Abstract
Introduction: Beyond the challenge of changing countries, cultures and continents, African-born Blacks living in the United States must cope with the stress of daily life. We assessed daily life stress and evaluated the influence of sleep as well as key socioeconomic and behavioral factors in 156 African-born Blacks (Age: 40±10y (mean±SD), BMI: 27.6±4.2 kg/m 2 , Male: 60%) who came to the United States as adults (≥age 18y). Methods: Daily life stress was assessed with the Perceived Stress Scale 10 (PSS) (range 0 to 40). Stressed was defined as the PSS threshold at the upper quartile for the population distribution (≥16) and Non-Stressed as PSS<16. Sleep was assessed with the Pittsburgh Sleep Quality Index (PSQI) (range 0 to 21). Poor Sleep Quality was defined by traditional criteria, specifically PSQI>5. Logistic regression was used to determine the odds of being Stressed because of: Poor Sleep Quality, low income (<40k/y), no health insurance, no college degree, no life partner, smoking, alcohol consumption, sedentary behavior and United States residency≥10y. Results: In the Stressed vs. Non-Stressed, PSS were: 21±4 vs. 9±4, P <0.001 and PSQI were: 6±3 vs. 4±3, P <0.001, respectively. The Pearson correlation coefficient for the relationship between PSS and PSQI was: r=0.38, P <0.001. The odds of being Stressed were significant if income was low (OR 7.1, P <0.001), health insurance was absent (OR 4.7, P <0.001), the person had no life partner (OR 2.5, P =0.017), or was a smoker (OR 5.6, P =0.023). United States residence≥10y tended to decrease the odds of being in the Stressed category (OR 0.5, P =0.058). Of note, the group with United States residence≥10y had a higher rate of income≥40k than the group with US residence<10y (71% vs. 32%, P <0.001). Conclusions: Daily life stress in African-born Blacks is closely tied to poor sleep quality and exacerbated by low income, lack of health insurance and no life partner. The decreased stress associated with longer duration of United States residence may be due to better economic status.
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