title: The Social Patterning of Sleep in African Americans: Associations of Socioeconomic Position and Neighborhood Characteristics with Sleep in the Jackson Heart Study.
abstract: We investigated cross-sectional associations of individual-level socioeconomic position (SEP) and neighborhood characteristics (social cohesion, violence, problems, disadvantage) with sleep duration and sleep quality in 5,301 African Americans in the Jackson Heart Study.
  
  
  
  All measures were self-reported. Sleep duration was assessed as hours of sleep; sleep quality was reported as poor (1) to excellent (5). SEP was measured by categorized years of education and income. Multinomial logistic and linear regression models were fit to examine the associations of SEP and neighborhood characteristics (modeled dichotomously and tertiles) with sleep duration (short vs. normal, long vs. normal) and continuous sleep duration and quality after adjustment for demographics and risk factors.
  
  
  
  The mean sleep duration was 6.4 ± 1.5 hours, 54% had a short (≤ 6 h) sleep duration, 5% reported long (≥ 9 h) sleep duration, and 24% reported fair to poor sleep quality. Lower education was associated with greater odds of long sleep (odds ratio [OR] = 2.19, 95% confidence interval [CI] = 1.42, 3.38) and poorer sleep quality (β = -0.17, 95% CI = -0.27, -0.07) compared to higher education after adjustment for demographics and risk factors. Findings were similar for income. High neighborhood violence was associated with shorter sleep duration (-9.82 minutes, 95% CI = -16.98, -2.66) and poorer sleep quality (β = -0.11, 95% CI = -0.20, 0.00) after adjustment for demographics and risk factors. Results were similar for neighborhood problems. In secondary analyses adjusted for depressive symptoms in a subset of participants, most associations were attenuated and only associations of low SEP with higher odds of long sleep and higher neighborhood violence with poorer sleep quality remained statistically significant.
  
  
  
  Social and environmental characteristics are associated with sleep duration and quality in African Americans. Depressive symptoms may explain at least part of this association.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.|Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston MA.
authors.forename: Dayna A
authors.initials: DA
authors.lastname: Johnson
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
authors.forename: Lynda
authors.initials: L
authors.lastname: Lisabeth
authors.affiliation: My Brothers Keeper, Inc., Jackson, MS.|University of Mississippi Medical Center, Jackson, MS.
authors.forename: DeMarc
authors.initials: D
authors.lastname: Hickson
authors.affiliation: Department of Public Health and Health Sciences, University of Michigan-Flint, Flint, Michigan.
authors.forename: Vicki
authors.initials: V
authors.lastname: Johnson-Lawrence
authors.affiliation: University of Mississippi Medical Center, Jackson, MS.
authors.forename: Tandaw
authors.initials: T
authors.lastname: Samdarshi
authors.affiliation: Morehouse School of Medicine's Cardiovascular Research Institute, Atlanta, GA.
authors.forename: Herman
authors.initials: H
authors.lastname: Taylor
authors.affiliation: Dornsife School of Public Health, Drexel University, Philadelphia, PA.
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez Roux
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D012890:Sleep / Q000502:physiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000208:ethnology / Q000209:etiology*; D012923:Social Class; D055815:Young Adult
keywords: African American; Jackson Heart Study; neighborhood characteristics; sleep duration; sleep quality; socioeconomic status