Sleep and cardiometabolic health by government-assisted rental housing status among Black and White men and women in the United States

Objectives: To investigate Black-White disparities in suboptimal sleep and cardiometabolic health by government-assisted rental housing status.

Design: National Health Interview Survey (NHIS) pooled cross-sectional data (2004-2016).

Setting: United States.

Participants: Black and White adult participants (n = 80,880).

Measurements: Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals for self-reported unrecommended (<6 hours), short (≤6-<7 hours), and long (>9 hours) sleep duration (each separately vs recommended (≤7-9 hours)) and sleep difficulties (eg, trouble falling/staying asleep ≥3 days/week) (yes vs no) among Blacks compared to Whites within rental housing categories (government-assisted vs unassisted), separately, for men and women. Within sex/housing categories, we applied the same approach to compare cardiometabolic health outcomes (ie, overweight/obesity, hypertension, diabetes, heart disease, stroke) between Blacks with worse sleep and Whites with recommended sleep. Models were adjusted for age and other potential confounders.

Results: Participants' mean age was 42 ± 18 years, 57% were female, and 30% Black. Blacks in unassisted housing had a higher prevalence of unrecommended and short sleep (PR = 1.22 [1.15-1.30] -men, PR = 1.14 [1.08-1.21] -women) compared to their White counterparts (p_{housing⁎race} = 0.001 -men, p_{housing⁎race} = 0.008 -women), but no Black-White differences (PR = 0.88 [0.73-1.07] -men, PR = 0.98 [0.89-1.09] -women) were observed among government-assisted renters. Generally, Blacks were less likely to report sleep difficulties than Whites. Cardiometabolic health disparities between Blacks with worse sleep and Whites with recommended sleep were generally smaller among government-assisted renters, but relationships varied by sex.

Conclusions: There were no racial disparities in short sleep duration, and cardiometabolic health disparities were generally attenuated when Blacks and Whites resided in government-assisted rental housing.