The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms.

Sleep duration is associated with cardiovascular disease and diabetes risk factors, depression, automobile and workplace accidents, and prospective mortality. Little is known, however, about sleep patterns in the US population. The 2004-2007 National Health Interview Survey-Sample Adult Files provide nationally representative data for 110,441 noninstitutionalized US adults aged 18 years or older, and multinomial logistic regression examines whether variables in 5 domains-demographic, family structure, socioeconomic, health behavior, and health status-are associated with long or short sleep duration. Being older, non-Hispanic black, or a current or former smoker; having low levels of education, income, or few income sources; consuming few or numerous drinks in a week; or reporting cardiovascular disease, diabetes, depression, underweight, or activity limitations is associated with increased odds of both long and short sleep duration. Other variables are associated with shorter (e.g., living with young children, being unmarried, working long hours, more frequent binge drinking) or longer (e.g., being younger, Mexican American, pregnant, or having low levels of physical activity) sleep hours. The authors identify numerous risk factors for long and short sleep; many of those variables are potential confounders of the relation between sleep hours and other health outcomes.

Jail and prison inmates had a higher burden of most chronic medical conditions than the general population even with adjustment for important sociodemographic differences and alcohol consumption.

Objectives-We investigated whether there were gender differences in chronic medical, psychiatric, and substance-dependence disorders among jail inmates and whether substance dependence mediated any gender differences found.Methods-We analyzed data from a nationally representative survey of 6982 US jail inmates. Weighted estimates of disease prevalence were calculated by gender for chronic medical disorders (cancer, hypertension, diabetes, arthritis, asthma, hepatitis, and cirrhosis), psychiatric disorders (depressive, bipolar, psychotic, posttraumatic stress, anxiety, and personality), and substancedependence disorders. We conducted logistic regression to examine the relationship between gender and these disorders.Results-Compared with men, women had a significantly higher prevalence of all medical and psychiatric conditions (P≤.01 for each) and drug dependence (P<.001), but women had a lower prevalence of alcohol dependence (P<.001). Gender differences persisted after adjustment for sociodemographic factors and substance dependence.Conclusions-Women in jail had a higher burden of chronic medical disorders, psychiatric disorders, and drug dependence than men, including conditions found more commonly in men in the general population. Thus, there is a need for targeted attention to the chronic medical, Correspondence should be sent to Ingrid A. Binswanger, MD, MPH, University of Colorado Denver School of Medicine, Division of General Internal Medicine, Mailstop B180, 12631 East 17th Ave., Aurora, CO 80045 (ingrid.binswanger@ucdenver.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link. Contributors I.A. Binswanger, J.O. Merrill, J. G. Elmore, and M.C. White conceptualized and designed the study. I. A. Binswanger acquired, analyzed, and interpreted the data, supervised the study, and drafted the article. P.M. Krueger assisted with data analysis. J.O. Merrill, P.M. Krueger, M. C. White, R. E. Booth, and J. G. Elmore critically reviewed several drafts of the article.Note. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the US Department of Veterans Affairs, the Robert Wood Johnson Foundation, or the University of Colorado Denver. The funding sources had no role in the design and conduct of the study or analysis and interpretation of the data and did not participate in the decision to submit this manuscript for publication or in the preparation of the manuscript. Human Participant ProtectionData were obtained from secondary sources. The protocol for data analysis was approved by the Colorado Multiple institutional review board and was considered exempt by the institutional review boards of the University of Washington, Seattle; the University of California, San Francisco; and the University of Texas Health Science Center at Houston. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript psychiatric, and drug-treatment needs of women at risk for incarceration, both ...