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Rumination mediates associations between microaggressions and sleep quality in Black Americans: the toll of racial microstressors

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Abstract

Disparities in health outcomes between Black and White Americans are well-documented, including sleep quality, and disparities in sleep may lead to disparities in health over the life course. A meta-model indicates that cognitive processes may underly the connection between race and poor sleep quality, and ultimately, health disparities. That is, there are race-specific stressors that disproportionately affect Black Americans, which are associated with poor health through biological, cognitive, and behavioral mechanisms (e.g., sleep). Among these race-specific stressors is discrimination, which has been linked to poor sleep quality, and there is a body of literature connecting perseverative cognition (e.g., rumination and worry or vigilance) to poor sleep. Microaggressions, a more subtle but pervasive form of discrimination, are another race-specific stressor. Although less research has considered the connection of microaggressions to perseverative cognition, there are some studies linking microaggressions to health outcomes and sleep. Therefore, using a cross-sectional survey, we tested the following hypotheses: racism-related vigilance and rumination would mediate the relationship between discrimination and poor sleep as well as between microaggressions and poor sleep among Black Americans (N = 223; mean age = 35.77 years, 53.8% men, 86% employed, 66.8% with college degree or higher education). Results of seven parallel mediation models showed that neither rumination nor racism-related vigilance mediated a relationship between discrimination and poor sleep quality. However, rumination partially mediated relationships between the six microaggression sub-scales and poor sleep quality: there were significant indirect effects for Foreigner/Not Belonging (β = .13, SE = 0.03, 95% CI 0.08, 0.20), Criminality (β = .11, SE = 0.03, 95% CI 0.05, 0.17), Sexualization (β = .10, SE = 0.03, 95% CI 0.05, 0.17), Low-Achieving/Undesirable (β = .10, SE = 0.03, 95% CI 0.05, 0.15), Invisibility (β = .15, SE = 0.04, 95% CI 0.08, 0.23), and Environmental Invalidations (β = .15, SE = 0.04, 95% CI 0.08, 0.23). Overall, these findings indicate support for the meta-model, demonstrating a specific pathway from racial microstressors to poor sleep quality. Furthermore, these results suggest the importance of developing clinical and community approaches to address the impact of microaggressions on Black Americans’ sleep quality.

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Notes

  1. T-tests were used to compare differences in poor sleep quality between men and women. Due to the low prevalence of discordant gender identity (3 participants), it was not possible to evaluate differences between these participants and those with concordant gender identities. Likewise, due to the low number of participants identifying as non-binary, groupwise comparisons were not possible.

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Funding

This work was supported by a National Institutes of Health National Cancer Institute Grant (# T32CA193193) and a research award from the University of Missouri-Kansas City School of Graduate Studies.

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  1. Elizabeth J. Wilson

    Present address: Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA

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  1. Department of Psychology and Counseling, University of Missouri-Kansas City, Kansas City, MO, USA

    Elizabeth J. Wilson, Anahi R. Primgaard, Erin P. Hambrick, Jacob M. Marszalek, Johanna E. Nilsson & Kymberley K. Bennett

  2. Department of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    Jannette Berkley-Patton

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by EJW. The first draft of the manuscript was written by EJW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Wilson, E.J., Primgaard, A.R., Hambrick, E.P. et al. Rumination mediates associations between microaggressions and sleep quality in Black Americans: the toll of racial microstressors. J Behav Med 47, 515–530 (2024). https://doi.org/10.1007/s10865-023-00464-0

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