Neighborhoods and Sleep Health: Mediating Roles of Psychological Distress and Physical Activity

Sleep has been recognized as a major determinant of physical and mental health. Emerging studies suggested that social and built environments should be considered as important determinants of sleep health, however causal mechanisms between neighborhood factors and sleep health still remain unclear. The proposed dissertation is a connected set of papers including a systematic review and longitudinal studies investigating associations between neighborhood stressors and sleep health as well as potential causal mechanisms via psychological distress and physical activity. The longitudinal studies employed comprehensive measures of neighborhood characteristics and sleep health along with g-estimation and mediation analysis techniques. Neighborhood social and built environments may contribute to poor sleep health, particularly in low-income and racial/ethnic minority neighborhoods, and psychological distress can be a salient pathway linking these neighborhood characteristics and sleep health. Based on our findings, interventions to improve sleep should target modifiable factors and enhance neighborhood environments. These sorts of strategies have the potential to improve not only sleep health but also other health outcomes