GEOGRAPHIC ASSOCIATION BETWEEN NEIGHBORHOOD SLEEP HEALTH AND CHILD OPPORTUNITY INDEX: DATA AT THE CENSUS TRACT LEVEL

Abstract

INTRODUCTION: Regional sleep health may reflect other important indicators of health and well-being. METHODS: Data on neighborhood sleep health values were obtained from the “500 Cities” Data collected by the CDC that includes census tract and proportion of the population in each geographic region that report values associated with health. Sleep health was assessed with questions administered in the Behavioral Risk Factor Surveillance System. Data include the population of each census tract as well as census-estimated proportion of the population in each census tract that report obtaining at least 7 hours of sleep (sufficient sleep). Covariates in analyses included the population of a census tract, proportion with healthcare access, and proportion with specific health conditions. The Child Opportunity Index (COI) is a publicly available index (DiversityDataKids.org) reported at the census tract level. It provides indices for “Education,” “Health & Environment,” and “Social & Economic” domains, as well as a global score. The 500 Cities data were merged with the COI data, using census tract as the matching variable. Linear regression analyses examined COI global and subscale scores as outcome variable and proportion of the population obtaining sufficient sleep as the independent variable, unadjusted and adjusted for covariates. When data were merged, 27,130 census tracts were included. RESULTS: Sleep sufficiency was associated with global COI, such that for each additional percent of the population that obtains >=7 hours of sleep, COI is 3.6 points higher (95%CI[3.57,3.64]; p<0.0005); this was attenuated in adjusted analyses (B=1.58; 95%CI[1.53,1.63]; p<0.0005). Each component of COI was related to sleep sufficiency, including education (B=3.06; 95%CI[1.19,1.33]; <0.0005), health & environment (B=2.23; 95%CI[2.19,2.28]; p<0.0005), and social & economic (B=3.61; 95%CI[3.57,3.64]; p<0.0005). All associations were attenuated but significant at the p<.05 level in adjusted analyses. CONCLUSIONS: Regional prevalence of insufficient sleep was negatively associated with Child Opportunity Index, which itself is an important predictor of a wide range of health and economic outcomes. Community sleep health interventions should be investigated in the future for potential wide-ranging benefits.