The Social Patterning in a Multi-ethnic Population: Associations of Socioeconomic Position, Neighborhood Characteristics and Psychosocial Stressors with Sleep.
Although sleep is instrumental for health and well-being, the vast majority of adults have sleep problems at least a few nights a week or more. Poor sleep is associated with a host of chronic diseases that disproportionately affect minority populations. Evidence indicates minority populations have poorer sleep than non-Hispanic whites. Recent research suggests that socioeconomic position (SEP) neighborhood characteristics and psychosocial stressors may be novel risk factors for sleep outcomes worthy of further exploration, particularly among minority populations where research is lacking.
This dissertation uses data from the Stroke Health and Risk Education (SHARE) Project and the Jackson Heart Study (JHS) to investigate the cross-sectional associations of SEP, neighborhood characteristics and psychosocial stressors with sleep outcomes (duration, sleepiness, quality) in Hispanic and African Americans. Multinomial logistic and linear regression models were used to examine the associations of each exposure with sleep duration (short vs. normal, long vs. normal, and continuous sleep duration) and sleep quality after adjustment for demographics, SEP, and risk factors.
In the first analysis, we investigated associations between neighborhood characteristics (safety, disadvantage, crime) and sleep (duration and daytime sleepiness) among participants in the SHARE project, a predominantly Hispanic American population. Lower neighborhood safety was associated with a higher daytime sleepiness score after adjustment for confounders. The second analysis using JHS data investigated associations between SEP (education and income), neighborhood characteristics (social cohesion, violence, problems, disadvantage) and sleep (duration and quality) in a population of African Americans. Low individual SEP was associated with long sleep and poor sleep quality; and adverse neighborhood characteristics were associated with longer average sleep duration and poor sleep quality after adjustment for confounders. Lastly, we investigated the associations of psychosocial stressors with sleep (duration, quality) using data from the JHS. Higher levels of psychosocial stressors were associated with short sleep, shorter average sleep duration and poorer sleep quality after adjustment for confounders.
The findings of this dissertation improve our understanding of the factors contributing to poor sleep among understudied racial/ethnic groups. Future studies should further examine these associations of SEP, adverse neighborhoods and psychosocial stressors and poor sleep using prospective cohort data.PhDEpidemiological ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111512/1/daynaa_1.pd
