McWhorter Receives NIH Diversity Supplement Grant for Pediatric Rural Health Research
LEXINGTON, Ky. (Nov. 3, 2023) – Ketrell L. McWhorter, PhD, MBA, ACE-CPT, ACE-FNS, assistant professor of epidemiology and environmental health in the UK College of Public Health, has been awarded a Diversity Supplement Grant from National Center for Advancing Translational Science (NCATS), a branch of the National Institutes of Health. These grants aim to ensure that the translational science workforce is broadly representative across racial, ethnic, sex, gender, age, socioeconomic, geographic and disability status.
McWhorter has dedicated her career to understanding how early-life exposures—be they environmental, nutritional, or social—impact long-term cardiometabolic outcomes. The Diversity Supplement Grant supports her project “Impact of co-exposures on Pediatric Obesity and Sleep in Appalachian Children,” which stems from the fact that residents of Appalachia experience the nation’s highest rate of insufficient sleep as well as high rates of obesity, smoking, and environmental exposure to toxicants. Research has demonstrated that biomarkers of exposure to second-hand smoke and metals are linked to sleep disturbances, but this has not been examined in relationship to childhood obesity.
Her study therefore seeks to disentangle the complex relationship between children’s exposure to second-hand smoke and air pollution, its impact on their sleep, and how these factors influence body weight and cardiometabolic outcomes.
To do so, she is using data from the robust Communities Actively Researching Exposure Study (CARES), a community-engaged research study in Appalachia examining the effect of air pollution on cognitive development of children. To date CARES has collected environmental and biological data from more than 500 children and their primary caregivers, many of whom have been followed for over a decade.
The CARES research is led by Erin Haynes, DrPH, MS, professor of preventive medicine and environmental health and chair of the department of epidemiology and environmental health in the UK College of Public Health, and associate director of the UK Center for Clinical and Translational Science. CCTS). Haynes serves a mentor to McWhorter on the Diversity Supplement Grant, as does Ellen Hahn, PhD, RN, FAAN, professor in the UK Colleges of Nursing and Public Health, director of UK-CARES (Center for Appalachian Research in Environmental Sciences), and director of BREATHE (including the Tobacco Policy Research Program, the Kentucky Center for Smoke-free Policy, and the Radon Policy Research Program).
“It is exciting to have the CARES cohort be useful in moving the science forward as we investigate environmental factors on body mass index and sleep in rural children,” Haynes said.
Prior to receiving the Diversity Supplement Grant, McWhorter conducted a pilot study based on CARES data. She found that in this population of rural Appalachian children, all of whom live near one of the largest ferromanganese refineries in the region, 30-32% experience short sleep, especially children with exposure to secondhand smoke (as measured through serum cotinine). Twenty percent of the children experienced habitual snoring, a symptom of sleep-disordered breathing, a condition to which they’re already vulnerable given increased rates of exposure to second-hand smoke and metals.
“The research I’m conducting through this Diversity Supplement Grant looks at how co-exposures to second-hand smoke and metals impact body mass index. The endocrine system is sensitive to environmental exposures, and our metabolism is housed in the endocrine system with regulation of insulin,” McWhorter said. “I’m also looking at how sleep fits in—does sleep moderate this relationship? Does sleep strengthen or attenuate this association, does it somehow make the impact of these exposures less intense?”
Sleep, McWhorter points out, is an active period for our bodies: long-term memory is solidified and waste elimination occurs during sleep.
“If you truncate sleep, you’re not allowing your body to finish the process of eliminating a lot of these waste products. Chronic poor sleep and snoring also makes your heart work harder, which is why it’s related to cardiovascular disease. Sleep is a third of our lives, ideally, and in our go-getter society we just don’t value it.”
Her hope is that findings from this study will help to empower the CARES communities with information about the importance of sleep and preventive health behaviors. Rural America, she says, is an often-overlooked subgroup of our population, particularly in epidemiologic studies.
“I’m a currently a Science Communications Faculty Fellow because I want to be able to effectively translate back to the community the importance of prevention when it comes to sleep hygiene and tobacco use. I can’t do anything about the ferromanganese plant near them, but what I can do is try to increase health literacy and let the community know that sleep helps mitigate the relationship between environmental exposures and certain poor health outcomes.”
Access to the Diversity Supplement Grant funding is facilitated by the UK Center for Clinical and Translational Science (CCTS), which is funded by NCATS.
“Dr. McWhorter is an outstanding investigator and highly deserving of this award,” said Philip Kern, MD, director of the CCTS. “This project will target fundamental problems in this rural underserved community that will have broad implications for the health of these growing children and will potentially have a huge social return on investment.”
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