Neighborhood social cohesion and sleep health among sexual minoritized US adults and intersections with sex/gender, race/ethnicity, and age.

Objectives: Neighborhood social cohesion or living in communities characterized by trust and social ties may mitigate sleep disparities among sexual minoritized vs. heterosexual persons; but its relation to sleep health is understudied among sexual minoritized groups. To investigate associations between perceived neighborhood social cohesion and sleep health among adult US men and women who identified as "lesbian or gay, bisexual, or something else," we used cross-sectional National Health Interview Survey data (2013-2018).

Methods: Participants reported neighborhood social cohesion (categorized as low or medium vs. high) and sleep characteristics. Adjusting for sociodemographic, health, and residential characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals for poor sleep.

Results: Among 4666 sexual minoritized adults, 44% reported low, 32% medium, and 24% high neighborhood social cohesion. Women, minoritized racial/ethnic groups, and young adults disproportionately reported low neighborhood social cohesion. Overall, low vs. high neighborhood social cohesion was associated with a higher prevalence of short sleep (PR=1.27 [95% confidence interval:1.11-1.45]) and all sleep disturbances (e.g., PR_{insomnia symptoms}=1.36 [1.19-1.55]). PRs were often higher as intersectionality or membership to multiple minoritized groups increased.

Conclusions: Lower perceived neighborhood social cohesion was associated with poorer sleep. Fostering community cohesiveness may mitigate sleep disparities among sexual minoritized adults.