0929 The Social Determinants of Health and Sleep Health: A Latent Class Analysis

Abstract

Introduction Social determinants of health (SDOH) have been linked to well-being, quality-of-life and health disparities. We aim to investigate, 1) To classify adults based on their SDOH characteristics, and 2) To examine association between SDOH classes and sleep health. Methods This study used 2020 National Health Interview Survey data (n=31,568). SDOH was captured by health insurance, well-visits, delayed medical care, neighborhood walkability, social support, food insecurity, food stamp, poverty, and education. Sleep health was captured by: 1) Sleep quantity (hours): very short (< 5), short (5-6), normal (7-8), and long (≥9); 2) Sleep quality: trouble falling asleep or staying asleep; 3) Sleep medication, 4) Feeling well-rested, and 5) Fatigue. Latent class analysis generated a 3-class model with a gradient on all SDOH characteristics. Generalized structural equation modeling was used to examine associations between adverse’ SDOH classes and sleep health, with Class 1 (lowest probability of adverse’ SDOH), as reference category. Results Adults in Class 3 were 36% more likely to have short sleep than normal sleep. Classes 2 and 3 were 16% and 24% more likely to have trouble falling asleep on “some days”; 26% and 40% more likely on “most days”; and 28% and 77% more likely every day than never. Classes 2 and 3 were 22% and 23% more likely to have trouble staying asleep on “some days”; 36% and 35% more likely on “most days”; and 48% and 77% more likely every day than never. Class 2 was 19% more likely to take sleep medications on “some days” and 25% more likely every day than never. Classes 2 and 3 were 26% and 86% more likely to never feel well-rested; 30% and 60% more likely to feel well-rested on “some days” than every day. Classes 2 and 3 were 17% and 49% more likely to feel fatigued on “some days”; 43% and 99% more likely on “most days”; 55% and twice as likely to feel fatigued every day than never. Conclusion Adverse SDOH are associated with worsened unhealthy sleep. Further research is needed for the implementation of interventions to improve sleep health among marginalized groups more impacted by adverse SDOH. Support (if any) G1-5524901