June 9, 2022

Alma Solis (Duke University)

Social determinants of disease susceptibility: measuring sleep and stress

Spring 2022 Graduate Student Award in Social & Biological Determinants of Health


picture of Alma SolisThe focus of this research project is to apply a One Health Disparities framework to explore how social determinants of health influence disease susceptibility disparities in rural Madagascar. This project investigates how sleep disparities can inform the relationship between the social environment and disease susceptibility. Sleep is rooted in human evolutionary history with ecological constraints and functional benefits that inform sleep patterns. There are high costs of inadequate sleep such as increased risk of non-communicable diseases (obesity, type II diabetes, cardiovascular health) and maladaptive immune responses to communicable diseases. In high-income countries, sleep disparities are more widely reported in Black and Hispanic communities. Often times driven by social factors including housing in noisy areas, racial discrimination, low socio-economic status, and adverse childhood experiences. Thus, I investigate sleep disparities in Madagascar, a low-income country undergoing rapid changes in its natural and social environment. I will determine how the social environment contributes to short or fragmented sleep and disease susceptibility by (a) collecting data on community member sleep patterns using both health surveys and actigraphy data and (b) connecting these sleep metrics, sociodemographic survey data, and stress data to Leptospira seroprevalence and reported symptom data in community members. I hypothesize that sleep duration and fragmentation influences disease susceptibility, with short or fragmented sleep leading to higher probability of Leptospira infection and reported symptoms. Findings from this study will inform our understanding of how the social environment influences disease susceptibility and shine a light on the importance of addressing sleep disparities in global health.


Alma (ella/she/hers) is a Ph.D. candidate in Evolutionary Anthropology department at Duke University. Her research focuses on social determinants of health in remote village communities in northeast Madagascar. Through her research she investigates the relationship between anthropogenic social environments and risk of zoonotic disease exposure, susceptibility, and adverse health outcomes.