Department of Human Development and Family Science, Auburn University, Auburn, AL, USA.
Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA.
Sleep Med. 2023 Aug;108:61-70. doi: 10.1016/j.sleep.2023.05.021. Epub 2023 Jun 1.
To examine social class discrimination as a mediator of socioeconomic disparities in sleep outcomes in an adolescent sample.
Sleep was assessed from established actigraphy (efficiency, long wake episodes, duration) and self-report (sleep/wake problems, daytime sleepiness) measures among 272 high school students in the Southeastern region of the United States (35% low income; 59% White, 41% Black, 49% female, Mean age = 17.3, SD = 0.8). Social class discrimination was assessed using a new measure, the Social Class Discrimination Scale (SCDS; 22-items), and an established measure, the Experiences of Discrimination Scale (EODS; 7-items). Socioeconomic disadvantage (SED) was measured as an aggregate of six indicators.
The SCDS was associated with sleep efficiency, long wake episodes, sleep/wake problems and daytime sleepiness (but not sleep duration), and significantly mediated the socioeconomic gradient in each sleep outcome. Black males experienced higher levels of social class discrimination than Black females, White males, or White females. A race by gender moderation effect was evident for two of the five sleep outcomes (sleep efficiency and long wake episodes) suggesting a stronger association between social class discrimination and sleep problems for Black females than White females but no clear race differences among males. The EODS was not associated with objective sleep outcomes or SED but was associated with self-reported sleep and showed a similar pattern of moderation effects.
Findings suggest that social class discrimination may contribute to socioeconomic disparities in sleep problems, with some variability across measures and demographic groups. Results are discussed in light of evolving trends in socioeconomic health disparities.
在青少年样本中，考察社会阶层歧视作为社会经济差异与睡眠结果关系的中介因素。
在美国东南部地区的 272 名高中生中，使用经过验证的活动记录仪（效率、长醒期、持续时间）和自我报告（睡眠/觉醒问题、白天嗜睡）测量方法评估睡眠（35%低收入；59%白人，41%黑人，49%女性，平均年龄 17.3，标准差 0.8）。使用新的社会阶层歧视量表（SCDS；22 项）和已建立的歧视经历量表（EODS；7 项）评估社会阶层歧视。社会经济劣势（SED）是用六个指标的总和来衡量的。
SCDS 与睡眠效率、长醒期、睡眠/觉醒问题和白天嗜睡（但不包括睡眠时间）有关，并且显著中介了每个睡眠结果的社会经济梯度。黑人男性比黑人女性、白人男性或白人女性经历了更高水平的社会阶层歧视。种族和性别之间的调节效应在五个睡眠结果中的两个（睡眠效率和长醒期）中表现明显，这表明黑人女性与社会阶层歧视之间的关联比白人女性更强，而男性之间则没有明显的种族差异。EODS 与客观睡眠结果或 SED 无关，但与自我报告的睡眠有关，并且表现出类似的调节效应模式。
研究结果表明，社会阶层歧视可能是导致社会经济差异与睡眠问题之间关系的一个因素，而且在不同的测量方法和人口群体中存在一定的差异。研究结果在考虑社会经济健康差异的演变趋势时进行了讨论。
