Neighborhood social cohesion and sleep health among White, Black, and Hispanic/Latino men and women in United States: Findings from the National Health Interview Survey

Abstract

Background: Social environmental factors such as unfavorable neighborhood cohesion may contribute to poor sleep by, for example, activating stress pathways. Methods: Using pooled cross-sectional data from 144,776 participants of the 2013-2017 National Health Interview Survey (NHIS), we examined overall and race/ethnicity-specific associations between neighborhood social cohesion and sleep health among White, Black, Hispanic/Latino, and Asian adults. Neighborhood social cohesion score (NSC) was measured based on self-reported responses to four questions related to trust and support, which were categorized into low, medium, and high groups. Very short sleep duration was defined as <6 hours; short sleep <7 hours, recommended sleep 7-8 hours, and long sleep ≥9 hours. Sleep difficulties were assessed based on “trouble falling asleep 3+ days,” “trouble staying asleep 3+ days,” “waking up feeling rested 4+ days,” and “took sleep medication ≥1 times” all in the previous week. Adjusting for sociodemographics, health behaviors, and health indicators, Poisson regression with robust variance was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep duration and difficulty by low vs. high NSC and medium vs. high NSC. Results: Among 144,776 adults, mean age was 47±0.1 years, 48% were men, and 69% white. Overall, low vs. high NSC was associated with a higher prevalence of very short (PR=1.32; 95% CI: 1.25-1.40) and short (PR=1.19; 95% CI: 1.16-1.22) sleep duration. Low vs. high NSC was positively associated with very short sleep duration among Whites (PR=1.37; 95% CI: 1.28-1.47), Blacks (PR=1.13; 95% CI: 1.01-1.28), and Hispanics/Latinos (PR=1.30; 95% CI: 1.11-1.53). Among Asians, low NSC was associated with short sleep duration (PR=1.19; 95% CI: 1.06-1.32). Conclusions: Sleep difficulties were more prevalent among all racial/ethnic groups with less than high NSC. Low neighborhood social cohesion was associated with shorter sleep duration and sleep difficulty across racial/ethnic groups, and more research is warranted.