Exploring associations between state education initiatives and teachers' sleep: A social-ecological approach.

Social policies that are not specifically aimed at impacting health can still have health consequences. State education reforms, such as standardized testing and stringent accountability for schools and teachers, may affect teacher health by changing their working conditions. This study explores associations between state education initiatives and teachers' sleep, an important predictor of productivity and chronic health conditions. The Behavioral Risk Factor Surveillance System 2013 and 2014 data sets provided sleep and demographic data for 7836 teachers in 29 states in the United States. We linked the teacher data to state education reform data from the U.S. Department of Education. Logistic regression was used to estimate odds ratios (ORs) of reporting inadequate sleep (i.e., <6.5 h and <5.5 h) associated with state education policies after adjusting for demographic characteristics. Teachers had significantly higher odds of reporting inadequate sleep if their state financed professional development, sanctioned or rewarded schools based on student performance, and regulated classroom materials for state-wide common core standards (ORs ranging from 1.25 to 1.84). More strictly defined inadequate sleep (<5.5 h) had generally higher ORs than less strict definition (<6.5 h). The Race-to-the-Top award, a US federal grant designed to encourage states to implement reforms through regulations and legislations, was also associated with inadequate sleep (OR = 1.41, p < 0.01, for <6.5 h; OR = 1.55, p < 0.01, for <5.5 h). Although this exploratory study did not have district- and school-level implementation data, the results suggest that some state education policies may have impacts on teacher sleep. Consequences of education reform for teacher health deserve more attention.