Education and health disparities by race/ethnicity and socioeconomic status (SES) are well documented among adolescents. Sleep, a health behavior, may be a fundamental mechanism contributing to both. Teenagers are the least likely of any age group to get sufficient sleep and there are racial/ethnic and SES disparities in sleep quantity and quality. Multilevel (individual, family, neighborhood) stressors may also contribute to disparities in sleep, education and health. The goal of our project, Effects of Sleep on Education and Health Outcomes Among Adolescents, is to use objective measures of sleep (duration, timing, quality) to examine if sleep deprivation among teenagers is related to education and health. Our prospective study of a diverse sample of teens will enable us to investigate the temporal relationships among sleep, education and health outcomes.
Our specific aims are to : 1) investigate if sleep mediates the relationship between race/ethnicity/SES and education and health outcomes; 2) determine if sleep mediates the relationship between multilevel measures of stress and education and health outcomes; and 3) examine whether differential exposures to multilevel stressors partially account for ethnoracial and SES disparities in sleep. In a two-year, multiple-wave cohort study we will follow ~540 9th grade students from two high schools in a semi-rural area in north-central Georgia. Wrist-worn accelerometers will provide objective measures of sleep duration, timing, and quality and collected during Spring of 9th grade and again for the same students during Fall of 10th grade. These data will be linked to extensive student-level education (grades, reading skills, standardized test scores, tardiness, attendance, disciplinary referrals and suspensions) and health (self-rated mental and physical health and health-related absences) outcomes from two time periods of those enrolled (9th and 10th grades). Multilevel stressors (individual-level stress/discrimination, family-level home chaos, neighborhood-level disadvantage) will be obtained from surveys and publicly available data in both 9th and 10th grades. Data on potential covariates will be collected including: 1) objectively measured physical activity using actigraphy when sleep measures are obtained; 2) objectively measured body mass index and cardiorespiratory fitness in 9th grade; and 3) individual data from survey modules administered during 9th and 10th grades assessing student characteristics (e.g., race/ethnicity, sex, puberty, employment, social support, screen time), and family characteristics (household structure). Multi-level causal mediation analysis will decompose the contribution of sleep quality and quantity to race/SES disparities in education and health outcomes. This project exemplifies a unique partnership between education and public health sectors with results having practical value to a wide range of sectors and organizations. Results may find that sleep deprivation, a common yet modifiable risk factor, is a mechanism for education and health disparities. This research will lead to the development and implementation of larger scale longitudinal and intervention studies.
In a two-year multiple-wave study we will survey ~540 9th grade student and follow them into their 10th grade from two high schools in a semi-rural area in north-central Georgia to determine if: sleep explains a portion of ethnoracial and SES disparities in education and health outcomes; sleep mediates the relationship between multilevel measures of stress and education and health outcomes; and differential exposures to multilevel stressors partially account for ethnoracial and SES disparities in sleep. This research will assist with identifying whether sleep-related interventions may be a strategy for reducing disparities and improving education and health outcomes among diverse teenagers and will lead to larger scale longitudinal and intervention studies.
