":"2024041204451472000_2024.04.09.24305555v1.50","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jagp.2016.02.049","article-title":"Racial\/ethnic differences in insomnia trajectories among U","volume":"24","year":"2016","journal-title":"S. older adults. Am J Geriatr Psychiatry"},{"key":"2024041204451472000_2024.04.09.24305555v1.51","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.14517"},{"issue":"3","key":"2024041204451472000_2024.04.09.24305555v1.52","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/j.jvs.2015.03.065","article-title":"Cuban Americans have the highest rates of peripheral arterial disease in diverse Hispanic\/Latino communities","volume":"62","year":"2015","journal-title":"J Vasc Surg"},{"key":"2024041204451472000_2024.04.09.24305555v1.53","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2505"},{"key":"2024041204451472000_2024.04.09.24305555v1.54","doi-asserted-by":"crossref","unstructured":"Smith PM , Koehoorn M . Measuring gender when you don\u2019t have a gender measure: constructing a gender index using survey data. Int J Equity Health. 2016 May 28;15:82.","DOI":"10.1186\/s12939-016-0370-4"}],"container-title":[],"original-title":[],"link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1101\/2024.04.09.24305555","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T19:57:58Z","timestamp":1768507078000},"score":1,"resource":{"primary":{"URL":"http:\/\/medrxiv.org\/lookup\/doi\/10.1101\/2024.04.09.24305555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,10]]},"references-count":54,"URL":"https:\/\/doi.org\/10.1101\/2024.04.09.24305555","relation":{},"subject":[],"published":{"date-parts":[[2024,4,10]]},"subtype":"preprint"}}