Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02131, USA.
Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Int J Environ Res Public Health. 2018 Mar 21;15(4):564. doi: 10.3390/ijerph15040564.
Housing environments can directly and indirectly affect sleep, and blacks are more likely than whites to live in suboptimal housing conditions, which may independently contribute to sleep disparities. However, few large-scale epidemiological studies consider the potential influence of housing type on sleep health. Using data from the 2004-2015 National Health Interview Survey, we investigated overall and Black-White differences in the association between housing type (house/apartment versus mobile home/trailer) and sleep duration as well as sleep difficulties among 226,208 adults in the U.S. Poisson regression with robust variance was used to estimate sex-specific prevalence ratios (PR) for sleep categories, first comparing houses/apartments to mobile homes/trailers and then blacks to whites within housing types. All models were adjusted for age, educational attainment, income, occupational class, self-reported general health status, and region of residence. Compared to participants living in houses/apartments, the prevalence of short sleep was higher for men (PR = 1.05 (95% confidence interval (CI): 1.02-1.08)) and women (PR = 1.07 (95% CI: 1.04-1.09)) in mobile homes/trailers. Black men (PR = 1.26 (95% CI: 1.21-1.30)) and women (PR = 1.24 (95% CI: 1.20-1.27)) in a house/apartment were more likely to be short sleepers than their white counterparts. There was generally no significant difference in sleep characteristics (except long sleep) between black and white men in mobile homes/trailers after adjustments, and black men in houses/apartments as well as black women in both housing types were less likely to report sleep difficulties although being more likely to report short sleep. Overall, individuals in mobile homes/trailers, which may represent suboptimal housing, had worse sleep than those in houses/apartments; and racial differences in the quality of houses and apartments are likely to greatly vary in ways that still contribute to sleep disparities. Race-sex group differences in sleep duration among residents in a house/apartment and even a lack of racial difference among individuals living in mobile homes/trailers support the need for more research on residential environments and eventually multi-level interventions designed to reduce sleep disparities.
住房环境可以直接或间接地影响睡眠,而且与白人相比,黑人更有可能居住在条件不佳的住房环境中,这可能独立导致睡眠差距。然而,很少有大规模的流行病学研究考虑住房类型对睡眠健康的潜在影响。利用 2004-2015 年全国健康访谈调查的数据,我们研究了美国 226208 名成年人中住房类型(独立屋/公寓与移动房屋/拖车)与睡眠持续时间以及睡眠困难之间的总体关联以及黑人和白人之间的差异。使用稳健方差的泊松回归估计了睡眠分类的性别特异性患病率比(PR),首先将独立屋/公寓与移动房屋/拖车进行比较,然后在住房类型内将黑人与白人进行比较。所有模型均根据年龄、教育程度、收入、职业阶层、自我报告的一般健康状况和居住地区进行了调整。与居住在独立屋/公寓的参与者相比,移动房屋/拖车内的男性(PR = 1.05(95%置信区间(CI):1.02-1.08))和女性(PR = 1.07(95% CI:1.04-1.09))的短睡患病率更高。在独立屋/公寓中的黑人男性(PR = 1.26(95% CI:1.21-1.30))和女性(PR = 1.24(95% CI:1.20-1.27))更有可能成为短睡者比他们的白人同龄人。在调整后,移动房屋/拖车内的黑人和白人男性在睡眠特征(除长睡外)方面通常没有显着差异,而独立屋/公寓中的黑人男性以及两种住房类型中的黑人女性报告睡眠困难的可能性较小,尽管他们更有可能报告短睡。总体而言,居住在移动房屋/拖车内的人,其住房条件可能较差,睡眠质量比居住在独立屋/公寓内的人差;而且,住房质量方面的种族差异可能会以极大的方式差异很大,从而仍然导致睡眠差距。独立屋/公寓内居民的睡眠持续时间存在种族-性别差异,甚至移动房屋/拖车内居民之间也不存在种族差异,这支持了对居住环境进行更多研究并最终进行旨在减少睡眠差距的多层次干预的必要性。