Reports of SES Discrimination and Subjective Sleep Quality in African-American and White Adults Open Access
Van Dyke, Miriam (2015)
Abstract
Research on reports of discrimination and risk for chronic diseases has grown, but much of this work has 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. We examined the cross-sectional association between self-reports of SES discrimination and subjective sleep quality, an emerging risk factor for poor health. We also examined whether associations varied by SES or race - given well-documented black-white disparities in sleep quality. Participants were 425 African-American and White adults (67.5% female, 50.6% African-American, 55.3% college educated) aged 30-65 from the Morehouse & Emory Team Up to eliminate Cardiovascular Health Disparities (META-HEALTH) study. Self-reports of SES discrimination were assessed with a modified Experiences of Discrimination Scale and subjective sleep complaints were assessed with the Pittsburgh Sleep Quality Index. SES and race-stratified linear regression analyses were conducted to examine the association between reports of SES discrimination and subjective sleep quality after controlling for demographics, self-reports of racial and gender discrimination, financial and general stress, BMI, and depressive symptoms. Compared to Whites, African-Americans reported higher levels of both SES and racial discrimination (p-values <0.0001), but not gender discrimination (p>0.1). In race-stratified models, self-reports of SES discrimination were significantly associated with subjective sleep quality in African-Americans after adjusting for demographics (β=1.58, p<0.01). The association remained significant after adjustment for other forms of discrimination (neither of which were significantly associated with sleep quality), BMI, and stress (β=1.49, p<0.01); but was reduced to marginal significance after adjusting for depressive symptoms (p=0.06). No significant associations were observed in Whites (p>0.1). No consistent patterns emerged in SES-stratified models. Findings suggest that self-reports of SES discrimination may be an important risk factor for subjective sleep quality among African-Americans.
Table of Contents
Chapter I.
Background. 1
Chapter II. Manuscript
Introduction. 5
Methods. 9
Results. 14
Discussion. 16
Chapter III.
Public Health Implications, Possible Future Directions. 21
Tables and Figure. 24
Reference. 36
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