Neighborhood Social Cohesion and Sleep Health by Age, Sex/Gender, and Race/Ethnicity in the United States.

Dana M Alhasan,Symielle A Gaston,Patrice C Williams,Ichiro Kawachi,Chandra L Jackson,W Braxton Jackson

doi:10.3390/ijerph17249475

Abstract

Although low neighborhood social cohesion (nSC) has been linked with poor sleep, studies of racially/ethnically diverse participants using multiple sleep dimensions remain sparse. Using National Health Interview Survey data, we examined overall, age, sex/gender, and racial/ethnic-specific associations between nSC and sleep health among 167,153 adults. Self-reported nSC was categorized into low, medium, and high. Very short sleep duration was defined as <6 h; short as <7 h, recommended as 7–9 h, and long as ≥9 h. Sleep disturbances were assessed based on trouble falling and staying asleep, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep dimensions by low and medium vs. high nSC. The mean age of the sample was 47 ± 0.1 years, 52% of those included were women, and 69% were Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of very short sleep (PR = 1.29; (95% CI = 1.23–1.36)). After adjustment, low vs. high nSC was associated with very short sleep duration among NH-White (PR = 1.34 (95% CI = 1.26–1.43)) and NH-Black (PR = 1.14 (95% CI = 1.02–1.28)) adults. Low nSC was associated with shorter sleep duration and sleep disturbances.

Highlights

Short sleep duration and sleep disturbances, such as trouble falling asleep, are highly prevalent among the United States (U.S.) population [1]
Consistent with our hypothesis, we found that participants who reported living in a neighborhood with low vs. high social cohesion generally experienced shorter sleep duration and more sleep disturbances
We observed stronger associations of sleep duration among women living in areas with low vs. high neighborhood social cohesion (nSC) compared to men, which corresponded with our hypothesis, no other notable differences were observed between sex/gender except for the fact that waking up feeling unrested was stronger among men than women

Summary

Introduction

Short sleep duration and sleep disturbances, such as trouble falling asleep, are highly prevalent among the United States (U.S.) population [1]. It is estimated that one-third of adults habitually obtain less than the recommended amount of at least seven hours of sleep [2]. Groups even more likely to experience short sleep and sleep disturbances include those ≥50 years old compared to 18–30 years old [3], women compared to men [4], and non-Hispanic (NH)-Black [2,5,6]. Hispanic/Latinx [5,7], and Asian [8] compared to NH-White adults. One study reported that 43.4% of NH-Black, 31.5% of Hispanic/Latinx, and 27.1% of Asians obtained less than seven hours of sleep, compared to 19.4% of NH-White adults [5]. Public Health 2020, 17, 9475; doi:10.3390/ijerph17249475 www.mdpi.com/journal/ijerph

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