Neighborhood-level sleep health and childhood opportunities

Abstract

Objectives: Regional sleep differences may reflect other important indicators of health and well-being. Examining sleep health at the regional level can help inform policies to improve population health. We examined the relationship between neighborhood-level adult sleep health (modeled in this study via adult sleep duration) and other health metrics and multiple indicators of child-relevant opportunity.

Methods: Data were obtained from the "500 Cities" data collected by the CDC, including the proportion of the adult population in each tract that report obtaining at least 7 h of sleep. The Child Opportunity Index (COI) provides indices for "education," "health and environment," and "social and economic" domains, as well as a global score. When data were merged, 27,130 census tracts were included. Linear regression analyses examined COI associated with the proportion of the adult population obtaining 7 h of sleep.

Results: Adult sleep duration was associated with global COI, such that for each additional percent of the population that obtains ≥ 7 h of sleep, COI increases by 3.6 points (95%CI[3.57, 3.64]). Each component of COI was separately related to adult sleep duration. All associations were attenuated but significant in adjusted analyses. In stepwise analyses, sleep health via adult sleep duration emerged as the strongest correlate of global COI, accounting for 57.2% of the variance (p < 0.0001). Similarly, when stepwise analyses examined each component of COI as dependent variable, sleep health consistently emerged as the most substantial correlate (all p < 0.0001).

Conclusion: Community levels of sufficient sleep are associated with greater childhood opportunities, which itself is robustly associated with a wide range of health and economic outcomes. Future work can examine whether this association can develop into scalable interventions.

Keywords: child opportunity; neighborhood; pediatric sleep; short sleep; sleep health disparities.