Multi-level modeling of social disparities in sleep and health

睡眠和健康方面的社会差异的多层次建模

• 批准号: 8305517
• 负责人: Andre B. Araujo
• 金额: $ 11.53万
• 依托单位: NEW ENGLAND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-21 至 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8305517
• 关键词: Affect; Age; Air; Air Pollution; Airborne Particulate Matter; American; Americas; Area; Behavioral; Boston; Cardiovascular Diseases; Censuses; Chronic Obstructive Airway Disease; Clinical; Cohort Studies; Community Health; Complex; Conflict (Psychology); Congestive Heart Failure; Coronary heart disease; Crime; Data; Databases; Diabetes Mellitus; Diet; Ethnic Origin; Ethnic group; Exploratory/Developmental Grant; Foundations; Health; Health Surveys; Healthcare Systems; Hispanics; Hour; Housing; Human; Hygiene; Hypertension; Individual; Inflammation; Interview; Knowledge; Life; Life Style; Link; Literature; Manuscripts; Measures; Medical; Mental Depression; Minority; Minority Groups; Modeling; Neighborhoods; New England; Noise; Obesity; Outcome; Pain; Pathway interactions; Peer Review; Pharmaceutical Preparations; Physical activity; Pollution; Polysomnography; Population; Population Density; Population Distributions; Poverty; Process; Psychosocial Stress; Public Health; Race; Reporting; Request for Applications; Research; Research Institute; Research Personnel; Resources; Risk Factors; Sampling; Sleep; Sleep Disorders; Smoking; Social Environment; Socioeconomic Status; Stroke; Symptoms; Techniques; Time; United States Environmental Protection Agency; United States National Institutes of Health; Violence; Woman; Work; aged; biopsychosocial; cost; density; follow-up; health disparity; low socioeconomic status; men; mortality; noise pollution; novel; nutrition; obesity risk; population based; research study; response; sex; social; social disparities

7. PROJECT SUMMARY/ABSTRACT Sleep is essential to human health. Sleep problems affect a substantial proportion of the US population and cost the US healthcare system hundreds of billions of dollars annually. At the same time, social disparities (including those related to age, sex, socioeconomic status (SES), and race/ethnicity) in health have been repeatedly documented. The current literature on social disparities in sleep is in conflict regarding the existence of social disparities, their origins, and how social disparities in sleep may manifest themselves in social disparities in health. The overall objective of this application is to make cost-efficient use of an existing data resource [the Boston Area Community Health (BACH) Survey; U01DK056842)] in order to close key knowledge gaps regarding the mechanisms linking social determinants with sleep, as well as mechanisms underlying the way in which social disparities in sleep manifest themselves in downstream health disparities. The BACH Survey is a population-based, random-sample, cohort study that included 5,506 diverse (white, Hispanic, black) women and men between the ages of 30-79 y at baseline; 4,145 subjects were recently re- interviewed (83% response rate) 5 years later. The BACH Survey database will be linked with publically- available data [(i.e., US Census Bureau and EPA] for a number of the proposed analyses. There are two specific aims. (1) Examine the influence that social determinants have on sleep. This will include estimating (using multi-level modeling) the individual- and neighborhood-level social determinants of sleep quantity, sleep quality, and use of prescription and non-prescription sleep aids, determining the extent to which the associations between individual- and neighborhood-level social determinants and sleep are driven by other risk factors, including pain and voiding symptoms, and quantifying the relationship of external noise and air pollution (by geo-spatial analytic techniques) with sleep quantity, sleep quality, and use of prescription and non-prescription sleep aids. (2) Examine the associations between sleep and health outcomes. This will include examining age-, sex-, SES-, and race/ethnic group-specific longitudinal associations between sleep measured at baseline in relation to incident hypertension, obesity, diabetes, cardiovascular disease, and all- cause mortality and identifying variables that may be on the pathway (e.g., nutrition, inflammation, psychosocial stress, depression, use of sleep-related medications) between sleep and these health outcomes. This cost- and time-efficient study of social determinants, sleep, and health has the potential to fill critical gaps in the literature within the framework of a new conceptual approach that integrates novel data using state-of- the-art statistical techniques. The use of the R21 mechanism will serve as a springboard for the investigators to initiate additional studies in the area of sleep. Given the emerging relevance of sleep as a critical factor in human health, the potential scientific impact of the proposed study is substantial.

7. 项目概要/摘要 睡眠对人类健康至关重要。睡眠问题影响着相当大比例的美国人口 每年给美国医疗保健系统造成数千亿美元的损失。与此同时，社会不平等 （包括与年龄、性别、社会经济地位（SES）和种族/民族相关的）健康状况 反复记录。当前关于睡眠社会差异的文献在以下方面存在冲突： 社会差异的存在、其起源以及睡眠方面的社会差异如何表现在 健康方面的社会差异。该应用程序的总体目标是经济有效地利用现有的 数据资源 [波士顿地区社区健康 (BACH) 调查； U01DK056842)]以关闭密钥 关于社会决定因素与睡眠的联系机制以及机制的知识差距 睡眠方面的社会差异在下游的健康差异中表现出来。 BACH 调查是一项基于人群的随机样本队列研究，其中包括 5,506 名不同人群（白人、白人、 基线年龄在 30-79 岁之间的西班牙裔、黑人）女性和男性； 4,145 名受试者最近接受了重新评估 5 年后接受采访（83% 的回复率）。 BACH 调查数据库将与公开链接- 一些拟议分析的可用数据[（即美国人口普查局和美国环保局）。有两个 具体目标。 (1)考察社会决定因素对睡眠的影响。这将包括估计 （使用多层次模型）个人和社区层面的睡眠质量的社会决定因素 处方和非处方助眠剂的质量和使用，确定睡眠辅助剂的使用程度 个人和社区层面的社会决定因素与睡眠之间的关联是由其他风险驱动的 因素，包括疼痛和排尿症状，并量化外部噪音和空气的关系 污染（通过地理空间分析技术）与睡眠数量、睡眠质量以及处方和药物的使用 非处方安眠药。 (2) 检查睡眠与健康结果之间的关联。这将 包括检查睡眠之间年龄、性别、社会经济地位和种族/民族特定的纵向关联 在基线时测量与高血压、肥胖、糖尿病、心血管疾病和所有疾病相关的 导致死亡并确定可能存在的变量（例如营养、炎症、 睡眠与这些健康结果之间的社会心理压力、抑郁、使用与睡眠相关的药物）。 这项针对社会决定因素、睡眠和健康的经济高效的研究有可能填补关键空白 在文献中，在一种新概念方法的框架内，该方法使用状态整合新颖的数据 最先进的统计技术。 R21机制的使用将作为研究人员的跳板 启动睡眠领域的更多研究。鉴于睡眠作为一个关键因素的新兴相关性 人类健康，拟议研究的潜在科学影响是巨大的。