0258 Intersectional Discrimination: An Approach to Understanding Insomnia Symptoms in Minoritized Populations

Abstract Introduction Minoritized groups in the United States experience discrimination that impacts their physical and mental well-being. People with multiple minoritized identities, such as being a racial/ethnic minority or sexual minority, often experience worsened health outcomes due to the intersectional nature of discrimination. The insidious nature of structural racism, classism, and genderism serves as a root cause of chronic disease disparities, including insomnia. This study aims to test the association of intersectional discrimination and symptoms of insomnia among minoritized populations with multiple marginalized identities. Methods In August 2022, US adults aged 18 years completed internet-based surveys. Demographic quota sampling was used to make the sample representative of the US 2020 population by age, sex, and race/ethnicity. Respondents answered questions assessing intersectional discrimination using the intersectional discrimination index (InDI). The InDi captures measures of three forms of discrimination: anticipated, everyday, and major. Symptoms of insomnia were measured via the Sleep Condition Indicator. Descriptive and logistic regression analyses were performed. Results Among respondents (n= 4,966), insomnia symptoms were more prevalent among women (21.3%) vs men (14.0%), among those who identified as multi-racial or other (24.5%) vs other racial and ethnic groups (Asian/Pacific Islander, 10.4%; non-Hispanic Black 12.1%; Hispanic 17.9%; and non-Hispanic White, 18.5%. Across all three subscales of the InDI (e.g., anticipated, every day, and major discrimination), intersectional discrimination was a better predictor for insomnia than those without InDi. Across race-by-gender interactions, individuals who are both racial/ethnic and gender minorities did not endorse higher symptoms of insomnia. Individuals who are other/multi race and a sexual minoritized group (e.g. non-heterosexual) OR= 1.7 (C.I. 0.68-2.02) and experienced discrimination were likely to endorse symptoms of insomnia. Conclusion In this study individuals who reported any form of discrimination were more likely to report symptoms of insomnia. While race or sex alone (except among Asian American/Pacific Islanders) are not predictors of insomnia, experiences of discrimination do predict insomnia. Individuals who are sexual minorities and of other racial minority groups might endorse high symptoms of insomnia. This study suggests that more research is needed to understand the unique role of how discrimination might increase insomnia for persons who sit at the margins of oppression. Support (if any)