Discrimination and sleep disturbance among older Black Americans: A longitudinal analysis of the Health and Retirement Study.

Objectives: Black and older adults have higher risk for sleep problems than their White and younger counterparts. Yet, our understanding of the determinants of sleep problems specifically among older Black adults is severely limited. The aim of this study was to determine whether everyday and major discrimination are longitudinally associated with sleep disturbance in a nationally representative sample of older Black adults.

Methods: Non-Latinx Black respondents aged 51+ were selected from waves 8 (2006) through 15 (2020) of the Health and Retirement Study (baseline N = 1397). Sleep disturbance was measured with the 4-item Jenkins Sleep Questionnaire. The 6-item Everyday Discrimination Scale was used to measure everyday discrimination, and the Major Experiences of Discrimination Scale was used to measure major discrimination. Analyses controlled for sociodemographics, health behaviors, and health conditions. Lagged mixed-effects linear regression models were performed to test the longitudinal associations between baseline discrimination and sleep disturbance over 12years.

Results: Higher baseline everyday discrimination was longitudinally associated with more severe sleep disturbance. Compared to respondents who reported no major discrimination at baseline, those who reported two or more major discrimination experiences had more severe sleep disturbance over time.

Conclusions: This study provides critical information on the possible longitudinal drivers of sleep disparities at the population level. This information has implications for better understanding the mechanisms of health disparities and for attaining health equity.