Iowa State University, United States.
University at Albany, State University of New York, United States.
Soc Sci Med. 2019 Jan;221:115-123. doi: 10.1016/j.socscimed.2018.12.002. Epub 2018 Dec 6.
The current study examined whether sleep mediates the effect of discrimination experiences on mental and physical health over time. Prior research suggests a partially mediated relation; however, these studies used cross-sectional designs which provide insufficient causal evidence.
The study used longitudinal data available from the Midlife in the United States Study (MIDUS II, Biomarker project, and MIDUS III) applying structural equation modeling to evaluate whether self-reported sleep (N = 866) mediated the impact of discrimination on mental and physical health outcomes.
Self-reported sleep quality partially mediated the effect of discrimination on mental and physical health. Analyses also indicated self-reported daytime dysfunction (i.e., difficulties maintaining alertness and motivation during the day) as a key component of sleep that mediates the discrimination and mental and physical health relations. Interestingly, having multiple marginalized identities did not amplify the impact of discrimination on sleep and health.
These findings build upon previous cross-sectional research by better supporting the causal assertion that experiences of discrimination undermine sleep, which in turn worsens both mental and physical health. Altogether, results underscore the harmful impact of discrimination on health indirectly through sleep and offer insight into directions for future research.
本研究旨在探讨歧视经历是否会随时间推移通过睡眠来影响心理健康和身体健康。先前的研究表明两者之间存在部分中介关系，但这些研究使用的是横断面设计，提供的因果证据不足。
该研究使用了来自美国中年研究（MIDUS II、生物标志物项目和 MIDUS III）的纵向数据，应用结构方程模型来评估自我报告的睡眠（N=866）是否中介了歧视对心理健康和身体健康结果的影响。
自我报告的睡眠质量部分中介了歧视对心理健康和身体健康的影响。分析还表明，自我报告的日间功能障碍（即白天保持警觉和积极性的困难）是睡眠中介歧视与心理健康和身体健康关系的关键组成部分。有趣的是，拥有多种边缘化身份并不会放大歧视对睡眠和健康的影响。
这些发现通过更好地支持歧视经历会破坏睡眠，进而恶化心理健康和身体健康的因果论断，进一步扩展了先前的横断面研究。总的来说，研究结果强调了歧视通过睡眠对健康的间接有害影响，并为未来的研究方向提供了启示。
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