Socioeconomic status discrimination is associated with poor sleep in African-Americans, but not Whites

• Type of Material: Article
• Authors: Miriam E. Van Dyke, Emory University; Laura Vaccarino, Emory University; Arshed Quyyumi, Emory University; Tene Lewis, Emory University
• Language: English
• Date: 2016-03-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016 Elsevier Ltd. All rights reserved.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.socscimed.2016.02.012
• Title of Journal or Parent Work: Social Science and Medicine
• ISSN: 0277-9536
• Volume: 153
• Start Page: 141
• End Page: 147
• Grant/Funding Information: This study was supported by the following funding: NIH/NHLBI 1 U01 HL79214-01; NIH/NHLBI 1 U01 HL079156-01; M01-RR00039; NIH/NCRR 5P20RR11104; NIH/NCRR 5U54RR022814. TT Lewis was supported by NIH/NHLBI K01HL92591.; V Vaccarino was supported by NIH/NHLBI K24 HL077506.
• Keywords: Public, Environmental & Occupational Health; PERCEIVED DISCRIMINATION; Social Sciences, Biomedical; Science & Technology; FOLLOW-UP; African-Americans; CANCER INCIDENCE; Social discrimination; Biomedical Social Sciences; QUALITY INDEX; Sleep; BLACK WOMENS HEALTH; Social Sciences; RACIAL DISPARITIES; SELF-REPORTED EXPERIENCES; Life Sciences & Biomedicine; ETHNIC DISCRIMINATION; LONGITUDINAL ANALYSIS; POPULATION
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Rationale: Research on self-reported experiences of discrimination and health has grown in recent decades, but has largely focused on racial discrimination or overall mistreatment. Less is known about reports of discrimination on the basis of socioeconomic status (SES), despite the fact that SES is one of the most powerful social determinants of health. Objective: We sought to examine the cross-sectional association between self-reported SES discrimination and subjective sleep quality, an emerging risk factor for disease. We further examined whether associations differed by race or SES. Methods: We used logistic and linear regression to analyze data from a population-based cohort of 425 African-American and White middle-aged adults (67.5% female) in the Southeastern United States. SES discrimination was assessed with a modified Experiences of Discrimination Scale and poor subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Results: In logistic regression models adjusted for age, gender, and education, reports of SES discrimination were associated with poor sleep quality among African-Americans (OR = 2.39 95%, CI = 1.35, 4.24), but not Whites (OR = 1.03, 95% CI = 0.57, 1.87), and the race × SES discrimination interaction was significant at p = 0.04. After additional adjustments for reports of racial and gender discrimination, other psychosocial stressors, body mass index and depressive symptoms, SES discrimination remained a significant predictor of poor sleep among African-Americans, but not Whites. In contrast to findings by race, SES discrimination and sleep associations did not significantly differ by SES. Conclusion: Findings suggest that reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans and support the need to consider the health impact of SES-related stressors in the context of race.