Geographic distribution of insufficient sleep across the United States: a county-level hotspot analysis.
Geographic distribution of insufficient sleep across the United States: a county-level hotspot analysis.
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DOI：
10.1016/j.sleh.2015.06.003
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发表时间：
2015-09-01
期刊：
影响因子：
4.1
通讯作者：
Branas C
中科院分区：
文献类型：
--
作者：
Grandner MA;Smith TE;Jackson N;Jackson T;Burgard S;Branas C
睡眠不足与心脏代谢风险和神经认知障碍有关。睡眠不足的决定因素包括许多社会和环境因素。对地理热点/冷点的评估可能会发现新的风险群体和/或公共卫生干预目标。本研究的目的是辨别第一个数据集中的地理模式，其中包括县级睡眠数据。使用了2009年行为风险因素监测系统。睡眠不足通过调查项目进行评估并分为两类。可获得来自 n = 2231 个县的数据。对高/低水平睡眠不足（热点/冷点）的显着空间集中度的测试使用了局部空间集中度的 Getis-Ord G* 统计量，该统计量是根据缺失数据的性质而选择的。 84 个县是睡眠不足程度较高的热点县 (P < .01)，45 个县是睡眠不足程度较低的冷区县 (P < .01)。热点地区包括阿拉巴马州（1 个县）、阿肯色州（1 个县）、佐治亚州（1 个县）、伊利诺伊州（1 个县）、肯塔基州（25 个县）、路易斯安那州（1 个县）、密苏里州（4 个县）、俄亥俄州（7 个县）、田纳西州（12 个县）、德克萨斯州（9 个县）、弗吉尼亚州（6 个县）和西弗吉尼亚州（16 个县）。阿拉巴马州（1 个县）、乔治亚州（2 个县）、伊利诺伊州（6 个县）、爱荷华州（6 个县）、密歇根州（2 个县）、明尼苏达州（1 个县）、北卡罗来纳州（1 个县）、德克萨斯州（7 个县）、弗吉尼亚州（12 个县）和威斯康星州（6 个县）发现了冷点。几个连续的热点和冷点很明显。值得注意的是，睡眠不足水平最高的 17 个县位于肯塔基州、田纳西州、弗吉尼亚州和西弗吉尼亚州交汇处的连续区域（所有 P < .0002）。美国睡眠不足的地理分布不均匀。一些地区（尤其是阿巴拉契亚部分地区）睡眠不足的比例过高，可能是干预的目标。需要进一步调查地理变异的决定因素，这将增强这些数据对开展公共卫生运动的效用。
Insufficient sleep is associated with cardiometabolic risk and neurocognitive impairment. Determinants of insufficient sleep include many social and environmental factors. Assessment of geographic hot/coldspots may uncover novel risk groups and/or targets for public health intervention. The aim of this study was to discern geographic patterns in the first data set to include county-level sleep data. The 2009 Behavioral Risk Factor Surveillance System was used. Insufficient sleep was assessed with a survey item and dichotomized. Data from n = 2231 counties were available. Tests for significant spatial concentrations of high/low levels of insufficient sleep (hotspots/coldspots) used the Getis-Ord G* statistic of local spatial concentration, chosen due to the nature of missing data. Eighty-four counties were hotspots, with high levels of insufficient sleep (P < .01), and 45 were coldspots, with low insufficient sleep (P < .01). Hotspots were found in Alabama (1 county), Arkansas (1), Georgia (1), Illinois (1), Kentucky (25), Louisiana (1), Missouri (4), Ohio (7), Tennessee (12), Texas (9), Virginia (6), and West Virginia (16). Coldspots were found in Alabama (1 county), Georgia (2), Illinois (6), Iowa (6), Michigan (2), Minnesota (1), North Carolina (1), Texas (7), Virginia (12), and Wisconsin (6). Several contiguous hotspots and coldspots were evident. Notably, the 17 counties with the highest levels of insufficient sleep were found in a contiguous set at the intersection of Kentucky, Tennessee, Virginia, and West Virginia (all P < .0002). Geographic distribution of insufficient sleep in the United States is uneven. Some areas (most notably parts of Appalachia) experience disproportionately high amounts of insufficient sleep and may be targets of intervention. Further investigation of determinants of geographic variability needs to be explored, which would enhance the utility of these data for development of public health campaigns.