Sleep disparity in the population poor sleep quality is strongly associated with poverty and ethnicity 英文参考文献.docVIP

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Sleep disparity in the population poor sleep quality is strongly associated with poverty and ethnicity 英文参考文献.doc

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Sleep disparity in the population poor sleep quality is strongly associated with poverty and ethnicity 英文参考文献

Pateletal.BMCPublicHealth2010,10:475 /1471-2458/10/475 RESEARCH ARTICLE OpenAccess “Sleepdisparity”inthepopulation:poor sleepqualityisstronglyassociatedwith povertyandethnicity NiravPPatel1,MichaelAGrandner2,3*,DaweiXie4,CharlesCBranas4,NalakaGooneratne2,3,5 Abstract Background:Littleisknownaboutthesocialdeterminantsofsleepattainment.Thisstudyexaminesthe relationshipofrace/ethnicity,socio-economicstatus(SES)andotherfactorsuponsleepquality. Methods:Across-sectionalsurveyof9,714randomlyselectedsubjectswasusedtoexploresleepqualityobtained byself-report,inrelationtosocioeconomicfactorsincludingpoverty,employmentstatus,andeducationlevel.The primaryoutcomewaspoorsleepquality.DatawerecollectedbythePhiladelphiaHealthManagementCorporation. Results:Significantdifferenceswereobservedintheoutcomeforrace/ethnicity(African-AmericanandLatino versusWhite:unadjustedOR=1.59,95%CI1.24-2.05andOR=1.65,95%CI1.37-1.98,respectively)andincome (belowpovertythreshold,unadjustedOR=2.84,95%CI2.41-3.35).Inmultivariablemodeling,healthindicators significantlyinfluencedsleepqualitymostprominentlyinpoorindividuals.Afteradjustingforsocioeconomic factors(education,employment)andhealthindicators,theassociationofincomeandpoorsleepquality diminished,butstillpersistedinpoorWhiteswhileitwasnolongersignificantinpoorAfrican-Americans(adjusted OR=1.95,95%CI1.47-2.58versusOR=1.16,95%CI0.87-1.54,respectively).Post-collegeeducation(adjustedOR= 0.47,95%CI0.31-0.71)protectedagainstpoorsleep. Conclusions:A“sleepdisparity”existsinthestudypopulation:poorsleepqualityisstronglyassociatedwith povertyandrace.Factorssuchasemployment,educationandhealthstatus,amongstothers,significantlymediated thiseffectonlyinpoorsubjects,suggestingadifferentialvulnerabilitytothesefactorsinpoorrelativetonon-poor individualsinthecontextofsleepquality.Considerationofthiscouldhelpoptimizetargetedinterventionsin certaingroupsandsubsequentlyreducetheadversesocietaleffectsofpoorsleep. Background insightful but sleep attainment, in reality, is s