Does sleep quality mediate the association between neighborhood disorder and self-rated physical health?

Objectives: We examine the association between perceived neighborhood disorder and self-rated physical health. Building on previous research, we test whether this association is mediated by sleep quality. Methods: We use data from the 2004 Survey of Texas Adults (n= 1323) to estimate a series of ordinary least squares regression models. We formally assess mediation by testing for significant changes in the effect of neighborhood disorder before and after adjusting for sleep quality. Results: We find that residence in a neighborhood that is perceived as noisy, unclean, and crime-ridden is associated with poorer self-rated physical health, even with controls for irregular exercise, poor diet quality, smoking, binge drinking, obesity and a host of relevant sociodemographic factors. Our results also indicate that the relationship between neighborhood disorder and self-rated physical health is partially mediated by lower sleep quality. Conclusion: Targeted interventions designed to promote sleep quality in disadvantaged neighborhoods may help to improve the physical health of residents in the short-term. Policies aimed at solving the problem of neighborhood disorder are needed to support sleep quality and physical health in the long-term.