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This research adds to the
This research adds to the body of evidence showing the long-term health benefits of years of schooling. A recent review of the evidence on the impact of education on health finds health benefits arise from receiving high quality education (Cohen & Syme, 2013). Relating education and literacy, quality of educational experience was associated with the reading level of the pupils (Fryer & Levitt, 2004; Heck, 2007). Our study helped to elucidate a specific pathway through which education impacts depressive symptoms. Doing so is critical for targeting educational policies and programs to influence levers of change.
Results from the National Adult Literacy Survey (NALS) reveal there is substantial room for improvement in literacy skills of high school graduates. Close to 1 in 5 adults with high school diplomas perform at the lowest level of literacy (Level1). Respondents in the lowest level of literacy have difficulty locating more than a single piece of information from a short text, table, or graph or performing arithmetic operations (Kirsch et al., 2002). This study indicates promoting literacy may have long-term mental health benefits.
Ethical statement
Funding
Dr. Tchetgen Tchetgen’s work was funded by the National Institutes of Health (NIH) grants AI113251 and ES020337. Dr. Gilman’s work was supported in part by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Conflicts of interests
Acknowledgements
Introduction
Gay, bisexual, and other men who have sex with men (MSM) often experience poor sleep health (Duncan et al., 2016a; Rahman & Silber, 2000). For example, as compared to heterosexual individuals, one study found that gay males wake up earlier and go to sleep significantly later, indicating that gay males have shorter sleep duration (Rahman & Silber, 2000). A recent study of MSM found that about one-third of the sample reported poor sleep quality and almost half reported sleeping less than 7h every night (Duncan et al., 2016a). Poor sleep health, among the general abiraterone acetate and among sexual minorities, has been associated with a range of adverse health outcomes, including risk of HIV, mental health, diabetes, and obesity (Buxton & Marcelli, 2010; Duncan et al., 2016a; Jean-Louis et al., 2014; Mallon, Broman, & Hetta, 2005; Xiao, Keadle, Hollenbeck, & Matthews, 2014; Zhang et al., 2015).
Emerging research has examined the role of financial hardship (when one has insufficient financial resources to adequately meet household’s needs) on health outcomes (Ayala, Bingham, Kim, Wheeler, & Millett, 2012; Chi & Tucker-Seeley, 2013; Ferrie, Martikainen, Shipley, & Marmot, 2005; Lynch, Kaplan, & Shema, 1997; Tucker-Seeley, Harley, Stoddard, & Sorensen, 2013; Tucker-Seeley, Li, Subramanian, & Sorensen, 2009; Tucker‐Seeley, Abel, Uno, & Prigerson, 2015), including sleep health (Hill, Burdette, & Hale, 2009; Magee, Gordon, & Caputi, 2014; McHale, Kim, Kan, & Updegraff, 2011), among general populations. For instance, a study using data from the 2004 Survey of Texas Adults (n = 1504) found that financial hardship was associated with poor sleep quality (Hill et al., 2009). While no research has assessed the potential associations between financial hardship and various dimensions of sleep health among MSM and other sexual minority populations, there is a recent important study that investigated associations between socioeconomic status (i.e., income, employment status, education) and sleep health among gay and bisexual men living with HIV (Downing Jr et al., 2016). In particular, this US-based study found that these traditional socioeconomic status indicators were associated with sleep health, particularly poor self-reported sleep quality and the use of medication for improving sleep, among their sample of gay and bisexual men.
The minority stress model, as articulated by Meyer (Meyer, 2003), proposes that stigma, prejudice, and discrimination are chronic psychosocial stressors that can lead to negative health outcomes in marginalized populations such as MSM populations. Institutionalized forms of homophobia (e.g., a lack of employment non-discrimination protections) have significant implications for the health of sexual minorities (Hatzenbuehler, Phelan, & Link, 2013). A growing body of literature has suggested that MSM earn less than heterosexual men and that this is due to manifestations of discrimination in the workplace, including the firing of an individual or denying them employment, denying a promotion, or giving negative performance evaluations on the basis of their sexual orientation (; Badgett & Frank, 2007). Wage gaps between heterosexual and sexual minority men have been reported in studies in the United States, the United Kingdom and France. For example, nucleus (cell) is reported that MSM in France suffer from an average wage penalty equal to -6.3% when compared to heterosexual men (Laurent & Mihoubi, 2012). Socioeconomic manifestations of homophobic prejudice may lead to increased financial hardship among MSM.