The relationship between social fragmentation and sleep among adolescents living in Boston, Massachusetts.
BACKGROUND
Sufficient sleep is needed for the healthy development of youth. However, only a small minority of adolescents obtain adequate amounts of sleep. Although individual-level correlates of sleep have been identified, studies investigating the influence of the environment on sleep are warranted.


METHODS
By using cross-sectional data collected from 1878 urban adolescents living in 38 neighborhoods participating in the 2008 Boston Youth Survey (BYS), we determined the association between neighborhood social fragmentation and sleep. Social fragmentation of each participant's residential neighborhood was composed using 2010 US Census data. Multilevel regression models were used to determine the association between social fragmentation and meeting the recommended hours of sleep (>8.5 h) and sleep duration while controlling for individual-level sex, race, age and nativity.


RESULTS
Moderate (OR = 0.51, 95% CI = 0.27, 0.97) and high (OR = 0.33, 95% CI = 0.18, 0.61) social fragmentation within the residential neighborhood was associated with a decreased likelihood of obtaining adequate sleep. Those in moderate (β = -23.9, 95% CI = -43.1, -4.8) and high (β = -22.1, 95% CI = -43.3, -0.9) socially fragmented neighborhoods obtained fewer minutes of sleep per night.


CONCLUSIONS
Social fragmentation may be an important determinant of sleep among youth living in urban settings.
Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Roman
R
Pabayo
Bouvé College of Health Sciences, Northeastern University, Boston, MA 02115, USA.
Beth E
BE
Molnar
School of Nursing, Science and Health Professions, Regis College, Weston, MA 02493, USA.
Nancy
N
Street
Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Ichiro
I
Kawachi
D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology; D001900:Boston / Q000453:epidemiology; D019352:Censuses; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D011203:Poverty; D012044:Regression Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012574:Schools; D012890:Sleep; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology; D012931:Social Environment; D014505:Urban Population
environment; public health; social determinants