References - How inequality is affecting sleep quality among disadvantaged families

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Finally, disparities in sleep health among racial/ethnic populations are substantial but modifiable and include differences in sleep duration and sleep hygiene. For example, interactive bedtime routines are less common among low-income and racial/ethnic minority families than among their socioeconomically advantaged, non-racial/ethnic–minority counterparts (23,24), whereas parent–child co-sleeping is more common. Rates of sleep-disordered breathing also are higher among racial/ethnic minority and low-income children, and these children are least likely to receive treatment for the disorder (25). Cultural values influence sleep practices; however, sleep health disparities could be reduced by increasing parents’ knowledge and skills about how to obtain healthy sleep for their children.


Racial Differences in Reported Napping and Nocturnal Sleep in 2- to 8-Year-Old Children Brian Crosby, BA* , Monique K. Le Bourgeois, PhD*, and John Harsh, PhD*

At age 8, 39.1% of black children were reported to nap, compared with only 4.9% of white children. Black children also napped significantly more days per week, had shorter average nocturnal sleep duration, and slept significantly less on weekdays than on weekend nights. Despite differences in sleep distribution, total weekly sleep duration (diurnal and nocturnal) was nearly identical for the 2 racial groups at each year of age. 


Sleep Health. 2019 Feb;5(1):49-57. doi: 10.1016/j.sleh.2018.09.010. Epub 2018 Oct 15. Racial Disparities and Sleep Among Preschool Aged Children: A Systematic Review Jonathan P Smith 1, Shakia T Hardy 2, Lauren E Hale 3, Julie A Gazmararian 2

The results provided consistent evidence that white, non-Hispanic children were more likely to go to bed earlier and more regularly, have longer nocturnal sleep, and nap less than most racial and ethnic minorities. 


Factors That Influence Where Babies Sleep in the United States The Impact of Feeding Method, Mother’s Race/Ethnicity, Partner Status, Employment, Education, and Income Kathleen Kendall-Tackett, PhD, IBCLC, RLC, FAPA1 Zhen Cong, PhD2 Thomas Hale, PhD3

Consistent with previous findings, we found that African American and American Indian mothers were more likely to bedshare, as were lower income and single mothers. We also found that bedsharing mothers were more likely to have lower education levels, be younger age at first birth, and were less likely to be currently employed. There were also striking racial/ethnic differences on location of night feeds, where mothers think babies should sleep, and their reasons for engaging in their nighttime parenting practices.


Sleep as a Potential Fundamental Contributor to Disparities in Cardiovascular Health Chandra L. Jackson,1 Susan Redline,2 and Karen M. Emmons3


The review, of 41 studies, found that infants born to minority women typically received poorer care in the neonatal intensive care unit (NICU) compared with white newborns.

According to the latest CDC figures, the rate of preterm birth among U.S. black women remains about 50% higher than that of white women -- at 14%, versus 9%.



Reducing Racial/Ethnic Disparities in Childhood Obesity The Role of Early Life Risk Factors

Early childhood risk factors (age 1-3 years) included... the presence of a television set in the room where the child sleeps at age 4 years,


Perceived Discrimination and Adolescent Sleep in a Community Sample

Bridget J. Goosby, Jacob E. Cheadle, Whitney Strong-Bak, Taylor C. Roth, Timothy D. Nelson


Racial/ethnic sleep disparities in US school-aged children and adolescents: a review of the literature

Author links open overlay panel Dana Guglielmo MPH a Julie A. Gazmararian PhD, MPH Joon Chung Ann E. Rogers PhD, RN Lauren Hale PhD

In this review, we critically examined and compared results from 23 studies that have investigated racial/ethnic sleep disparities in American school-aged children and adolescents ages 6-19 years. We found that White youth generally had more sufficient sleep than minority youth, Hispanics had more than Blacks, and there was inconclusive evidence for Asians and other minorities.


INSOMNIA SLEEP HEALTH SLEEP TOOLS & TIPS What’s the Connection Between Race and Sleep Disorders


Associations of Early Life Risk Factors With Infant Sleep Duration

Michael D Nevarez 1, Sheryl L Rifas-Shiman, Ken P Kleinman, Matthew W Gillman, Elsie M Taveras

Maternal depression during pregnancy, early introduction of solid foods, infant TV viewing, and attendance of child care were associated with shorter infant sleep duration. Racial/ethnic minority children slept fewer hours in the first 2 years of life than white children. Our results suggest that various risk factors, some potentially modifiable, are worthy of clinical consideration when addressing infant sleep duration.


