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Discrimination and Health Among First-Generation Hispanic/Latinx Immigrants: the Roles of Sleep and Fatigue

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Abstract

Introduction

A growing literature documents the associations between discrimination and health. Emerging evidence suggests that among Hispanic/Latinx immigrants, discrimination leads to the deterioration of health outcomes over time. While sleep has been proposed as an important mediator of the relationship between discrimination and health, few studies have explicitly investigated this pathway, particularly among Hispanic/Latinx populations.

Objective

To investigate the relationships between racial/ethnic discrimination, sleep, and physical and mental health among Hispanic/Latinx immigrants in the USA.

Data and Methods

Using data from a parent study of first-generation Hispanic/Latinx immigrants in the southeastern USA, we conducted sequential mediation analyses using the bootstrapping method to investigate whether self-reported sleep duration, sleep quality, and fatigue mediate the relationship(s) between self-reported discrimination, as measured by the discrimination subscale of the Riverside Acculturative Stress Inventory, and self-reported physical and mental health.

Results

Nocturnal awakenings, fatigue, and sleep quality were statistically significant sequential mediators of the relationship between discrimination and physical health (b = −.001, SE = .001, CI [−.0027, −.0001]); fatigue alone also mediated this relationship (b = −.01, SE = .01, CI [−.0279, −.0003]). Nocturnal awakenings, fatigue, and sleep quality were also significant sequential mediators of the relationship between discrimination and mental health (b = −.001, SE = .001, CI [−.0031, −.0001]).

Conclusion

Sleep and fatigue play an important role in linking discrimination and health among first-generation Hispanic/Latinx immigrants. The development and implementation of interventions that focus on reducing fatigue among this population could mitigate the effects of unfair treatment on health outcomes.

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Acknowledgements

We thank each of the students in the Green Inequality Lab for their data collection efforts, including Rebecca Arboleda, Jennifer Argueta-Contreras, Maryam Azeem, Regina Drake-Parguey, Jorge Reyes Faberlle, Maria Gonzalez, Amber Gooch, Lis James, Karen Aroche Jimenez, Faith Kunkel, Jessica Lemus, Kimberly Menjivar, Helen Seitz, Yena Son, Michelle Veliz Vargas, Ashley Williams, and Hope Wolf. We are also grateful to Nyeisha Daniels, Maghboeba Mosavel, and Aracely Harris, CEO of Hispanic Cultural Consultants. We also thank Dr. Milena Melo, Dr. Patricia Michelson-King, and Becca Wethered for their excellent translation services and Jennifer Eggerling-Boeck for her outstanding copyediting. Finally, we remain extraordinarily grateful to the community members that made this study possible. All errors and omissions are our own.

Funding

This work was partially supported by the Cancer Prevention and Control Research Accelerator Monies (RAMs) Award, Massey Cancer Center, Virginia Commonwealth University.

The first author’s research is supported by the University Wisconsin-Madison School of Medicine and Public Health Centennial Scholar/Clinician Program and the Society of Family Planning Research Fund (SFPRF13-CM4).

The senior author’s research is supported by the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK112009).

The authors are solely responsible for the content of this article and these views do not necessarily represent those of the Centennial Scholars Program, the Society of Family Planning, or the National Institutes of Health. The third author’s research is supported by the Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University.

All study policies and procedures received approval from the Institutional Review Board at Virginia Commonwealth University and were aligned with both institutional standards and those outlined in the Helsinki Declaration of 1975. All individual study participants provided informed consent.

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Authors and Affiliations

  1. Departments of Population Health Sciences and Obstetrics and Gynecology, University of Wisconsin, WI, Madison, USA

    Tiffany Green

  2. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

    Jelaina Shipman, Cecelia Valrie, Rosalie Corona & Nao Hagiwara

  3. Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, VA, USA

    Cecelia Valrie

  4. Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA

    Tatiana Kohlmann & Shawn Valiani

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  1. Tiffany Green
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Correspondence to Tiffany Green.

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Green, T., Shipman, J., Valrie, C. et al. Discrimination and Health Among First-Generation Hispanic/Latinx Immigrants: the Roles of Sleep and Fatigue. J. Racial and Ethnic Health Disparities 9, 2105–2116 (2022). https://doi.org/10.1007/s40615-021-01149-7

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