Early Contextual Influences on Young Adult Sleep and Sleep Inequities

Abstract

The residential neighborhood environment has been associated with a range of health outcomes and health inequities, including sleep. Sleep duration, quality, and variability have been increasingly studied as behavioral health mechanisms linking the social context to the disruption of physiological systems and development of disease. Current research has focused on concurrent neighborhood associations with sleep and centered on measures of socioeconomic characterizations, and self-reported sleep outcomes. While there is broad consensus that childhood experiences are foundational to adult health, few have considered the childhood neighborhood contexts that link early life experiences to later health outcomes and health inequities. To address these knowledge gaps, this two-study dissertation uses a developmental approach to examine direct and indirect associations between the neighborhood context in childhood and sleep problems and sleep disparities among a sample of Black (52%) and White (48%) college students (n = 263). Primary residential addresses were mapped to census tracts and used to capture annual concentrations of criterion air pollutants from the Environmental Protection Agency’s Air QUAlity TimE Series Project (EQUATES), and indices of neighborhood opportunity through the Childhood Opportunity Index (COI). For both studies, outcome measures of sleep duration, quality, and variability were assessed via actigraphy over 8 consecutive days. Focused on the physical environment, the first study found childhood exposure to air pollution (particulate matter smaller than 2.5 μm, PM2.5) from ages 2 to 17 was associated with wakefulness after sleep onset (WASO) in young adulthood. Focused on the built environment, the second study found direct and mediating associations between neighborhood opportunity in childhood and adverse childhood experiences (ACEs) on measures of sleep variability and self-reported sleep problems in young adulthood. Together, results indicated unique, lasting contributions of the childhood residential neighborhood environment on sleep and racial sleep inequities in young adulthood. The findings underscore the importance of childhood contexts for later health and contribute to the need for a developmental perspective within the growing body of research examining the neighborhood environment and sleep health inequities.