Racial disparities in sleep: the role of neighborhood disadvantage

Abstract

Objective Disparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep. Methods Data were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age = 56.8 years, SD=11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables. Results AAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps < .001). Neighborhood disadvantage was significantly associated with WASO (B = 3.54, p = .028), but not sleep minutes (B = −2.21, p = .60) or latency (B = 1.55, p = .38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B = 4.63, p = .035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant. Conclusion Findings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency.

Disparities in Hypertension Among African-Americans: Implications of Insufficient Sleep

“…It is pertinent that the large majority of these population-based studies relied on self-reported information on sleep duration, which may be biased by the individuals' tendency to overestimate sleep, and only moderately correlates with sleep quantity as determined from actigraphy or polysomnography [30]. Nevertheless, divergent ethnic-dependent sleep durations are apparent, and possibly amplified, also when considering objective sleep measures [28,[31][32][33][34][35]. In the Multi-Ethnic Study of Atherosclerosis (MESA), actigraphyderived habitual sleep duration in Blacks was the lowest amid all racial/ethnic groups, with 43.4% of them sleeping less than 6 hours (vs 19.3% of White) [28].…”

Depression among Black Youth; Interaction of Class and Place

“…In a recent study, Black youth who lived in predominantly White areas reported more PRD than those who lived in predominantly Black areas [ 48 ]. Place is shown to be linked to PRD [ 49 , 50 , 51 , 52 ], sleep [ 53 ], distress [ 54 , 55 ], stress [ 56 ], suicide [ 57 ], and depression [ 58 ]. SES aspects of the neighborhood, racial composition, physical and social environment, and segregation are all neighborhood and contextual factors that have mental health implications [ 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ].…”

Does context matter? A multilevel analysis of neighborhood disadvantage and children's sleep health

“…Prior research has documented racial disparities in sleep 12,47 but relatively few studies have examined how neighborhood characteristics might explain these disparities. 48,49 In addition to neighborhood disorder, neighborhood-level demographic characteristics accounted for a portion of racial/ethnic bedtime disparities in our models, especially among black children. These findings are important, as they suggest that black-white sleep disparities during childhood are partly rooted in dissimilar environmental conditions.…”