{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:48:20Z","timestamp":1792525700085,"version":"4.5.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T00:00:00Z","timestamp":1649721600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P30 DK020572"],"award-info":[{"award-number":["P30 DK020572"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["P60 MD002249"],"award-info":[{"award-number":["P60 MD002249"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["T32-AG000221"],"award-info":[{"award-number":["T32-AG000221"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Aging Health"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Objectives: Chronic stressors are associated with cardiometabolic health conditions and disparities. Mechanisms linking stressors and health remain poorly understood. Methods: Two cohort studies (Cardiac Rehabilitation And The Experience [CREATE] and Tracking Risk Identification for Adult Diabetes [TRIAD]) with harmonized variables were used to examine relationships between six types of chronic stressors in adulthood and Hypothalamic\u2013Pituitary\u2013Adrenal (HPA) axis dysregulation, as indicated by blunted diurnal cortisol slopes, which are stress-sensitive biomarkers implicated in cardiometabolic health (merged N = 213, mean age 61, 18% Black). A secondary aim was to explore whether these chronic stressors accounted for Black\u2013White disparities in HPA axis regulation. Results: Some chronic stressors were linked to HPA axis dysregulation, with recent stressors most salient ( b = 0.00353, SE = 0.00133, p = .008). Black\u2013White disparities in HPA axis regulation persisted after controlling for racial differences in chronic stressors, which reduced the disparity 11.46%. Discussion: Chronic stressors in adulthood may increase risk for HPA axis dysregulation and associated cardiometabolic health outcomes but may not be a key factor in racial disparities.<\/jats:p>","DOI":"10.1177\/08982643221085903","type":"journal-article","created":{"date-parts":[[2022,4,12]],"date-time":"2022-04-12T06:37:05Z","timestamp":1649745425000},"page":"448-459","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Mechanisms of Cardiometabolic Health Outcomes and Disparities: What Characteristics of Chronic Stressors are Linked to HPA-Axis Dysregulation?"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-8130","authenticated-orcid":false,"given":"Julie Ober","family":"Allen","sequence":"first","affiliation":[{"name":"Department of Health and Exercise Science, University of Oklahoma, Norman, USA"},{"name":"Research Center for Group Dynamics, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1798-2285","authenticated-orcid":false,"given":"Briana","family":"Mezuk","sequence":"additional","affiliation":[{"name":"Research Center for Group Dynamics, University of Michigan, Ann Arbor, USA"},{"name":"Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DeAnnah R.","family":"Byrd","sequence":"additional","affiliation":[{"name":"Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James L.","family":"Abelson","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Rafferty","sequence":"additional","affiliation":[{"name":"Institute for Social Research, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Abelson","sequence":"additional","affiliation":[{"name":"Institute for Social Research, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"White","sequence":"additional","affiliation":[{"name":"Department of Health and Exercise Science, University of Oklahoma, Norman, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Institute for Social Research, University of Michigan, Ann Arbor, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,12]]},"reference":[{"key":"bibr1-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2015.08.018"},{"key":"bibr2-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2009.06.011"},{"key":"bibr3-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2017.05.018"},{"key":"bibr4-08982643221085903","volume-title":"Diabetes disparities among racial and ethnic minorities","author":"Agency for Healthcare Research and Quality (AHRQ)","year":"2001"},{"key":"bibr5-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1007\/s42000-018-0065-x"},{"key":"bibr6-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/1557988319870969"},{"key":"bibr7-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-017-4400-6"},{"key":"bibr8-08982643221085903","volume-title":"National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2017","author":"Centers for Disease Control and Prevention (CDC)","year":"2017"},{"key":"bibr9-08982643221085903","first-page":"3","volume-title":"The social psychology of health: Claremont symposium on applied social psychology","author":"Cohen S.","year":"1988"},{"key":"bibr10-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.11.007"},{"key":"bibr11-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000131"},{"key":"bibr12-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyp277"},{"key":"bibr13-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2014.08.018"},{"key":"bibr14-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1017\/S1742058X04042031"},{"key":"bibr15-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X11666141122220003"},{"key":"bibr16-08982643221085903","volume-title":"Guidelines for best practice in cross-cultural surveys","author":"Granda P.","year":"2016"},{"key":"bibr17-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2009.06.017"},{"key":"bibr18-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/1557988313480227"},{"key":"bibr19-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.64"},{"key":"bibr20-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2009.12.009"},{"key":"bibr21-08982643221085903","first-page":"67","volume-title":"The role of saliva cortisol measurement in health and disease","author":"Halford C.","year":"2012"},{"key":"bibr22-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00902.2008"},{"key":"bibr23-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2008.143446"},{"key":"bibr24-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2009.10.002"},{"key":"bibr25-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp154"},{"key":"bibr26-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.09.042"},{"key":"bibr27-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2014.07.028"},{"key":"bibr28-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1037\/0882-7974.19.4.637"},{"key":"bibr29-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1002\/smi.2835"},{"key":"bibr30-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2014.01.017"},{"key":"bibr31-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2009.05331.x"},{"key":"bibr32-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/2156869313480892"},{"key":"bibr33-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0985"},{"key":"bibr34-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1037\/a0024768"},{"key":"bibr35-08982643221085903","volume-title":"High and rising mortality rates among working-age adults","author":"National Academies of Sciences, Engineering, &amp; Medicine (NASEM)","year":"2021"},{"key":"bibr36-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-1818"},{"key":"bibr37-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060308"},{"issue":"45","key":"bibr38-08982643221085903","first-page":"112","volume":"9","author":"Pouwer F.","year":"2010","journal-title":"Discovery Medicine"},{"key":"bibr39-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1027"},{"key":"bibr40-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2016.17"},{"key":"bibr41-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1410401111"},{"key":"bibr42-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1017\/S1742058X11000087"},{"key":"bibr43-08982643221085903","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305543"},{"key":"bibr44-08982643221085903","first-page":"355","volume-title":"Race, ethnicity, and health: A public health reader","author":"Thorpe R. J.,","year":"2012","edition":"2"},{"key":"bibr45-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.03.017"},{"key":"bibr46-08982643221085903","volume-title":"Historical income table H-8. Median household income by state: 1984 to 2020. Current population survey, 1985 to 2021 annual Social and economic supplements [dataset]","author":"U.S. Census Bureau","year":"2021"},{"key":"bibr47-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000757"},{"key":"bibr48-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-014-0195-0"},{"key":"bibr49-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.psyneuen.2014.07.024"},{"key":"bibr50-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.03.021"},{"key":"bibr51-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/0002764213487340"},{"key":"bibr52-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/0022146510383838"},{"key":"bibr53-08982643221085903","doi-asserted-by":"publisher","DOI":"10.1177\/135910539700200305"}],"container-title":["Journal of Aging and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08982643221085903","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08982643221085903","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08982643221085903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T19:37:19Z","timestamp":1777491439000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08982643221085903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,12]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1177\/08982643221085903"],"URL":"https:\/\/doi.org\/10.1177\/08982643221085903","relation":{},"ISSN":["0898-2643","1552-6887"],"issn-type":[{"value":"0898-2643","type":"print"},{"value":"1552-6887","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,12]]}}}