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Abstract Introduction Sleep health is defined as a multidimensional pattern of sleep and wakefulness that is adapted to individual, societal, and environmental demands, and that fosters mental and physical well-being. Prior research demonstrates that social determinants, operating at the household, interpersonal, and community levels, associate with individual dimensions of sleep health (e.g., sleep duration), and may underlie racial disparities in such dimensions. However, scant research has investigated social determinants of multidimensional sleep health. The current study investigates cross-sectional associations between multi-level social determinants, including household food insecurity, interpersonal discrimination, and neighborhood social cohesion, safety and satisfaction, and multidimensional sleep health among a low-income, Black American community-based sample. Methods Participants included 530 Black American participants (82% female; mean age= 60.3) from two urban neighborhoods. Based on the Ru SATED construct, we constructed a composite Sleep Health (SH) score from the sum of scores representing “healthy” and “unhealthy” ranges of 6 sleep dimensions i.e., regularity, satisfaction, alertness/ sleepiness, timing, efficiency and duration (Range = 0-6). Sleep dimensions were derived from actigraphy or self-reports. Food insecurity (range=0-3), interpersonal discrimination (range=0-21), and neighborhood cohesion, safety, and satisfaction (each with range=1-5) were measured via validated self-report surveys. Linear regression analyses examined the association between each social determinant and sleep health, after adjustment for age, sex, neighborhood, education, and body mass index. Results Greater food insecurity and greater interpersonal discrimination were associated with poorer sleep health scores (B=-.15; SE=.05 and B=-.03; SE=.01, respectively). In contrast, greater neighborhood safety and satisfaction were associated with better sleep health scores (B= .22; SE=.06 and B=.11; SE=.05, respectively). There was not a significant association between social cohesion and sleep health. Conclusion These findings demonstrate that determinants of sleep health go beyond the individual level, encompassing socio-environmental influences that may act as risk or protective factors. Our results suggest that both individual and policy-level interventions may be needed to mitigate pervasive and enduring sleep health disparities. Support (if any) AG R01AG072652
Troxel et al. (Sat,) studied this question.