The City Doesn’t Sleep: Community Perceptions of Sleep Deficits and Disparities
Abstract
:1. Introduction
1.1. Background
1.2. A Role for Community-Based Participatory Research (CBPR) in Understanding Sleep
2. Materials and Methods
2.1. Identifying a Sample Area Using GIS Mapping
2.2. Recruitment and Participants
2.3. Semi-Structured Focus Group Protocol
2.4. Analysis
3. Results
3.1. Economic Insecurity
“No money, no car, no job, no sleep.”
“I think if there were just more jobs in the community, we would sleep better because if you had a nice job, you wouldn’t have to worry about getting a roof over your head, or you know, there’s so many problems that would be alleviated by just having gainful secure employment. Even if you have a job, you worry about losing it. You could go to sleep with peace of mind because you’re employed. So, I think that has a lot to do with sleep differences.”
“There’s lots of contributing factors to people not having good rest, you know. Like, you know, jobs. If you know you’re the head of the household with bills and different things like that. I think if we get more jobs and the financials get better here because of that … I think people will be getting a lot better sleep because they’ll be going to sleep knowing they have a job to wake up to in the morning and they can provide for their families. Until then, I don’t see too much sleep happening.”
“It could just be the economy overall. The worry and stress level is high in the city and you can’t go to sleep.”
“The financial crisis we’re going through makes some areas sleep worse.” “I think when economic change comes, we’ll get more sleep. I think people will get more rest.”
“It all goes back to money.”“I think we’re trying to get money, trying to survive. You can work two jobs and still be just below the poverty level. You can’t sleep in poverty.”
3.2. Safety Insecurity
“Gunshots wake you up because you wonder what is going on, so you really can’t go back to sleep.”“Gunshots, the ambulance, the police. That wakes you up and keeps you up.”
“Worrying about being shot, getting robbed, things like that. That can keep people up and awake. Just fear.”“The crime-ridden neighborhoods, the gunshots, break-ins, murders. You worry at night.”“If I leave my car out or something like that, I get up constantly throughout the night, checking to see if my car is still there. We’ve been broken into a couple of times. Even my garage has been broken into, so I get up through the night, check the windows, check the doors, and make sure everything is going good.”“I have a daughter that got shot. When I know she’s out, I will not sleep until I know she is safely in her house, calls me on the phone. She’s like, ‘Momma, you know I’m twenty-six years old. Stop worrying about me all the time.’ But I do. Are they in the house? Are they safe? I’m not going to sleep until I know she’s in the house.”
“I’m talking about the drug dealers that be on the corner. They ain’t got no jobs. They’re drinking.”“Now you drive down the older neighborhoods and whatnot…. It looks like a jungle.”“The neighborhood looks like a third world country.”“There are too many problems in the neighborhood. You’ve got gang violence. You’ve got an STD outbreak. It’s too much. So that’s what leads to worse sleep.”
“There are kids coming down the street at 1, 2, 3, 4, and 5 in the morning.”“We have people walking up and down the street all night. You know they haven’t had their rest because they were standing in the street talking all night.”“The music on the corner is before the shooting, and then the ambulance. So, you are up.”
3.3. Future Insecurity
“Society has changed over the last twenty or thirty years. Things just aren’t what they used to be.”“I worry about my kids and societal changes. What will the future be like for them and me? It keeps me awake at night.”“Just the community in general. There’s not a future for our kids.”
“When you have to depend on the city, county, and state to even get you through—you don’t have control of your life. That’s stress. That’s why I can’t sleep.”“I mean, it just seems like everything is in somebody else’s hands. So, you don’t sleep because you’re worried. You know, there’s just so many things that you don’t feel you’re in control of at all.”“You are not in control of your life, you know. You don’t know what’s going to happen.”“You are made to do things that you can’t control your stress level. You know it is hard to control stress.”“You know everyone is in survival mode and sleep just goes. You are worrying about survival.”“Like I said, you don’t have no options. What do you worry about? You’re just out of luck basically.”
“I believe that times in the city are so stressed. Everywhere I go, you see it, you know. People are concerned about their jobs, the welfare of their children, their homes. Some people have just lost hope altogether, you see it out there all the time. Just overall lost hope. We can’t sleep because of lost hope.”
3.4. Hecticness and Time Pressure
“We live in what I call the microwave. We want it fast, and we want it now. We be tired enough to get to sleep, but I am going all the time. And I know I got to do this, don’t forget to do that, you know, make sure you do this, make sure you do that. Just going all the time.”“I just have too much going on. It’s too busy. I can’t sleep.”“If you’re in a situation that has a lot of activities going on in the environment, you’re not going to be aware that it’s a problem when you don’t sleep. And you’ll start to realize, man, this is the reason why I don’t sleep, because of my environment. If it’s constantly fast-paced, you’re not going to sleep.”
