Neighborhood Change: Impact on Sleep and Obesity-Related Health Disparities

描述(由申请人提供)：生活在社会经济不利地区的个人肥胖率和肥胖相关发病率高得不成比例，包括身体角色限制和心血管疾病(CVD)的风险增加。将邻里劣势与健康结果联系起来的潜在机制的研究主要集中在白天的健康行为上，包括饮食或体力活动。然而，睡眠是一种关键的健康行为，它与邻里劣势有关，并可能在解释邻里劣势与健康之间的联系方面发挥因果作用。然而，现有的关于邻里劣势和睡眠的研究完全是基于横断面数据，使用睡眠和邻里特征的自我报告。在我们团队之前资助的、正在进行的研究开发的现有研究基础设施的基础上，我们有一个独特而重要的机会来研究在大量经济投资的刺激下，建筑和社会环境的变化是否改善了睡眠，进而减少了与肥胖相关的健康差距。研究队列包括从两个城市社区随机选择的1100名低收入非裔美国成年人，其中一个社区在未来5年内正在经历戏剧性的复兴(即干预社区)，而另一个社区(社会人口统计学上匹配的对照社区)没有经历任何这样的变化。我们将增加对睡眠的纵向评估，使用活动描记、自我报告，并在300个子样本中对阻塞性睡眠呼吸暂停进行客观的家庭监测，以提供对社区变化之前、期间和之后的睡眠状况的丰富表征。从这项研究中获得的证据将对确定新的个人层面和社区层面的因素具有重大的科学和政策意义，这些因素有助于在健康方面造成显著和普遍的种族和社会经济差异。

DESCRIPTION (provided by applicant): 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.