Hicken Margaret T, Lee Hedwig, Ailshire Jennifer, Burgard Sarah A, Williams David R
Department of Epidemiology, University of Michigan, 3634 SPH Tower, 1416 Washington Heights, Ann Arbor, MI 48109, 734.615.9205.
Race Soc Probl. 2013 Jun 1;5(2):100-112. doi: 10.1007/s12552-013-9095-9.
Although racial/ethnic disparities in health have been well-characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well-understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-White compared to White Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially-salient chronic stress - "racism-related vigilance" - and sleep difficulty. We found that, compared to the White adults in our sample, Black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (White, Black, Hispanic). Black adults reported greater levels of sleep difficulty compared to White adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to White adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.
尽管生物医学、公共卫生和社会科学研究已充分描述了健康方面的种族/族裔差异，但这些差异的决定因素仍未得到很好的理解。与美国制度性和人际间种族歧视经历相关的慢性心理社会压力可能是这些差异的一个重要决定因素，因为不同科学学科中越来越多的文献记录了压力对健康的不利影响，以及非裔美国人比白人美国人经历的压力水平更高。然而，使用具有人口代表性的数据，关于压力对健康以及特别是因种族歧视导致的健康差异的重要性的实证文献仍然很少且参差不齐。在本文中，我们探讨了一种新的种族突出慢性压力测量指标——“与种族主义相关的警惕性”——与睡眠困难之间的关联。我们发现，与我们样本中的白人成年人相比，黑人（而非西班牙裔）成年人报告的警惕性水平更高。在我们的样本（白人、黑人、西班牙裔）中，所有种族/族裔群体的这种警惕性与睡眠困难呈相似程度的正相关。与白人成年人相比，黑人成年人报告的睡眠困难水平更高。在对教育和收入进行调整后，这种差异略有减弱。然而，在对与种族主义相关的警惕性进行调整后，这种差异完全消失。与白人成年人相比，我们发现西班牙裔成年人也有类似的结果模式，不过，睡眠困难方面的差异较小且无统计学意义。由于睡眠质量对健康的重要性，我们的结果表明，对种族歧视的预期和执着是健康方面种族差异的一个重要决定因素。