“Time. If I have enough time to get things accomplished throughout that day, so I felt that I got this accomplished, then I can go to sleep real well. Time is the issue.”“It’s not worry. I think that it is time pressure. Too much to do.”
“Just going all the time. You have so many thoughts in your head. My mind just don’t calm down enough to sleep when I have so much to do.”
3.5. Proximate Sleep Environment
“Mattresses. A bad mattress keep you awake.”“If you ask people what they want they’ll say mattresses.”“I slept better in the country because the air was cleaner, didn’t have all the city stink. It just seemed darker; you don’t have all the bright lights.”“Neighbors got the radio on too loud.”“I think air pollution and noise pollution is big, too, especially in an area like this.”
4. Discussion
Implications and Directions for Future Research
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Liu, Y.; Wheaton, A.G.; Chapman, D.P.; Cunningham, T.J.; Lu, H.; Croft, J.B. Prevalence of healthy sleep duration among adults—United States, 2014. MMWR Morb. Mortal. Wkly. Rep. 2016, 65, 137–141. [Google Scholar] [CrossRef]
- Bixler, E. Sleep and society: An epidemiological perspective. Sleep Med. 2009, 10, S3–S6. [Google Scholar] [CrossRef] [PubMed]
- Altevogt, B.M.; Colten, H.R. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem; National Academies Press: Washington, DC, USA, 2006. [Google Scholar]
- Cai, H.; Shu, X.-O.; Xiang, Y.-B.; Yang, G.; Li, H.; Ji, B.-T.; Gao, J.; Gao, Y.-T.; Zheng, W. Sleep duration and mortality: A prospective study of 113,138 middle-aged and elderly Chinese men and women. Sleep 2015, 38, 529–536. [Google Scholar] [CrossRef] [PubMed]
- Healthy People 2020. Available online: https://www.healthypeople.gov/2020/topics-objectives (accessed on 16 August 2019).
- Johnson, D.A.; Jackson, C.L.; Williams, N.; Alcántara, C. Are sleep patterns influenced by race/ethnicity a marker of relative advantage or disadvantage? Evidence to date. Nat. Sci. Sleep 2019, 11, 79–95. [Google Scholar] [CrossRef] [PubMed]
- Shaw, R.; McKenzie, S.; Taylor, T.; Olafiranye, O.; Boutin-Foster, C.; Ogedegbe, G.; Jean-Louis, G. Beliefs and attitudes toward obstructive sleep apnea evaluation and treatment among blacks. J. Natl. Med. Assoc. 2012, 104, 510–519. [Google Scholar] [CrossRef]
- Bilsbury, C.D.; Rajda, M. What’s wrong with sleep hygiene? Sleep Med. 2004, 5, 513–517. [Google Scholar] [CrossRef]
- Åkerstedt, T.; Kecklund, G.; Axelsson, J. Impaired sleep after bedtime stress and worries. Biol. Psychol. 2007, 76, 170–173. [Google Scholar] [CrossRef]
- Alcántara, C.; Patel, S.R.; Carnethon, M.; Castañeda, S.F.; Isasi, C.R.; Davis, S.; Ramos, A.R.; Arredondo, E.; Redline, S.; Zee, P.C.; et al. Stress and sleep: Results from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. SSM Popul. Health 2017, 3, 713–721. [Google Scholar] [CrossRef]
- Beatty, D.L.; Hall, M.H.; Kamarck, T.A.; Buysse, D.J.; Owens, J.F.; Reis, S.E.; Mezick, E.J.; Strollo, P.J.; Matthews, K.A. Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE Project. Health Psychol. 2011, 30, 351–359. [Google Scholar] [CrossRef]
- Troxel, W.M.; Buysse, D.J.; Matthews, K.A.; Kravitz, H.M.; Bromberger, J.T.; Sowers, M.; Hall, M.H. Marital/cohabitation status and history in relation to sleep in midlife women. Sleep 2010, 33, 973–981. [Google Scholar] [CrossRef]
- Henry, D.; McClellen, D.; Rosenthal, L.; Dedrick, D.; Gosdin, M. Is sleep really for sissies? Understanding the role of work in insomnia in the US. Soc. Sci. Med. 2008, 66, 715–726. [Google Scholar] [CrossRef] [PubMed]
- Knudsen, H.K.; Ducharme, L.J.; Roman, P.M. Job stress and poor sleep quality: Data from an American sample of full-time workers. Soc. Sci. Med. 2007, 64, 1997–2007. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hicken, M.T.; Lee, H.; Ailshire, J.; Burgard, S.A.; Williams, D.R. “Every shut eye ain’t sleep”: The role of racism-related vigilance in racial/ethnic disparities in sleep difficulty. Race Soc. Probl. 2013, 5, 100–112. [Google Scholar] [CrossRef] [PubMed]
- Slopen, N.; Lewis, T.T.; Williams, D.R. Discrimination and sleep: A systematic review. Sleep Med. 2016, 18, 88–95. [Google Scholar] [CrossRef]
- Shockey, T.M.; Wheaton, A.G. Short sleep duration by occupation group—29 states, 2013–2014. MMWR Morb. Mortal. Wkly. Rep. 2017, 66, 207–213. [Google Scholar] [CrossRef]
