title: Racial disparities in sleep: the role of neighborhood disadvantage.
abstract: Disparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep.
  
  
  
  Data were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age = 56.8 years, SD = 11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables.
  
  
  
  AAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps < 0.001). Neighborhood disadvantage was significantly associated with WASO (B = 3.54, p = 0.028), but not sleep minutes (B = -2.21, p = 0.60) or latency (B = 1.55, p = 0.38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B = 4.63, p = 0.035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant.
  
  
  
  Findings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency.
authors.affiliation: Department of Human Development and Family Studies, Auburn University, AL, USA. Electronic address: tom.fullerrowell@gmail.com.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Fuller-Rowell
authors.affiliation: Department of Human Development and Family Studies, Auburn University, AL, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Curtis
authors.affiliation: Department of Human Development and Family Studies, Auburn University, AL, USA.
authors.forename: Mona
authors.initials: M
authors.lastname: El-Sheikh
authors.affiliation: Department of Human Development and Family Studies, Auburn University, AL, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Chae
authors.affiliation: Department of Health and Behavioral Sciences, University of Colorado Denver, USA.
authors.forename: Jennifer Morozink
authors.initials: JM
authors.lastname: Boylan
authors.affiliation: Department of Psychology, University of Wisconsin - Madison, WI, USA.
authors.forename: Carol D
authors.initials: CD
authors.lastname: Ryff
mesh_terms: D056044:Actigraphy; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D012111:Residence Characteristics; D012890:Sleep / Q000187:drug effects; D000068776:Sleep Aids, Pharmaceutical / Q000627:therapeutic use; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States; D044465:White People
chemical_list: D000068776:Sleep Aids, Pharmaceutical
keywords: Actigraphy; Health inequalities; Neighborhood inequality; Race; Sleep disparities; Sleep efficiency