Shakira Franco Suglia

Shakira Franco Suglia
Emory University | EU · Department of Epidemiology

MS, ScD

About

141
Publications
10,981
Reads
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4,792
Citations
Citations since 2017
81 Research Items
3056 Citations
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20172018201920202021202220230200400600
20172018201920202021202220230200400600
Additional affiliations
June 2011 - January 2016
Columbia University
Position
  • Professor (Assistant)
January 2010 - December 2011
Boston University
January 2009 - December 2010
Boston University Medical Campus
Education
September 2002 - June 2006
Harvard School of Public Health
Field of study
  • Epidemiology

Publications

Publications (141)
Article
Violence, experienced in either childhood or adulthood, has been associated with physical health outcomes, including cardiovascular disease. However, the consistency of the existing literature has not been evaluated. In 2013, the authors conducted a PubMed and Web of Science review of peer-reviewed articles published prior to August 2013 on the rel...
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Background Maltreatment during childhood and adolescence has been associated with chronic conditions in adulthood including cardiovascular disease. However, less is known about the effects of childhood maltreatment on cardiovascular risk factors prior to development of cardiovascular disease, or whether these effects are evident in young adulthood....
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Background and objectives: This study tested whether dating violence (DV) victimization is associated with increases in BMI across the transition from adolescence to young adulthood and whether gender and previous exposure to child maltreatment modify such increases. Methods: Data were from participants (N = 9295; 49.9% female) in the National L...
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Background Family functioning may impact children’s cardiometabolic health; however, few studies have examined multiple cardiometabolic markers among a diverse racial/ethnic cohort. The relationship between child- and caregiver-reported family functioning and the cardiometabolic health of Hispanic/Latino youth was examined.Method Data were from the...
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Background: MicroRNA (miRNA) circulating in plasma has been proposed as biomarkers for a variety of diseases and stress measures, including depression, stress, and trauma. However, few studies have examined the relationship between stress and miRNA during pregnancy. Methods: In this study, we examined associations between measures of stress and...
Article
Child maltreatment (CM) is associated with multiple adverse health outcomes. Hence, there is a great need to identify factors that promote resilience in CM survivors. Mentorship may promote positive coping in CM survivors, but this may vary by health outcome and mentor/mentee characteristics. Among participants in a United States nationally represe...
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Purpose To estimate the effect of childhood trauma on postpartum visit attendance and explore mediation by posttraumatic stress disorder (PTSD) and depressive symptoms. Methods We analyzed data from Grady Trauma Project surveys linked to electronic medical records. We measured childhood trauma using the Childhood Trauma Questionnaire and 4-12 week...
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Religiosity may influence COVID-19 vaccination. However, it remains unclear how religiosity is associated with beliefs toward COVID-19 and vaccination against it, particularly amongst ethnic minorities. This study examined the association between religiosity, vaccination intent, beliefs, and attitudes related to COVID-19 and vaccination among adult...
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Background Adverse childhood experiences (ACEs) may sensitize individuals to view situations in adulthood as more stressful, which may contribute to poor health outcomes. In populations facing disadvantage, ACEs may lead to the accumulation of stressors (stress proliferation or mediation hypothesis) throughout the life course. ACEs could also heigh...
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Background Negative emotional eating (EE) is associated with unfavorable behavioral and health outcomes. Understanding its association with positive factors, such as optimism, may shed light into novel interventions. We examined the association between optimism and negative EE in US Caribbean Latinx adults, a population disproportionately exposed t...
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Racial/ethnic and sex/gender disparities in sleep duration have been documented in adolescence and adulthood. Identifying racial/ethnic and sex/gender differences in sleep duration trajectories from adolescence to adulthood can inform interventions on the developmental periods individuals are most at risk for short sleep duration. We examined racia...
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Background Social isolation, the relative absence of or infrequency of contact with different types of social relationships, and loneliness (perceived isolation) are associated with adverse health outcomes. Objective To review observational and intervention research that examines the impact of social isolation and loneliness on cardiovascular and...
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Objectives: Experiences of child maltreatment are associated with cardiovascular risk and disease in adulthood, however the mechanisms underlying these associations are poorly understood. Methods: We examined associations between retrospectively self-reported exposure to child maltreatment (Early Trauma Inventory Self-Report Short Form), and inf...
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This study evaluated methods for creating a neighborhood adverse childhood experiences (ACEs) index, a composite measure that captures the association between neighborhood environment characteristics (e.g., crime, healthcare access) and individual-level ACEs exposure, for a particular population. A neighborhood ACEs index can help understand and ad...
