"Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity.
"Sleep disparity" in the population: poor sleep quality is strongly associated with poverty and ethnicity.
复制标题
DOI：
10.1186/1471-2458-10-475
复制
发表时间：
2010-08-11
影响因子：
4.5
通讯作者：
Gooneratne N
中科院分区：
文献类型：
--
作者：
Patel NP;Grandner MA;Xie D;Branas CC;Gooneratne N
人们对睡眠获得的社会决定因素知之甚少。本研究探讨了种族/民族，社会经济地位（SES）和其他因素对睡眠质量的关系。对9,714名随机选择的受试者进行了横断面调查，以探讨通过自我报告获得的睡眠质量与贫困，就业状况和教育水平等社会经济因素的关系。主要结果是睡眠质量差。数据由费城健康管理公司收集。在人种/种族（非洲裔美国人和拉丁裔与白色人：未校正OR = 1.59，95%CI 1.24-2.05和OR = 1.65，95%CI 1.37-1.98）和收入（低于贫困阈值，未校正OR = 2.84，95%CI 2.41-3.35）方面观察到显著差异。在多变量建模中，健康指标对睡眠质量的影响在贫困人群中最为显著。在调整社会经济因素（教育，就业）和健康指标后，收入和睡眠质量差的相关性减弱，但在贫困白人中仍然存在，而在贫困非洲裔美国人中不再显著（调整后OR = 1.95，95%CI 1.47-2.58 vs OR = 1.16，95%CI 0.87-1.54）。大学毕业后的教育（调整后的OR = 0.47，95%CI 0.31-0.71）保护睡眠不佳。研究人群中存在“睡眠差异”：睡眠质量差与贫困和种族密切相关。就业，教育和健康状况等因素，除其他外，显着介导这种影响，只有在穷人的科目，这表明在睡眠质量的背景下，这些因素在穷人相对于非穷人的差异脆弱性。考虑到这一点可以帮助优化某些群体的针对性干预措施，并随后减少睡眠不良的不良社会影响。
Little is known about the social determinants of sleep attainment. This study examines the relationship of race/ethnicity, socio-economic status (SES) and other factors upon sleep quality. A cross-sectional survey of 9,714 randomly selected subjects was used to explore sleep quality obtained by self-report, in relation to socioeconomic factors including poverty, employment status, and education level. The primary outcome was poor sleep quality. Data were collected by the Philadelphia Health Management Corporation. Significant differences were observed in the outcome for race/ethnicity (African-American and Latino versus White: unadjusted OR = 1.59, 95% CI 1.24-2.05 and OR = 1.65, 95% CI 1.37-1.98, respectively) and income (below poverty threshold, unadjusted OR = 2.84, 95%CI 2.41-3.35). In multivariable modeling, health indicators significantly influenced sleep quality most prominently in poor individuals. After adjusting for socioeconomic factors (education, employment) and health indicators, the association of income and poor sleep quality diminished, but still persisted in poor Whites while it was no longer significant in poor African-Americans (adjusted OR = 1.95, 95% CI 1.47-2.58 versus OR = 1.16, 95% CI 0.87-1.54, respectively). Post-college education (adjusted OR = 0.47, 95% CI 0.31-0.71) protected against poor sleep. A "sleep disparity" exists in the study population: poor sleep quality is strongly associated with poverty and race. Factors such as employment, education and health status, amongst others, significantly mediated this effect only in poor subjects, suggesting a differential vulnerability to these factors in poor relative to non-poor individuals in the context of sleep quality. Consideration of this could help optimize targeted interventions in certain groups and subsequently reduce the adverse societal effects of poor sleep.