THE IMPACT OF SOCIAL DETERMINANTS ON SLEEP HEALTH AMONG MIDDLE-AGED AND OLDER ADULTS

Abstract

Abstract Poor sleep health, including short or long duration and/or irregular timing may lead to a variety of chronic health conditions including diabetes and heart disease. An estimated 50-70 million adults in the United States have poor sleep health and this burden is disproportionately felt among systematically disadvantaged groups. While social and behavioral determinants of sleep duration and quality have been examined, sleep health, a multidimensional concept, has been less explored. The study aims to examine the impact of social determinants on sleep health among middle-aged and older adults. Data from the 2014 wave of the Health and Retirement Study were weighted and restricted to respondents of “Leave-Behind” questionnaire (n=5334). Sleep Health score was derived from sleep variables (range 0-100). Structural equation modeling was conducted using the R package lavaan. Sample mean age was 68.2 years (SD=10.1). Majority were female (60%) and white (76%) with mean Sleep Health score of 50 (SD=5.2). Black (p< 0.0001) and Latinx respondents (p< 0.0001) had worse sleep health than white respondents. Depression, financial strain, and neighborhood characteristics of socioeconomic status, social cohesion, and physical disorder mediated the relationship between race and sleep health. Ongoing chronic stress and everyday discrimination also mediated the relationship between race and Sleep Health among Black vs. white respondents. These findings suggest multiple individual and neighborhood-level determinants may negatively influence sleep health among a nationally representative sample of middle-aged and older Black and Latinx adults. Neighborhood-level characteristics may be modifiable factors that can be targeted to improve sleep and related health outcomes.