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Objectives To examine the associations between perceived changes in stress, eating, and weight during the COVID-19 pandemic among adults in Puerto Rico. Methods This cross-sectional analysis used data from the Puerto Rico Community Alliance Against COVID-19 Disparities (CEAL) study. A total of 551 adults (18 years) completed an online survey from...
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Introduction Numerous studies have examined the consequences of childhood adversity (CA) and socioeconomic status (SES) for health over the life course. However, few studies have examined the relation between childhood SES and CA as well as the influence of CA on adult SES. The objective of this study was to examine direct and indirect associations...
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Background: United States' federal and subfederal immigrant-related policy activity has increased in recent years. We hypothesize that these policies are structural determinants of health for Latinx communities, operating through access to resources, discriminatory enforcement, and stress. Methods: We searched seven databases for quantitative st...
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The acculturation gap theory provides a complex illustration of how cultural orientations affect health behaviors among adolescents, by assuming that familial cultural orientation gaps lead to compromised family functioning and children adopting negative health behaviors. This analysis used three methods to conceptualize cultural gaps to examine th...
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Purpose: Previous work has shown that asthma-related emergency department (ED) use is greatest among Black and Latine populations, but it is unknown whether health care use for exacerbations differs across settings (outpatient, ED, inpatient) and correlates with use of routine outpatient services. We aimed to measure disparities by race, ethnicity...
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Background: A body of literature shows that child maltreatment (CM) is associated with subsequent adiposity and inflammation, but few studies examine factors that buffer against these outcomes among survivors of CM. Child and adolescent team sports participation has been associated with positive mental and physical health outcomes, including decrea...
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This study examines the association of changes in weight status from teen to young adult ages with the number of ideal cardiovascular health (CVH) and clinical CVH metrics by adulthood. We hypothesized that increases in weight status from teen to young adult ages are associated with less ideal CVH metrics in adulthood. Data from a subset of partici...
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Background and Objective Carotid intima-media thickness (c-IMT) is a measurement of atherosclerosis, a progressive disease that develops as early as childhood and has been linked with cognitive impairment and dementia in the elderly. However, the relationship between c-IMT and midlife cognitive function as well as race and social disparities on thi...
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Background: School environments are important to consider for children's health. This study aims to determine if childhood peer bullying and school connectedness are associated with adolescent adiposity. Methods: A total of 3377 children from the age 9 child interview of the Fragile Families and Child Wellbeing Study had self-reported bullying a...
Article
Since its conceptualization, there has been a lack of consensus on the best way to operationalize allostatic load (AL). As a marker of the cumulative, physiological wear and tear on the body resulting from chronic exposure to stressors, it follows that AL should be higher among people who have faced more stressful life experiences. Thus, the purpos...
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While associations between stress and hypertension have been documented, little research has examined the association between coping and hypertension, especially in the context of understanding racial disparities. Utilizing data from the CHDS-DISPAR study, we examine the association between avoidant coping and hypertension among adults age 50 while...
Article
Early life stress (ELS) has been associated with an increased risk of cardiovascular disease. We examined whether ELS was associated with autonomic function and stress reactivity among individuals with coronary heart disease (CHD). We included patients with stable CHD from two parallel studies, the Mental Stress Ischemia Prognosis Study (MIPS) and...
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Growing evidence suggests that childhood trauma is associated with poorer cardiovascular health in adulthood, but few studies have examined potential mediators of these associations. We examined the links between different forms of childhood trauma (i.e., abuse, neglect, cumulative trauma) and cardiovascular health and explored potential mediators....
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Introduction: Alzheimer’s disease and related dementias (ADRD) are increasing in prevalence. While overt atherosclerosis is recognizable from childhood and has been linked to cognitive impairment and dementia in late life, information is scant on the association between subclinical atherosclerosis and cognitive impairment in midlife. We examined th...
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Background : Foreign-born Latino children in the United States (US) have poor asthma outcomes, but the role of routine care utilization in these outcomes is unclear. Our objective was to compare select ambulatory care utilization measures for asthma between foreign-born Latino, US-born Latino, and non-Hispanic white children. Methods : Using a mul...
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Objective To test whether a policy approach aimed at reducing prescription drug misuse, specifically, state monitoring of controlled substance prescriptions—Prescription Drug Monitoring Programs (PDMPs)—were associated with changes in Child Protective Services-reported maltreatment prevalence. Study design Using a difference-in-differences design...
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Objective: To understand the prevalence of child maltreatment-related emergency department (ED) visits in the United States, we examined data from the 2007 to 2014 Nationwide Emergency Department Sample. Methods: Based on existing literature, International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9 CM) ED discharge c...
