title: Relationships between housing and food insecurity, frequent mental distress, and insufficient sleep among adults in 12 US States, 2009.
abstract: BACKGROUND
  Housing insecurity and food insecurity may be psychological stressors associated with insufficient sleep. Frequent mental distress may mediate the relationships between these variables. The objective of this study was to examine the relationships between housing insecurity and food insecurity, frequent mental distress, and insufficient sleep.
  
  
  METHODS
  We analyzed data from the 2009 Behavioral Risk Factor Surveillance System in 12 states. Housing insecurity and food insecurity were defined as being worried or stressed "sometimes," "usually," or "always" during the previous 12 months about having enough money to pay rent or mortgage or to buy nutritious meals.
  
  
  RESULTS
  Of 68,111 respondents, 26.4% reported frequent insufficient sleep, 28.5% reported housing insecurity, 19.3% reported food insecurity, and 10.8% reported frequent mental distress. The prevalence of frequent insufficient sleep was significantly greater among those who reported housing insecurity (37.7% vs 21.6%) or food insecurity (41.1% vs 22.9%) than among those who did not. The prevalence of frequent mental distress was also significantly greater among those reporting housing insecurity (20.1% vs 6.8%) and food insecurity (23.5% vs 7.7%) than those who did not. The association between housing insecurity or food insecurity and frequent insufficient sleep remained significant after adjustment for other sociodemographic variables and frequent mental distress.
  
  
  CONCLUSIONS
  Sleep health and mental health are embedded in the social context. Research is needed to assess whether interventions that reduce housing insecurity and food insecurity will also improve sleep health and mental health.
authors.affiliation: Epidemiology and Surveillance Branch, Division of Population Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F-78, Atlanta, GA 30341. E-mail: ikd8@cdc.gov.
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Rashid S
authors.initials: RS
authors.lastname: Njai
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Kurt J
authors.initials: KJ
authors.lastname: Greenlund
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chapman
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Janet B
authors.initials: JB
authors.lastname: Croft
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D005523:Food Supply; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D012892:Sleep Deprivation; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D014481:United States; D055815:Young Adult