Perceived Racial Discrimination as an Independent Predictor of Sleep Disturbance and Daytime Fatigue

a Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, Department of Medicine , University of Pennsylvania.
Behavioral Sleep Medicine (Impact Factor: 2.34). 10/2012; 10(4):235-49. DOI: 10.1080/15402002.2012.654548
Source: PubMed


Perceived discrimination is a potential cause of racial and ethnic disparities in health. Disturbed sleep may serve as a mechanism linking perceived racism with health consequences. This study investigates data from 7,148 adults from Michigan and Wisconsin who participated in the 2006 Behavioral Risk Factor Surveillance System. Hierarchical logistic regression analyses explored associations between perceived racial discrimination and self-reported sleep disturbance and daytime fatigue. Sleep disturbance and daytime fatigue were reported in 19% and 21% of the sample, respectively. Black/African American respondents (21%) report perceiving worse experiences, compared to people of other races, when seeking health care at higher rates than non-Hispanic White respondents (3%). Results from logistic regression models show that perceived racial discrimination is associated with increased risks of sleep disturbance (odds ratio [OR] = 2.62, p < .0001) and daytime fatigue (OR = 2.07, p < .0001). After adjustment for all covariates, perceived discrimination remains a significant predictor of sleep disturbance (OR = 1.60, p = .04). The interaction between perceived racism and race (Black/African American vs. non-Hispanic White) was nonsignificant. This population-based research adds to the growing body of data, suggesting that perceived racism may impact health via its influence on sleep-wake behaviors.

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    • "income, education, wealth), psychosocial factors (e.g. job strain, discrimination, organizational culture), and services (healthcare access and utilization; worksite wellness policies ) (Ertel et al., 2011; Grandner et al., 2012, 2010b, 2013; Hicken et al., 2013; Lewis et al., 2013; Slopen and Williams, 2014). It is likely that factors such as social class, racism and culture have the potential to influence sleep quantity and quality on multiple levels. "
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    ABSTRACT: Sleep duration, associated with increased morbidity/mortality, has been shown to vary by race and occupation. Few studies have examined the additional influence of immigrant status. Using a nationally-representative sample of 175,244 US adults from the National Health Interview Survey from 2004 to 2011, we estimated prevalence ratios (PRs) for short sleep duration (<7 h/per day) among US- and non-US born Blacks and Latinos by occupation compared to their White counterparts using adjusted Poisson regression models with robust variance. Non-US born participants' mean age was 46 years, 55% were men, 58% were Latino, and 65% lived in the US ≥ 15 years. Short sleep prevalence was highest among US- and non-US born Blacks in all occupations, and the prevalence generally increased with increasing professional/management roles in Blacks and Latinos while it decreased among Whites. Adjusted short sleep was more prevalent in US-born Blacks compared to Whites in professional/management (PR = 1.52 [95% confidence interval (CI): 1.42–1.63]), support services (PR = 1.31 [95% CI: 1.26–1.37]), and laborers (PR = 1.11 [95% CI: 1.06–1.16]). The Black–White comparison was even higher for non-US born Black laborers (PR = 1.50 [95% CI: 1.24–1.80]). Similar for non-US born Latinos, Latinos born in the US had a higher short sleep prevalence in professional/management (PR = 1.14 [95% CI: 1.04–1.24]) and support services (PR = 1.06 [95% CI: 1.01–1.11]), but a lower prevalence among laborers (PR = 0.77 [95% CI: 0.74–0.81]) compared to Whites. Short sleep varied within and between immigrant status for some ethnicities in particular occupations, further illuminating the need for tailored interventions to address sleep disparities among US workers.
    Social Science & Medicine 10/2014; 118:71–79. DOI:10.1016/j.socscimed.2014.07.059 · 2.89 Impact Factor
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    • "There, however, have been limited race-specific investigations of sleep by industry of employment and occupation although important racial/ethnic differences in influential factors are likely to exist. For instance, one’s race/ethnicity as well as occupation likely plays an important role in producing psychosocial stress and job strain that negatively impacts health through, for example, discrimination or limited control over job demands/prestige as illustrated by the Karasek and Theorell demand-control model [20-22]. In a previous study, we found that the prevalence of short sleep increased as professional responsibility increased among Blacks while the prevalence decreased among their White counterparts [23]. "
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    ABSTRACT: Background Although short sleep is associated with an increased risk of morbidity as well as mortality and has been shown to vary by industry of employment and occupation, little is known about the relationship between work and sleep among Asian Americans. Methods Using a nationally representative sample of US adults (n = 125,610) in the National Health Interview Survey from 2004–2011, we estimated prevalence ratios for self-reported short sleep duration (<7 hours) in Asians compared to Whites by industry of employment and occupation using adjusted Poisson regression models with robust variance. Results Asians were more likely to report short sleep duration than Whites (33 vs. 28%, p < 0.001), and the Asian-White disparity was widest in finance/information and healthcare industries. Compared to Whites after adjustments, short sleep was also more prevalent among Asians employed in Public administration (PR = 1.35 [95% CI: 1.17,1.56]), Education (PR = 1.29 [95% CI: 1.08,1.53]), and Professional/Management (PR = 1.18 [95% CI: 1.03,1.36]). Short sleep, however, was lower among Asians in Accommodation/Food (PR = 0.81 [95% CI: 0.66, 0.99]) with no difference in Retail. In professional and support-service occupations, short sleep was higher among Asians, but was not different among laborers. Conclusions U.S. Asian-White disparities in short sleep varied by industries, suggesting a need to consider both race and occupational characteristics to identify high-risk individuals.
    BMC Public Health 06/2014; 14(1):552. DOI:10.1186/1471-2458-14-552 · 2.26 Impact Factor
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    ABSTRACT: Background: Chronic stress resulting from experiences of racism may increase the incidence of adult-onset asthma through effects on the immune system and the airways. We conducted prospective analyses of the relation of experiences of racism with asthma incidence in the Black Women's Health Study, a prospective cohort of black women in the United States followed since 1995 with mailed biennial questionnaires. Methods: Among 38,142 participants followed from 1997 to 2011, 1,068 reported incident asthma. An everyday racism score was created based on five questions asked in 1997 and 2009 about the frequency in daily life of experiences of racism (eg, poor service in stores), and a lifetime racism score was based on questions about racism on the job, in housing, and by police. We used Cox regression models to derive multivariable incidence rate ratios (IRRs) and 95% CIs for categories of each racism score in relation to incident asthma. Results: The IRRs were 1.45 (95% CI, 1.19-1.78) for the highest compared with the lowest quartile of the 1997 everyday racism score (P for trend<.0001) and 1.44 (95% CI, 1.18-1.75) for the highest compared with the lowest category of 1997 lifetime racism. Among women who reported the same levels of racism in 1997 and 2009, the IRRs for the highest categories of everyday and lifetime racism were 2.12 (95% CI, 1.55-2.91) and 1.66 (95% CI, 1.20-2.30), respectively. Conclusions: Given the high prevalence of experiences of racism and asthma in black women in the United States, a positive association between racism and asthma is of public health importance.
    Chest 07/2013; 145(3). DOI:10.1378/chest.13-0665 · 7.48 Impact Factor
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