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Trauma is a response to a deeply distressing or disturbing event, such as sexual assault, violent crime, or childhood abuse. Trauma has impacted the majority of Americans, with racial/ethnic minority and socioeconomically disadvantaged populations being disproportionately affected. Extensive evidence demonstrates trauma’s harmful effects on physica...
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Background Early life adversity and infections may theoretically affect the timing and effort of reproductive development. We examined associations of childhood adversity and exposure to tonsillitis with age at menarche in women age 40-64 years. Methods A multi-ethnic cohort of 394 women reported on exposure to parental maltreatment and maladjustm...
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Background The Environmental Affordances Model (EAM) proposes that the effects of chronic stress on depression are moderated by unhealthy behaviors and race/ethnicity. The unique social structures and contexts of Hispanics/Latinos in the U.S. may influence such relationships. This study evaluated whether unhealthy behaviors weakened the relationshi...
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Background Underserved subgroups are less likely to have optimal health prior to pregnancy. We describe preconception health indicators (behavior, pregnancy intention, and obesity) among pregnant Latina women with and without chronic stress in metro Atlanta. Design We surveyed 110 pregnant Latina women enrolled in prenatal care at three clinics in...
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Objective Asthma care is negatively impacted by neighbourhood social and environmental factors, and moving is associated with undesirable asthma outcomes. However, little is known about how movement into and living in areas of high deprivation relate to primary care use. We examined associations between neighbourhood characteristics, mobility and p...
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Early life adversities (ELA), include experiences such as child maltreatment, household dysfunction, bullying, exposure to crime, discrimination, bias, and victimization, and are recognized as social determinants of cardiovascular disease (CVD). Strong evidence shows exposure to ELA directly impacts cardiometabolic risk in adulthood and emerging ev...
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Environmental exposures, psychosocial stressors and nutrition are all potentially important influences that may impact health outcomes directly or via interactions with the genome or epigenome over generations. While there have been clear successes in large-scale human genetic studies in recent decades, there is still a substantial amount of missin...
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Background: Short sleep duration (e.g., <9 hours (hrs) for 6-12 years and <8 hrs for 13-18 years) is highly prevalent and associated with cardiometabolic risk among adolescents. Significant racial disparities in sleep duration among adolescents have been found. Investigating mechanisms driving sleep disparities is important for informing interventi...
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Introduction: Limited existing research suggests that immigration climate and enforcement practices represent a social determinant of health for immigrants, their families, and communities. However, national research on the impact of specific policies is limited. The goal of this article is to estimate the effect of county-level participation in a...
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MicroRNA (miRNA) circulating in plasma have been proposed as biomarkers for a variety of conditions and diseases, including complications during pregnancy. During pregnancy, about 15–25% of maternal plasma exosomes, a small size-class of EVs, are hypothesized to originate in the placenta, and may play a role in communication between the fetus and m...
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Childhood adversities (CAs) and infections may affect the timing of reproductive development. We examined the associations of indicators of CAs and exposure to tonsillitis and infectious mononucleosis (mono) with age at menarche. A multiethnic cohort of 400 women (ages 40–64 years) reported exposure to parental maltreatment and maladjustment during...
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Importance Higher blood pressure (BP) levels in children are associated with an increased risk for hypertension and subclinical cardiovascular disease in adulthood. Identifying trends in BP could inform the need for interventions to lower BP. Objective To determine whether systolic BP (SBP) and diastolic BP (DBP) levels among US children have chan...
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Stress across the life course is highly prevalent, particularly among immigrant and racial/ethnic minority women who face adversities associated with structural and interpersonal racism. Understanding how women perceive and describe stress and resilience can provide cultural context to inform interventions to improve health among pregnant women fac...
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Circulating miRNA may contribute to the development of adverse birth outcomes. However, few studies have investigated extracellular vesicle (EV) miRNA, which play important roles in intercellular communication, or compared miRNA at multiple time points in pregnancy. In the current study, 800 miRNA were profiled for EVs from maternal plasma collecte...
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Recent reports on the burden of cardiovascular disease (CVD) in the USA indicate that despite significant declines in CVD mortality in the late 20th century, this decline is now decelerating and may be worsened by inequalities in health care. Social factors contribute to most of the cardiovascular health disparities documented to date. Hispanics/La...
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The passage of US immigrant-related policies at the federal, state, and local level is on the rise. These policies may affect child health through several mechanisms. We performed a systematic review of English-language, peer-reviewed, quantitative studies examining US immigrant-related policies and the mental and physical health of youth in immigr...