Decline in SUIDs, sleep-related infant deaths differ by race, ethnicity


Eliminating Racial Disparities in Maternal and Infant Mortality


Emergence of racial/ethnic differences in infant sleep duration in the first six months of life


  • At one-month, Hispanic infants slept significantly less at night than white infants.
  • At six-months, Hispanic and Black infants slept less at night than white infants.
  • The near 1-h differential among Hispanics resulted in shorter total sleep.
  • Adjusting for SES attenuated associations across all racial/ethnic groups.
  • Sleep continuity attenuated associations for Hispanic infants at six-months.


Racial/ethnic sleep disparities in US school-aged children and adolescents: a review of the literature Dana Guglielmo, MPH a, ⁎, Julie A. Gazmararia


Racial and Ethnic Differences in Prenatal Life Stress and Postpartum Depression Symptoms

Author links open overlay panel Cindy H. Liua Rebecca Giallob Stacey N. Doanc Larry J. Seidmana Ed Tronic kd


This study determined the risk of core depression symptoms based on life stress domains during pregnancy and whether stressors varied by race/ethnicity. The sample consisted of 2,344 White, African American, Hispanic, and Asian/Pacific Islander (API) Massachusetts women who recently gave birth. African Americans and Hispanics who endorsed high relational and high financial stress were more likely to report high depressed mood and loss of interest; high physical stress was associated with high depressed mood among API. Screening based on life stress domains may be informative in determining risk for core depression symptoms during the postpartum period especially for minority groups.


Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women

Katy Backes Kozhimannil, Ph.D., M.P.A., Connie Mah Trinacty, Ph.D., Alisa B. Busch, M.D., M.S., Haiden A. Huskamp, Ph.D., and Alyce S. Adams, Ph.D.

Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, marginal difference at p<.10; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription.

Prevalence and predictors of maternal postpartum depressed mood and anhedonia by race and ethnicity

  1. H. Liu (a1) and E. Tronick (a2) 

DOI: https://doi.org/10.1017/S2045796013000413 Published online by Cambridge University Press: 12 August 2013



Depression requires the presence of either depressed mood or anhedonia, yet little research attention has been focused on distinguishing these two symptoms. This study aimed to obtain the prevalence rates of these two core depression symptoms and to explore the risk factors for each symptom by race/ethnicity.



2423 White, African American, Hispanic and Asian/Pacific Islander (API) women from the Massachusetts area completed the Pregnancy Risk Assessment Monitoring System (PRAMS) from 2007 to 2008.


Socioeconomic variables (SES) accounted for increased rates in depressed mood and anhedonia among African Americans and Hispanics compared with Whites. API women were still 2.1 times more likely to report anhedonia after controlling for SES. Stressors were associated with depressed mood across groups and associated with anhedonia for Whites and Hispanics. Having a female infant was associated with depressed mood for APIs. Being non-US born was associated with anhedonia for Whites, APIs and African Americans, but not Hispanics.


Prevalence rates for depressed mood and anhedonia differ across race/ethnic groups and risks associated with depressed mood and anhedonia depend on the race/ethnic group, suggesting the importance of distinguishing depressed mood from anhedonia in depression assessment and careful inquiry regarding symptom experiences with a diverse patient population.


Certain psychosocial factors are key predictors of a mother developing PPD. The predictors include low socioeconomic status (Kim et al., 2011), inadequate social resources (Albright, 1993; Mundorf et al., 2018; Oddy, Rowe, & Fisher, 2009), and limited access to therapeutic services (Kothari et al., 2016). Lack of partner support is also a key predictor of PPD (Fazlagić, 2011). Previous postpartum depression; a history of depression, anxiety, or stress; stressful life events; and childhood trauma can be predisposing factors for PPD (De Venter et al., 2016). Also, minority mothers, especially African Americans, are particularly prone to PPD (Abrams & Curran, 2007; Barakat, Martinez, Thomas, &

Handley, 2014; Guintivano et al., 2018; Horwitz, et al., 2007; Kim et al., 2012; Mukherjee, Fennie, Coxe, Madhivanan, & Trepks, 2018).


Previous studies have suggested that racial/ethnic minorities and the socioeconomically disadvantaged may be more likely to experience sleep patterns that are associated with adverse health outcomes. 

those reporting racism in health care settings being 60% more likely to experience sleep disturbance, even after accounting for all covariates. This finding was expanded upon by Slopen and Williams, who showed that major experiences of discrimination were associated with shorter sleep duration and more sleep difficulties


Compared to control dyads, postpartum parents experienced greater sleep disturbance, sleepiness, and sleepiness-associated impairments