- Grandner, M.A.; Patel, N.P.; Gehrman, P.R.; Xie, D.; Sha, D.; Weaver, T.; Gooneratne, N. Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints. Sleep Med. 2010, 11, 470–478. [Google Scholar] [CrossRef] [Green Version]
- Grandner, M.A.; Williams, N.J.; Knutson, K.L.; Roberts, D.; Jean-Louis, G. Sleep disparity, race/ethnicity, and socioeconomic position. Sleep Med. 2016, 18, 7–18. [Google Scholar] [CrossRef]
- Johnson, D.A.; Brown, D.L.; Morgenstern, L.B.; Meurer, W.J.; Lisabeth, L.D. The association of neighborhood characteristics with sleep duration and daytime sleepiness. Sleep Health 2015, 1, 148–155. [Google Scholar] [CrossRef] [Green Version]
- Arber, S.; Bote, M.; Meadows, R. Gender and socio-economic patterning of self-reported sleep problems in Britain. Soc. Sci. Med. 2009, 68, 281–289. [Google Scholar] [CrossRef] [Green Version]
- Ruiter, M.E.; DeCoster, J.; Jacobs, L.; Lichstein, K.L. Normal sleep in African-Americans and Caucasian-Americans: A meta-analysis. Sleep Med. 2011, 12, 209–214. [Google Scholar] [CrossRef] [Green Version]
- Durrence, H.H.; Lichstein, K.L. The sleep of African Americans: A comparative review. Behav. Sleep Med. 2006, 4, 29–44. [Google Scholar] [CrossRef] [PubMed]
- Centers for Disease Control and Prevention (CDC). Unhealthy sleep-related behavior—12 states, 2009. Morb. Mortal. Wkly. Rep. 2011, 60, 233–238. [Google Scholar]
- Morgenthaler, T.; Kramer, M.; Alessi, C.; Friedman, L.; Boehlecke, B.; Brown, T.; Coleman, J.; Kapur, V.; Lee-Chiong, T.; Owens, J.; et al. Practice parameters for the psychological and behavioral treatment of insomnia: An update. An American Academy of Sleep Medicine report. Sleep 2006, 29, 1415–1419. [Google Scholar] [PubMed]
- Hale, L.; Hale, B. Treat the source not the symptoms: Why thinking about sleep informs the social determinants of health. Health Educ Res. 2010, 25, 395–400. [Google Scholar] [CrossRef] [PubMed]
- US Census. QuickFacts Flint City, Michigan. Available online: https://www.census.gov/quickfacts/fact/table/flintcitymichigan/PST045216 (accessed on 20 September 2019).
- FBI Uniform Crime Reports. Available online: https://www.fbi.gov/services/cjis/ucr/publications#cius (accessed on 20 September 2019).
- Green, L.W.; Kreuter, M.W. Health Program Planning: An Educational and Ecological Approach, 4th ed.; McGraw-Hill: New York, NY, USA, 2005. [Google Scholar]
- Israel, B.A.; Coombe, C.M.; Cheezum, R.R.; Schulz, A.J.; McGranaghan, R.J.; Lichtenstein, R.; Reyes, A.G.; Clement, J.; Burris, A. Community-based participatory research: A capacity-building approach for policy advocacy aimed at eliminating health disparities. Am. J. Public Health 2010, 100, 2094–2102. [Google Scholar] [CrossRef]
- Williams, N.J.; Grandner, M.A.; Snipes, S.A.; Rogers, A.; Williams, O.; Airhihenbuwa, C.; Jean-Louis, G.; Grandne, M.A.; Snipes, A. Racial/ethnic disparities in sleep health and health care: Importance of the sociocultural context. Sleep Health 2015, 1, 28–35. [Google Scholar] [CrossRef]
- Israel, B.A.; Eng, E.; Schulz, A.J.; Parker, E.A. Methods for Community-Based Participatory Research for Health; Jossey-Bass: San Francisco, CA, USA, 2013. [Google Scholar]
- Bogart, L.M.; Uyeda, K. Community-based participatory research: Partnering with communities for effective and sustainable behavioral health interventions. Health Psychol. 2009, 28, 391–393. [Google Scholar] [CrossRef]
- Wilkinson, R. The challenge of prevention: A response to Starfield’s “Commentary: Pathways of influence on equity in health”. Soc. Sci. Med. 2007, 64, 1367–1370. [Google Scholar] [CrossRef]
- Kingsbury, J.H.; Buxton, O.M.; Emmons, K.M. Sleep and its relationship to racial and ethnic disparities in cardiovascular disease. Curr. Cardiovasc. Risk Rep. 2013, 7, 387–394. [Google Scholar] [CrossRef]
- Griffith, D.M.; Yonas, M.; Mason, M.; Havens, B.E. Considering organizational factors in addressing health care disparities: Two case examples. Health Promot. Pract. 2010, 11, 367–376. [Google Scholar] [CrossRef]
- Huber, M.S.Q.; Van Egeren, L.A.; Pierce, S.J.; Foster-Fishman, P.G. GIS applications for community-based research and action: Mapping change in a community-building initiative. J. Prev. Interv. Community 2009, 37, 5–20. [Google Scholar] [CrossRef] [PubMed]
- Becker, D. Health Behavior Research in Minority Populations: Access, Design and Implementation; NIH Publication No. 92-2965; U.S. Department of Health and Human Services: Washington, DC, USA, 1992.
