Individuals living in socioeconomically disadvantaged neighborhoods have disproportionately high rates of obesity and obesity-related morbidity, including increased risk for physical role limitations and cardiovascular diseases (CVD). Studies of potential mechanisms linking neighborhood disadvantage with health outcomes have primarily focused on daytime health behaviors, including diet or physical activity. However, sleep is a critical health behavior that is associated with neighborhood disadvantage, and may play a causal role in explaining the links between neighborhood disadvantage and health. However, the extant research on neighborhood disadvantage and sleep is based exclusively on cross-sectional data, using self-reports of sleep and neighborhood characteristics. Building on the existing research infrastructure developed by our team's previously funded, ongoing studies, we have a unique and important opportunity to study whether changes in the built and social environment, stimulated by substantial economic investment improves sleep, and in turn, reduces obesity-related health disparities. The study cohort includes a randomly selected cohort of 1100 low- income, African American adults, from two urban neighborhoods, one of which is undergoing a dramatic revitalization over the next 5 years (i.e., the intervention neighborhood), and the other (the sociodemographically-matched control neighborhood) is not undergoing any such changes. We will add longitudinal assessments of sleep using actigraphy, self-reports, and in a subsample of 300, objective, in-home monitoring of obstructive sleep apnea, to provide a rich characterization of sleep profiles before, during, and, after neighborhood changes. Evidence gained from this study would have substantial scientific and policy implications for identifying novel individual-level and neighborhood level factors that contribute to striking and pervasive racial and socioeconomic disparities in health.

Public Health Relevance

Individuals living in socioeconomically disadvantaged neighborhoods have significantly higher rates of obesity and obesity-related health problems, including physical role limitations and cardiovascular diseases (CVD). Sleep is a critical health behavior that is associated with neighborhood disadvantage and health consequences. Therefore, sleep may serve as an important pathway linking neighborhood disadvantage with obesity and physical role limitations. Our study represents a unique opportunity to evaluate whether improvements in neighborhood conditions, spurred by substantial economic revitalization, improves sleep and in turn, mitigates obesity-related health disparities in a high-risk adult population. Findings from this longitudinal study would provide a stronger test of the causal relationships between neighborhood disadvantage, sleep, and health.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Special Emphasis Panel (ZRG1-PSE-K (90))
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Laposky, Aaron D
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Rand Corporation
Santa Monica
United States
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