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Public health surveillance surveys provide key data from which the U.S. population health estimates are derived. We conducted a systematic review of the contemporary scientific literature on prevalent Latina/o child and adult health outcomes to determine the proportion of peer-reviewed articles derived from national or state U.S. public health surv...
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Introduction It is uncertain if disparities in asthma diagnosis between Latino and non-Hispanic white children stem from differences in diagnosis over time among children presenting with similar clinical scenarios suggestive of asthma. Methods We evaluated the odds of International Classification of Disease (ICD)-coded asthma diagnosis in Latino (...
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Background: Children with adverse childhood experiences (ACEs) are more likely to develop Attention-Deficit/Hyperactivity Disorder (ADHD). The reverse relationship - ADHD predicting subsequent ACEs - is vastly understudied, although it may be of great relevance to underserved populations highly exposed to ACEs. Methods: Participants were 5- to 1...
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Importance Compared with older patients, young adults with a history of myocardial infarction (MI) tend to have a higher burden of psychosocial adversity. Exposure to early-life stressors may contribute to the risk of adverse outcomes in this patient population, potentially through inflammatory pathways. Objective To investigate the association of...
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Introduction: Prior research has documented disparities in asthma outcomes between Latino children and non-Hispanic whites, but little research directly examines the care provided to Latino children over time in clinical settings. Methods: We utilized an electronic health record-based dataset to study basic asthma care utilization (timely diagno...
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Child maltreatment and elevated sensation seeking are associated with a wide range of negative outcomes. Longitudinal data from a study of Puerto Ricans living in two sociocultural contexts were used to determine whether child maltreatment subtypes, sex, or sociocultural context relate to trajectories of sensation seeking. Participants were 2,489 i...
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Purpose Childhood adversity is associated with increased risk of adult disease, including type 2 diabetes and hypertension. However, little is known about potential associations between childhood adversity and adverse pregnancy outcomes. The goal of this study is to examine the relationship between adverse childhood experiences (ACEs) and ever expe...
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Cardiovascular disease disparities are shaped by differences in risk factors across racial and ethnic groups. Housing remains an important social determinant of health. The objective of this statement is to review and summarize research that has examined the associations of housing status with cardiovascular health and overall health. PubMed/Medlin...
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This study examines: (1) the association between the neighborhood social environment and obesity among adolescents, (2) whether physical activity, screen time, and short sleep mediates this association, and (3) examine sex differences. Participants (n = 12,692; age 11–19 years old) came from Waves I and II of the National Longitudinal Study of Adol...
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Child maltreatment is common and has been associated with substance use addictions, yet few studies have examined associations with potentially addictive dietary and screen time behaviors. The goal of this study was to assess associations between retrospectively self-reported child maltreatment (sexual abuse, physical abuse, emotional abuse, and ne...
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Objectives: We aimed to determine the role of mothers' nativity and race/ethnicity on their children's emergency department utilization. Methods: Data from the Fragile Families and Child Wellbeing Study was used for the analyses. Descriptive and regression analyses were conducted to compare use of ED services between children of foreign-born ver...
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Background Exposure to childhood adversities (CA) is associated with sleep disturbances; however, evidence has largely been drawn from cross-sectional data and has not addressed the relationship across developmental stages. Also, most studies have primarily focused on non-Hispanic White cohorts with a dearth of longitudinal evidence about racial/et...
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Background: Obesity is present in 17% of US youth, age 2-19 years, but the extent to which obesity in childhood is associated with higher BMI and fat mass in middle age is unclear. In this study, links between childhood body size and BMI and body composition at age ∼50 were assessed. Methods: Child Health and Development Studies participants, born...
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Objective: Evidence stemming largely from retrospective studies suggests that childhood adversity (CA) is associated with earlier age at menarche, a marker of pubertal timing, among girls. Little is known about associations with pubertal tempo among boys or racial/ethnic minorities. We examined the association between CA and timing and tempo of pu...
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Background: News reports and hate crime data suggest that anti-Hispanic/Latino immigrant sentiment was expressed by some sectors of the U.S. public during the 2016 Presidential campaign and election. The purpose of this study was to examine the association between this period and cardiovascular disease (CVD) risk factors thought to be responsive to...
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NHLBI convened an interdisciplinary panel of experts in childhood adversity, social determinants of health, and cardiovascular disease (CVD) for a collaborative workshop, entitled “Social Determinants of Health: Early Life Adversity as a Contributor to Disparities in Cardiovascular Diseases.” This manuscript reports workshop proceedings addressing...
