{
    "abstract": "Neighborhood disinvestment is a downstream impact of structural racism, especially afflicting minoritized communities. Thus, neighborhood reinvestment may serve as a policy-level intervention to mitigate sleep and other health disparities. This study builds on previous work by leveraging a natural experimental design to evaluate the 5-year effects of neighborhood investments on residents' sleep.\nData are from the PHRESH Zzz study, a natural experiment conducted in two low-income, predominantly Black American, urban neighborhoods in Pittsburgh, Pennsylvania, with a randomly selected cohort [n=567; mean age=54.8 (SD=14.8); 77.6% female; 96% Black]. Sleep duration, wakefulness after sleep onset, and sleep efficiency were assessed via actigraphy and sleep quality via survey in 2013, 2016, and 2018. All publicly funded neighborhood investments between 2013 and 2016 were recorded and geocoded to calculate the distance from each respondent's residence to the investment. The primary exposure variable was residents' proximity to neighborhood investments (<0.1 of a mile).\nThe overall pattern of results showed worsening sleep over time, regardless of exposure to investments. However, over the 5-year period, those who lived physically close to investments (<0.1 mile) experienced significantly smaller decreases in sleep efficiency and smaller increases in wakefulness after sleep onset, relative to those who lived farther away.\nPreviously, we found that living near a neighborhood investment improved sleep outcomes over a short-term period of 3years. Current results indicate that improvements were partially sustained over 5years. Findings have implications for policy initiatives targeting upstream, structural determinants of sleep health disparities.",
    "authors": [
        {
            "affiliation": "Division of Social and Economic Well-Being, RAND, Pittsburgh, Pennsylvania, United States. Electronic address: wtroxel@rand.org.",
            "firstname": "Wendy M",
            "initials": "WM",
            "lastname": "Troxel"
        },
        {
            "affiliation": "Division of Social and Economic Well-Being, RAND, Pittsburgh, Pennsylvania, United States.",
            "firstname": "Ann",
            "initials": "A",
            "lastname": "Haas"
        },
        {
            "affiliation": "Division of Economics and Sociology, RAND, Santa Monica, California, United States.",
            "firstname": "Bonnie",
            "initials": "B",
            "lastname": "Ghosh-Dastidar"
        },
        {
            "affiliation": "Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.",
            "firstname": "Andrea L",
            "initials": "AL",
            "lastname": "Rosso"
        },
        {
            "affiliation": "Stony Brook University, Department of Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook, New York, United States.",
            "firstname": "Lauren",
            "initials": "L",
            "lastname": "Hale"
        },
        {
            "affiliation": "Arizona State University, College of Health Solutions, Phoenix, Arizona, United States.",
            "firstname": "Matthew P",
            "initials": "MP",
            "lastname": "Buman"
        },
        {
            "affiliation": "Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States.",
            "firstname": "Tamara",
            "initials": "T",
            "lastname": "Dubowitz"
        }
    ],
    "conclusions": null,
    "copyrights": "Copyright \u00a9 2025 The Authors. Published by Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.sleh.2025.03.009",
    "journal": "Sleep health",
    "keywords": [
        "Disparities",
        "Neighborhoods",
        "Public policy",
        "Sleep",
        "Sleep deserts",
        "Social determinants"
    ],
    "methods": null,
    "publication_date": "2025-04-23",
    "pubmed_id": "40263076",
    "results": "The overall pattern of results showed worsening sleep over time, regardless of exposure to investments. However, over the 5-year period, those who lived physically close to investments (<0.1 mile) experienced significantly smaller decreases in sleep efficiency and smaller increases in wakefulness after sleep onset, relative to those who lived farther away.",
    "title": "Sustained impacts of neighborhood investments on sleep health over a 5-year period: Insights from a natural experiment in two urban neighborhoods in the United States.",
    "xml": "<Element 'PubmedArticle' at 0x7885064e6b60>"
}