Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Jill Kelly

Second Advisor

Monica Ordway

Abstract

Introduction: Sleep health is a vital component of childhood health. However, sleep health disparities exist among toddlers from racially/ethnically diverse families living with socioeconomic adversity as early as 12 months of age. There is a gap in the current literature that includes environmental factors that may explain the factors contributing to these differences.Objective: To explore associations between toddler sleep health and environmental and societal factors at the neighborhood level using spatial analysis that may help elucidate factors which contribute to the race/ethnicity differences in toddlers unexplained by socioeconomic variables. Methods: A secondary analysis was performed on data collected from a longitudinal study of 110 parent-child dyads living in socioeconomically marginalized households completed in 2019 (1K23NR016277; PI: Ordway). A Geographic Information System (GIS) was used to investigate whether environmental factors at the neighborhood level influenced sleep health in the toddlers with completed actigraph-measured sleep data. ArcGIS Pro was used to conduct spatial analysis of select environmental factors and create maps to visualize these variables and their association with sleep characteristics with race/ethnicity differences identified in the larger study. Results: Univariate and multivariate analysis did not result in statistically significant association between bedtime or bedtime variability with neighborhood noise exposure, light exposure, mean income, and racial/ethnic demographic composition in the study area. Conclusion: Maps helped visualize clusters of participants in urban, low-income areas with high light and noise exposure. However, the socioeconomically and geographically homogeneous cohort may have limited the ability to fully examine differences in this study. Future research should include a larger sample size with varied socioecological backgrounds. The field of spatial analysis is rapidly changing and is likely to identify pathways connected to health disparities.

Comments

This is an Open Access Thesis.

Open Access

This Article is Open Access

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