Racial disparities in sleep health between Black and White young adults: The role of neighborhood safety in childhood

Abstract

Objectives: Black adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep.

Methods: Data were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from eight nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed.

Results: Black participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use.

Conclusions: Findings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.

Keywords: Actigraphy; Health inequalities; Neighborhood disadvantage; Race; Sleep disparities; Sleep duration.

Figure 1.

Path model showing indirect effects of race on time in bed (Panel A) and sleep duration (Panel B) via neighborhood safety. Note. N = 263. Coefficients are from a fully adjusted model with Model 4 covariates. Path coefficients are unstandardized. Residual variances are standardized. Race is coded as White = 0, Black = 1. *p < 0.05. **p < 0.01. ***p < 0.001.

Figure 2.

Path model showing indirect effects of race on daytime sleepiness via neighborhood safety and depressive symptoms. Note. N = 263. Coefficients are from a fully adjusted model with Model 4 covariates. Path coefficients are unstandardized. Residual variances are standardized. Race is coded as White = 0, Black = 1. *p < 0.05. **p < 0.01. ***p < 0.001.