Losing ground, losing sleep: Local economic conditions, economic vulnerability, and sleep.

Medical research shows that healthy sleep has benefits for human wellbeing. We contribute to the emerging social-epidemiological literature on the social determinants of sleep by considering how living in an area with poor economic circumstances can result in sleep loss through financial worry, uncertainty and stress. We use multilevel regression models and nationally-representative data from the Household, Income and Labour Dynamics in Australia Survey (n = 9181) and find that individuals who live in areas with high unemployment rates or experience individual-level economic vulnerability sleep less than comparable individuals in areas with low unemployment rates, or who do not experience financial hardships. The negative association between local economic conditions and sleep duration is substantially stronger amongst economically vulnerable individuals. This highlights the importance of considering multiple levels in the analysis of health inequalities, as status and location can intersect to produce and reproduce disadvantage systems.