0416 Living in an Ethnic Enclave is Associated with Reduced Risk of Insomnia Among Asian Americans

Abstract Introduction Neighborhood social and socioeconomic contexts have been linked to insomnia, but few studies have examined this association among Asian Americans, especially the role of ethnic enclaves. Methods The cross-sectional study consisted of 256 Chinese-, 256 Korean- and 267 Vietnamese Americans aged 30+ years in Southern California. We assessed neighborhood characteristics (residential segregation, ethnic enclaves, neighborhood socioeconomic status [nSES]) using geocoded data and neighborhood perceptions (safety, friendliness, social cohesion) by survey. Insomnia was measured using the Insomnia Severity Index (ISI), categorized into no clinically significant insomnia (0-7), subthreshold insomnia (8-14), and moderate/severe insomnia (≥15). Multinomial logistic regression was used to examine associations between neighborhood factors and insomnia, adjusting for age, sex, Asian origin, marital status, education, income, employment status, and population density. Results Results 14.8% reported moderate/severe insomnia. Compared to Asian Americans living in neighborhoods with a lower ethnic enclave index score, those with a higher score had 50% lower odds of moderate/severe insomnia (OR= 0.50, 95% CI: 0.31, 0.79) after adjustment. Report of less friendly neighbors was associated with ,higher odds of moderate/severe insomnia (OR=2.27, 95% CI: 1.08, 4.77), and feeling safe in one’s neighborhood ‘all of the time” was marginally associated with 42% lower odds of moderate/severe insomnia compared to feeling safe “none/some of the time” (OR=0.58, 95% CI: 0.31, 1.07, p< 0.1). Contrary to our hypothesis, higher neighborhood social cohesion was positively associated with subthreshold insomnia (OR=1.36, 95% CI 1.11, 1.67), and marginally associated with higher moderate/severe insomnia (OR=1.28, 95% CI: 0.99, 1.65, p< 0.1). This finding could be potentially due to the significant correlation we found between social cohesion and negative social support (r=0.07, p< 0.05). Interaction test results indicate that the association between living in an ethnic enclave and lower odds of moderate/severe insomnia was especially pronounced among individuals with lower educational attainment, and the association between higher social cohesion and higher odds of insomnia was present for Korean and Vietnamese Americans, but not for Chinese Americans. Conclusion Insomnia among Asian Americans appears to reflect a mix of protective effects of living in ethnic enclaves as well as the “dark side’ of social cohesion (negative social support). Support (if any)