Racial and ethnic disparities in the perceived neighborhood walking environment and self-reported sleep health: A nationally representative sample of the United States

Dzifa Adjaye-Gbewonyo; Amanda E Ng; Dayna A Johnson; Chandra L Jackson

doi:10.1016/j.sleh.2025.01.010

Racial and ethnic disparities in the perceived neighborhood walking environment and self-reported sleep health: A nationally representative sample of the United States

Sleep Health. 2025 Mar 11:S2352-7218(25)00030-0. doi: 10.1016/j.sleh.2025.01.010. Online ahead of print.

Authors

Dzifa Adjaye-Gbewonyo¹, Amanda E Ng², Dayna A Johnson³, Chandra L Jackson⁴

Affiliations

¹ National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA. Electronic address: DAdjayeGbewonyo@cdc.gov.
² National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.
³ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
⁴ Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Triangle Park, North Carolina, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA.

PMID: 40074608
DOI: 10.1016/j.sleh.2025.01.010

Abstract

Objectives: To identify associations between perceived neighborhood walkability and sleep across racial and ethnic groups of US adults.

Methods: Data from the 2020 National Health Interview Survey (N=27,521) were used to assess self-reported measures of walkability (pedestrian access, accessible amenities, unsafe walking conditions) and sleep (short and long duration; frequency of waking up unrested, trouble falling and staying asleep, sleep medication use). Stratified by racial and ethnic group, we calculated the age-adjusted prevalence of neighborhood walkability features and sleep measures and estimated prevalence ratios assessing associations between neighborhood walkability and sleep while adjusting for sociodemographic and health covariates.

Results: The prevalence of unsafe walking conditions due to crime was lowest among non-Hispanic White adults (6.9%), and access to places to relax was lowest among non-Hispanic Black adults (72.5%). The prevalence of short sleep duration was highest among non-Hispanic Black adults (37.9%). Neighborhood environment features had differential associations with sleep when stratified by race and ethnicity. For example, walking path access was related to lower sleep medication use among non-Hispanic Asian adults (adjusted prevalence ratio (aPR): 0.42, 95% CI: 0.19-0.91) but greater use among non-Hispanic White adults (aPR: 1.24, 95% CI: 1.05-1.46). More associations were observed among non-Hispanic White adults than other groups; and the strongest magnitude of association was observed among non-Hispanic Asian adults (traffic and sleep medication aPR: 0.31, 95% CI: 0.12-0.84).

Conclusions: Associations between the neighborhood environment and sleep vary and may be inconsistent by race and ethnicity. Future research may help identify determinants.

Keywords: Built environment; Health disparities; National Health Interview Survey; Sleep disturbances; Sleep duration; Walkability.

Published by Elsevier Inc.