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Greenspace Proximity in Relation to Sleep Health Among a Racially and Ethnically Diverse Cohort of US Women
Sleep is essential for overall health. Greenspace may contribute to sleep health through, for instance, improving mood, reducing sleep disruptors (e.g., poor air quality), and promoting physical activity. Although greenspace likely differs across populations, few studies have included diverse populations. To investigate greenspace-sleep health associations, overall and by age, race and ethnicity, and socioeconomic status, we used data collected at enrollment (2003-2009) from women in the Sister Study (n=1,612 Hispanic/Latina, n=4,421 non-Hispanic (NH)-Black, and n=41,657 NH-White). Participants’ geocoded home addresses were linked to NASA’s Moderate Resolution Imaging Spectroradiometer Normalized Difference Vegetation Index data (250m resolution) to capture greenspace tertiles (further categorized as low/moderate vs. high). Participants reported seven sleep dimensions, which we assessed individually, along with a multidimensional sleep health measure (categories: favorable, moderate, poor). Adjusting for individual- and environmental/neighborhood-level characteristics, we used Poisson regression with robust variance to estimate prevalence ratios and 95% confidence intervals (PR[CI]). We tested for interaction and estimated age-, race and ethnicity-, and educational attainment category-specific associations. Among participants (mean±SD age=55.7±9.0 years), those with low/moderate vs. high greenspace had a lower prevalence of favorable sleep (58% vs. 66%). After adjustment, low/moderate vs. high greenspace was associated with a 32% higher prevalence of moderate (PR=1.32 [1.27-1.38]) and 12% higher prevalence of poor (PR=1.12 [1.07-1.16]) vs. favorable sleep health. Magnitudes of associations were higher among NH-White women vs. minoritized racial-ethnic groups and women with higher vs. lower educational attainment. Higher greenspace was associated with favorable sleep, with stronger associations among groups with more social advantages. Highlights Few prior studies of greenspace and sleep included socially diverse samples. We investigated associations between greenspace proximity and sleep among US women. Effect modification by age, race-ethnicity, and socioeconomic status was assessed. Low/moderate greenspace proximity was associated with poorer sleep health. Associations were strongest among women with more social advantages.
Read moreMechanisms Underlying the Associations Between Different Types of Nature Exposure and Sleep Duration: An 18-Country Analysis
Figure 1. Schematic representation of conceptual model of the relationships between nature exposures, proposed mediators and insufficient sleep. Whilst green space has been linked to healthier sleep outcomes, the roles of specific types of nature exposure, potential underlying mechanisms, and between-country variations in nature-sleep associations have received little attention. Drawing on cross-sectional survey data from an 18-country sample of adults (N = 16,077) the current study examined: 1) the relative associations between six different types of nature exposure (streetscape greenery, blue view from home, green space within 1 km, coast within 1 km, green space visits, blue space visits) and insufficient sleep (<6 h vs. 7–10 h per day); 2) whether these relationships were mediated by better mental wellbeing and/or physical activity; and 3) the consistency of these pathways among the different countries. After controlling for covariates, neighbourhood nature measures (green space, coast within 1 km) were not significantly associated with insufficient sleep; but nature visible from home (streetscape greenery, blue views and recreational visits to green and blue spaces were each associated with less insufficient sleep. Significant nature-sleep associations were mediated, to varying degrees, by better mental wellbeing, but not self-reported physical activity. Country-level heterogeneity in the strength of nature-sleep associations was observed. Increasing nature visible from the home may represent a promising strategy for promoting healthier sleep duration at the population level, whilst nature-based interventions encouraging individuals to spend time in local green/blue spaces may be an appropriate target to assist individuals affected by insufficient sleep.
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