Matthew is an associate editor of The American Journal of Managed Care® (AJMC®). He has been working on AJMC® since 2019 after receiving his Bachelor's degree at Rutgers University–New Brunswick in journalism and economics.
Welfare recipients who were unable to meet their rent or mortgage payments were more likely to have impaired sleep duration and sleep quality, with those forced to move exhibiting more severe impairment.
As the disproportionate impact of the coronavirus disease 2019 (COVID-19) pandemic continues to affect the most vulnerable populations within the United States, a new study conducted by RAND Corporation finds that people who are unable to make their rent or mortgage payments exhibit less sleep duration and quality than those who do not have housing insecurity issues.
Published today in Sleep, the longitudinal study examined data from the California Socioeconomic Survey on 1046 welfare recipients of 1 of 6 counties: Alameda, Fresno, Los Angeles, Riverside, Sacramento, and Stanislaus. Participants who consented to provide their survey responses during 2015-2016 and 2017-2018 were included, with each respondent providing self-reported measures of sleep duration and sleep quality.
"Considering the downstream health implications of housing insecurity is particularly timely given the economic fallout from the coronavirus pandemic," said lead study author Robert Bozick, PhD, an adjunct researcher at RAND and senior fellow at the Kinder Institute for Urban Research at Rice University, in a statement. "National surveys show many Americans are having trouble making their housing payments, which may lead to greater reliance on social safety net programs like welfare in the near future."
Along with fellow study authors Wendy Troxel, PhD, of the Department of Behavioral and Policy Sciences at RAND, and Lynn Karoly, PhD, of RAND’s Department of Economics, Sociology, and Statistics, Bozick regressed the self-reported sleep measures on experiences of housing insecurity in the prior year.
Utilizing propensity score weights, the study serves as the first to analyze the relationship between housing insecurity and sleep outcomes when adjusting for potential bias from an array of observed covariates, including sleep duration and sleep quality measured prior to experiences with housing insecurity.
On average, participants slept 6.4 hours a night in the past month, with 30.9% stating they were unable to meet their rent or mortgage payments and 6.1% forced to move due to this financial burden.
Respondents who were unable to meet their rent or mortgage payments were found to sleep on average 22 fewer minutes a night and had lower sleep quality than those who did not report these issues. Notably, this disparity in sleep quality and duration ballooned further for those forced to move, as this group slept on average 32 fewer minutes a night and had lower quality sleep than those who were not forced to move.
"This is the first study that demonstrates that housing insecurity represents a distinct impediment to healthy sleep duration and quality," said Bozick. "The stability and condition of one's home environment are critically important for health and well-being."
Bozick R, Troxel WM, Karoly LA. Housing insecurity and sleep among welfare recipients in California. Sleep. Published online February 1, 2020. doi:10.1093/sleep/zsab005