You’ve likely heard the term social determinants of health used to describe nonmedical factors like education, socioeconomic status or even your zip code that can improve or worsen your health.

Erin heard a new term at a Harvard T.H. Chan School of Public Health panel on the science of sleep: the social determinants of sleep.

As it turns out, sleep isn’t an equal-opportunity activity. Instead, like so many aspects of public health, it cuts along racial and socioeconomic lines.

For example:

— A cross-sectional study analyzing sleep disparities found that while prevalence of short sleep duration (sleeping for fewer than seven hours) increased for Black, Hispanic/Latino and white participants during the 2004 to 2018 study period, short sleep was more prevalent among Black individuals than white individuals in every age group.

— The gap between Black and white participants’ sleep didn’t improve over the 15 years, according to the study, published in JAMA Network Open in 2022.

Poor sleep is also associated with poverty, according to the CDC:

— Sleep improves as families become more financially secure. Roughly 22 percent of adults with family incomes under 100 percent of the federal poverty level reported having trouble falling asleep most nights in 2020. In comparison, 13 percent of adults with family incomes greater or equal to 200 percent of the federal poverty level had trouble falling asleep most nights that year.

“It really is about thinking about broadening the lens beyond just the individual,” Carmela Alcántara, an associate professor at the Columbia University School of Social Work, said during the Harvard forum.

Low-income people and racial or ethnic minorities are more likely than high-income or white people to live in neighborhoods with more noise and light pollution, Alcántara said, causing both short- and long-term sleep loss and negative health effects.

Why it matters: According to panel member Azizi Seixas, an associate professor at the University of Miami Miller School of Medicine, sleep is associated with a litany of ill effects, including diseases such as Parkinson’s and cancer, accident risk, and reduced work productivity, among many others.

“How is it that sleep has such a global effect on us?” Seixas asked. ‘[It's] fundamental and primordial. Everything emanates from it.”

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Amazon has finalized its acquisition of primary care provider One Medical after the Federal Trade Commission decided not to challenge the tie-up. The agency told Politico that it will continue to look at how the merger may cause harm to competition down the road. Already, Amazon is rolling out a discount: $144 for the first year of membership.

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Today on our Pulse Check podcast, host Megan Messerly talks with Krista Mahr about her reporting on the CDC's presence in East Palestine, Ohio, the site of the train carrying dangerous chemicals that derailed, to assess potential health risks to residents.

Millions of people in the U.S. missed cancer screenings during the Covid-19 pandemic, leading to concerns about missed diagnoses.

But new data from Epic Research, based on hundreds of thousands of patients’ records, shows screenings largely returning or exceeding pre-pandemic levels.

Even better, the data doesn’t show an increase in more advanced cancer cases or higher cancer rates.

Still, there are some caveats: “While our data does not show an increase in advanced cancers, it might take years to fully realize the impact of missed screenings, especially for cancers with longer recommended intervals between screenings,” the researchers wrote.

In November, health data company Trilliant Health found a decline in cancer diagnoses, suggesting some cancers are being missed.

Canada is investing $204 million through 2024 in low-income countries to strengthen vaccine delivery systems, integrate Covid-19 vaccination into routine health services and support the scale-up of regional vaccine manufacturing capacity through its Global Initiative for Vaccine Equity.

The aim is to improve health systems in those countries so they can deliver more effective immunization and primary care, said Joshua Tabah, director general for health and nutrition at Global Affairs Canada, the country’s diplomatic agency.

The countries benefiting from the Canadian initiative are Bangladesh, Colombia, the Democratic Republic of the Congo, Ghana, Haiti, Jamaica, Mozambique, Nigeria, Senegal, South Africa and Tanzania.

The Canadian government selected them because the Covid vaccination rates there remain very low, Tabah told Carmen.

Last year, when the initiative started, the focus was on getting as many shots into arms as possible, he said. “Now we’re in the system-building portion, and that’s going to continue and intensify through next year,” Tabah said.

What that looks like depends on each country, but it can range from training health care workers to improving health information systems, Tabah said.

Finally, some $22 million will go to the mRNA vaccine technology transfer hub in South Africa, a World Health Organization-supported initiative to build capacity in low- and middle-income countries to produce mRNA vaccines that Tabah thinks “will change the vaccine landscape in sub-Saharan Africa.”