Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals

J Behav Med. 2021 Dec;44(6):811-821. doi: 10.1007/s10865-021-00234-w. Epub 2021 Jun 9.


Individuals with chronic low back pain (cLBP) frequently report sleep disturbances. Living in a neighborhood characterized by low-socioeconomic status (SES) is associated with a variety of negative health outcomes, including poor sleep. Whether low-neighborhood SES exacerbates sleep disturbances of people with cLBP, relative to pain-free individuals, has not previously been observed. This study compared associations between neighborhood-level SES, pain-status (cLBP vs. pain-free), and daily sleep metrics in 117 adults (cLBP = 82, pain-free = 35). Neighborhood-level SES was gathered from Neighborhood Atlas, which provides a composite measurement of overall neighborhood deprivation (e.g. area deprivation index). Individuals completed home sleep monitoring for 7-consecutive days/nights. Neighborhood SES and pain-status were tested as predictors of actigraphic sleep variables (e.g., sleep efficiency). Analyses revealed neighborhood-level SES and neighborhood-level SES*pain-status interaction significantly impacted objective sleep quality. These findings provide initial support for the negative impact of low neighborhood-level SES and chronic pain on sleep quality.

Keywords: Chronic low back pain; Neighborhood area deprivation; Sleep; Sociocultural influences on health and illness; Socioeconomic status.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Humans
  • Longitudinal Studies
  • Low Back Pain* / epidemiology
  • Residence Characteristics
  • Sleep
  • Social Class
  • Socioeconomic Factors