Elsevier

Preventive Medicine

Volume 51, Issues 3–4, September–October 2010, Pages 275-278
Preventive Medicine

Does sleep quality mediate the association between neighborhood disorder and self-rated physical health?

https://doi.org/10.1016/j.ypmed.2010.06.017Get rights and content

Abstract

Objectives

We examine the association between perceived neighborhood disorder and self-rated physical health. Building on previous research, we test whether this association is mediated by sleep quality.

Methods

We use data from the 2004 Survey of Texas Adults (n = 1323) to estimate a series of ordinary least squares regression models. We formally assess mediation by testing for significant changes in the effect of neighborhood disorder before and after adjusting for sleep quality.

Results

We find that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with poorer self-rated physical health, even with controls for irregular exercise, poor diet quality, smoking, binge drinking, obesity and a host of relevant sociodemographic factors. Our results also indicate that the relationship between neighborhood disorder and self-rated physical health is partially mediated by lower sleep quality.

Conclusion

Targeted interventions designed to promote sleep quality in disadvantaged neighborhoods may help to improve the physical health of residents in the short-term. Policies aimed at solving the problem of neighborhood disorder are needed to support sleep quality and physical health in the long-term.

Introduction

Residents of neighborhoods characterized by social disorganization (e.g., socioeconomic disadvantage) and disorder (e.g., noise, crime, and dilapidation) tend to exhibit poorer physical health than residents of more advantaged neighborhoods (Hill et al., 2005, Ross & Mirowsky, 2001). While prior research has contributed to our understanding of the physical health consequences of neighborhood context, additional research is needed to explain these patterns. Building on previous work, we test whether the association between neighborhood disorder (perceptions of neighborhood noise, cleanliness, and crime) and self-rated physical health is mediated by sleep quality.

Research shows that residence in disadvantaged and urban neighborhood environments is associated with low sleep quality and shortened sleep duration (Hale & Do, 2007, Hill et al., 2009). It is also well known that poor sleep quality, short sleep duration, and sleep disorders can contribute to a range of physical health risks, including, for example, hypertension, cardiovascular disease, stroke, metabolic dysregulation, and cognitive decrements. If living in a disadvantaged neighborhood environment can disrupt sleep, and poor sleep can undermine physical health, the association between perceived neighborhood disorder and self-rated physical health could be at least partially mediated or explained by sleep quality.

Section snippets

Data

We use data from the 2004 Survey of Texas Adults, a statewide probability sample of 1504 community-dwelling adults (18 and over) residing in Texas (Musick, 2004). Sampling was conducted using a modified random digit dialing design, with a household-level cooperation rate of 37% and a respondent-level cooperation rate of 89%. Each computer-assisted telephone interview lasted approximately 30–35 min and was also available in Spanish. All analyses are weighted to match the sample to the Texas

Results

Table 1 provides descriptive characteristics of the sample. The average respondent reports fairly low levels of neighborhood disorder and “good” physical health and sleep quality. With respect to lifestyle factors, we observe moderate to low rates of irregular exercise, fair or poor diet quality, smoking, binge drinking, and obesity.

Model 1 of Table 2 shows that neighborhood disorder is inversely associated with self-rated physical health. Those respondents who live in neighborhoods they

Discussion

Building on previous research, we used data from a statewide probability sample of Texas adults to formally test whether the association between neighborhood disorder and self-rated physical health is mediated by sleep quality. We found that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with a modest but statistically significant reduction in self-rated physical health. Our results also indicate that the relationship between neighborhood

Conflict of interest statement

The authors have no conflicts of interest to report.

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