- Kruger, R.A.; Casey, M.A. Focus Groups: A Practical Guide for Applied Research, 3rd ed.; Sage Publications: Thousand Oaks, CA, USA, 2000. [Google Scholar]
- Braun, V.; Clarke, J. Using thematic analysis in psychology. Qual. Res. Psychol. 2006, 3, 77–101. [Google Scholar] [CrossRef] [Green Version]
- Centers for Disease Control and Prevention. Social Determinants of Health: Know What Affects Health. Available online: https://www.cdc.gov/socialdeterminants/index.htm (accessed on 20 September 2019).
- Sleep Facts Information: Myths and Facts. Available online: https://www.sleepfoundation.org/articles/myths-and-facts-about-sleep (accessed on 16 August 2019).
- Hale, L.; Do, D.P. Racial differences in self-report of sleep duration in a population-based study. Sleep 2007, 30, 1092–1099. [Google Scholar] [CrossRef] [PubMed]
- Hill, T.D.; Burdette, A.M.; Hale, L. Neighborhood disorder, sleep quality, and psychological distress: Testing a model of structural amplification. Health Place 2009, 15, 1006–1013. [Google Scholar] [CrossRef] [PubMed]
- Mohajer, N.; Earnest, J. Widening the aim of health promotion to include the most disadvantaged: Vulnerable adolescents and the social determinants of health. Health Educ. Res. 2010, 25, 387–394. [Google Scholar] [CrossRef] [PubMed]
- Patel, N.P.; Grandner, M.A.; Xie, D.; Branas, C.C.; Gooneratne, N. “Sleep disparity” in the population: Poor sleep quality is strongly associated with poverty and ethnicity. BMC Public Health 2010, 10, 475. [Google Scholar] [CrossRef]
Characteristic | Focus Groups | Selected Area |
---|---|---|
Female | 56% | 73% |
African American | 92% | 57% |
Mean hours of sleep per night | 5.6 | 6.5 |
Mean sleep quality | 3.4 | 3.1 |
Theme 1: Economic Insecurity (7 Groups) |
---|
Job insecurity Underemployment Unemployment Financial concerns Poverty, lack of resources |
Theme 2: Safety Insecurity (6 Groups) |
Neighborhood violence Exposure to crime Concern about family safety Neighborhood disorder |
Theme 3: Future insecurity (6 Groups) |
Community direction Sense of control Loss of hope |
Theme 4: Hecticness (6 Groups) |
Lack of time Too busy |
Theme 5: Sleep environment (3 Groups) |
Mattress comfort Room temperature Noise Television |
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Sonnega, J.; Sonnega, A.; Kruger, D. The City Doesn’t Sleep: Community Perceptions of Sleep Deficits and Disparities. Int. J. Environ. Res. Public Health 2019, 16, 3976. https://doi.org/10.3390/ijerph16203976
Sonnega J, Sonnega A, Kruger D. The City Doesn’t Sleep: Community Perceptions of Sleep Deficits and Disparities. International Journal of Environmental Research and Public Health. 2019; 16(20):3976. https://doi.org/10.3390/ijerph16203976
Chicago/Turabian StyleSonnega, John, Amanda Sonnega, and Daniel Kruger. 2019. "The City Doesn’t Sleep: Community Perceptions of Sleep Deficits and Disparities" International Journal of Environmental Research and Public Health 16, no. 20: 3976. https://doi.org/10.3390/ijerph16203976