Social inequality and health: What role for sleep?

Presenter: Robert Meadows, Surrey University

Author: Robert Meadows

Co-author(s): Sara Arber

There is now a growing body of literature which suggests that sleep quality/quantity mediates the relationship between socio-economic status (SES) and health. This research is limited in two respects. First, social inequality is multidimensional and different dimensions of social position have different pathways to ill-health. There is a need to investigate whether the mediating role of sleep varies depending on what aspect of social inequality is being investigated. Second, sleep may play a complex role as a mediator. On the one hand, sleep can be seen as a health behaviour. On the other hand, sleep can be situated as a physiological response through which other pathways operate (i.e. job strain).

This paper uses data from Wave 4 of Understanding Society (n=43138). A series of path models are developed; each of which explore pathways from multiple measures of social position to self-reported ill-health. Model 1 includes ‘sleep problems’ as a potential mediator. Model 2 adds further risk and protective factors parallel to sleep problems. Model 3 positions sleep problems as both a parallel mediator and part of the causal chain through which other risk and protective factors may operate.

All models will be discussed. Results from model 1, for example, highlight how those in the lowest occupational group report poorer health (direct effect = 0.189). Those experiencing material deprivation also experience poor health (0.1). In both instances, the indirect effect through sleep is significant (Sobel test statistic = 4.86 and 5.19 respectively).