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Objectives: We aimed to determine the relation between childhood adversities and prior involvement with Child Protective Services (CPS) history among children presenting for evaluation at a Child Advocacy Center. Study design: The study evaluated children presenting to a Child Advocacy Center (CAC) from 2009 to 2014. A five-item child adversity...
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Purpose: The purpose of this study was to evaluate whether childhood maltreatment is associated with smoking behaviors and lifetime nicotine dependence and if associations are moderated by sex. We examined these associations among individuals who ever reported being regular smokers. Methods: Using data from the National Longitudinal Study of Ado...
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Immigration policy climate may have pervasive effects on the health of immigrants and their families. We examine how living in a state at the time of delivery with a more restrictive immigration policy climate impacts risk of very preterm birth (VPTB) among Hispanic mothers in the United States. We used data from the United States live birth files,...
Article
Objective: Comorbid asthma and obesity leads to poorer asthma outcomes, partially due to decreased response to controller medication. Increased oral steroid prescription, a marker of uncontrolled asthma, may follow. Little is known about this phenomenon among Latino children. Our objective was to determine whether obesity is associated with increas...
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A life course approach posits that early experiences are deeply influential on our later behaviors and characteristics, including our health. This puts a particular premium on thinking about early life as a determinant of the health of populations. The urban environment is a particular environment for children and adolescents, creating tremendous o...
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Introduction: Childhood obesity continues be a major public health concern in the United States, and disproportionately affects racial/ethnic minorities and children of lower socioeconomic status. Social environments such as schools are particularly influential in shaping child and adolescent health, and represent an important target for interventi...
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Background: Short sleep duration is linked to adverse cardiovascular risk factors among adolescents and racial disparities in sleep among this group is well documented. Thus, identifying determinants and its differential impact on sleep duration by race may be important for informing sleep interventions and reducing sleep disparities. Evidence sugg...
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Purpose: The weathering hypothesis states that chronic exposure to social and economic disadvantage leads to accelerated decline in physical health outcomes and could partially explain racial disparities in a wide array of health conditions. This systematic review summarizes the literature empirically testing the weathering hypothesis and assesses...
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We present summaries of the scientific discussions at the workshop that was convened on June 6-7, 2018, by the NHLBI. ¹²⁰National Heart, Lung, and Blood Institute. Promoting Cardiovascular Health in Early Childhood (0-5 years) and Transitions in Childhood through Adolescence—Executive Summary. 2018. https://www.nhlbi.nih.gov/events/2018/promoting-c...
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Purpose: The purpose of this study was to assess when in the life-course race-by-sex disparities in body mass index (BMI) emerge. Methods: Child Health and Development Studies participants, from whom height and weight data were collected at ages 5, 9-11, and 15-17 years, were followed up at the age of 50 years for anthropometric outcomes. Follow...
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Objectives:: Researchers have identified associations between neighborhood-level factors (eg, income level, tobacco retailer density) and smoking behavior, but few studies have assessed these factors in urban environments. We explored the effect of tobacco retailer density, neighborhood poverty, and housing type (multiunit and public) on smoking i...
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Background: Childhood social risk has been associated with increased risk of childhood obesity. However, little is known about early exposure of cumulative social risk on BMI percentile (BMIp) trajectories in early childhood. Methods: Public data from the Fragile Families and Child Wellbeing Study were analyzed (N = 3809). Maternal reports of ex...
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Background: Among adults, depressive symptoms are associated with higher rates of cardiovascular disease; however, the evidence is mixed regarding the association between depressive symptoms and hypertension, especially among young adults. The deleterious effects of some antidepressant medications on blood pressure may contribute to mixed findings...
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Adverse experiences in childhood and adolescence, defined as subjectively perceived threats to the safety or security of the child's bodily integrity, family, or social structures, are known to be associated with cardiometabolic outcomes over the life course into adulthood. This American Heart Association scientific statement reviews the scientific...
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Persons of Hispanic/Latino descent may represent different ancestries, ethnic and cultural groups and countries of birth. In the U.S., the Hispanic/Latino population is projected to constitute 29% of the population by 2060. A personalized approach focusing on individual variability in genetics, environment, lifestyle and socioeconomic determinants...
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Purpose: Prior studies examining the association between perceived stress and adiposity have reported mixed findings, and sex differences have largely not been examined. Methods: We examined the relationship between perceived stress and body mass index (BMI) and waist circumference in young adults in the National Longitudinal Study of Adolescent...
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Objective: The current study investigated mediators between childhood/adolescent adversities (e.g., dating violence, maltreatment, homelessness, and parental death), low socioeconomic status (SES) during adolescence, and cardiovascular disease (CVD) risk in young adulthood. The purpose of these analyses was to understand whether SES during adolesc...