The Inequity of Sleep Health in America

March 16, 2021 All posts Jared Sebastian
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In the world of sleep health education, we tend to recommend certain sleep habits as though they are equally possible for everyone to follow, but the truth is that sleep doesn’t just happen in a vacuum. There are cultural, environmental, and socioeconomic factors that can and do negatively affect the quality of people’s sleep, no matter how closely they adhere to sleep hygiene. These intersecting factors have been found to contribute to unequal sleep health across demographics. 

Researchers have studied closely the sleep disparities among racial and ethnic minority groups compared to the majority white population in the US. What they’ve found presents troubling evidence that a large percentage of our population is facing a lack of sleep on top of an already-significant amount of other inequities:

  • A Sleep in America poll conducted by the National Sleep Foundation found that Black respondents reported the least amount of sleep on weekdays, and subsequent survey studies have found similar results.

  • Higher rates of sleeping problems have been found in Hispanic and Latinx people than in whites, specifically an increased prevalence of short sleep and low-quality sleep.

  • While research into these groups’ sleep health is currently limited, researchers have found some evidence of Asian Americans and Indigenous Americans facing a higher burden of sleep problems.

  • Sleep apnea—a serious condition linked to cardiovascular complications—has been found to be noticeably more common among Black people and specifically Black young adults.

  • There are even indications that these sleep inequities have a detrimental effect that reverberates down through generations: BIPOC (Black, Indigenous, or people of color) mothers experiencing psychological distress and insomnia have been shown to have a negative impact on the sleep duration of their children.

 

The impact of poor sleep

When you realize just how foundational sleep is to our overall physical and mental wellbeing, it’s not hard to see just how harmful this lack of sleep can be to people in these communities. 

As a current illustration of how these sleep inequities may be impacting the health of BIPOC people in larger ways, a recent New York Times report found that the coronavirus pandemic has caused a sharp decline in the life expectancy of Black Americans. In the first half of 2020, the life expectancy of the Black population decreased by 2.7 years, erasing 20 years of gains. The NYT report also found that the death rate for Black Americans from COVID-19 has been 2 times higher than white Americans—among Hispanic people, the rate is 2.3 times higher.

But how does a higher rate of death from a virus connect back to overall health? The key is underlying conditions, such as hypertension and diabetes, which contribute to the likelihood of a coronavirus infection becoming fatal. And the communities in which these conditions are more prevalent? Black and Hispanic Americans.

As we always like to remind readers, sleep health is tightly woven into the fabric of your life as a whole. That’s why the better you sleep, the greater quality of life you experience. Unfortunately, this means that the inverse is also true—the more obstacles to good health you experience in your everyday life, the more difficult it is to sleep well. 


What is making healthy sleep inequitable?

For many folks in BIPOC communities, these obstacles are many, and currently, the policies and societal changes required to address them are all too scarce. Barriers to better sleep faced by minority racial and ethnic groups may include the following:

  • Hazardous work conditions, racial discrimination in the workplace, or trouble finding work that pays a living wage

  • Worries caused by changes in immigration status

  • Dealing with racism and prejudice on an individual level, including the psychological toll of microaggressions

  • Poor housing conditions, or a poor sleep environment

  • Stress brought on by broader structural injustices, including the over-policing of Black and Hispanic neighborhoods, and repeated incidents of police brutality

At the root of these many obstacles is the simple fact that BIPOC people in this country face an uphill battle in getting access to even the most basic needs for living a healthy life, turning a good night’s sleep into an out-of-reach luxury—a luxury which many of us who do have these basic needs met may take for granted.

Black man and woman standing in their small business storefront

How can we create more equitable access to healthy sleep?

On the community public health level, one of the strongest solutions that researchers have identified is to tailor proven sleep therapy and general sleep education tools specifically to BIPOC people. Traditionally, many therapy studies in the past were conducted with little representation from minority groups. This means it is a misstep to assume that methods which might work for white folks or those from the middle- or upper-class will work for BIPOC folks or working-class people. Developing sleep solutions at the community level requires empowering people in those communities with the resources they need to address sleep difficulties in a more contextual and localized way. 

It is also highly important that we address systemic inequalities with the broad, systemic solutions they require. If we truly believe that everyone deserves a better night’s sleep, we should voice support for equal access to basic needs like health care, housing, and safer, better-paying employment, in order to ensure that no one has to go without healthy sleep just because of the color of their skin or the measure of their wealth. 


Every human body needs healthy sleep

Sleep is quite simply our bodies’ most efficient way of maintaining, repairing, and growing itself, in every conceivable way. It is of the utmost importance that we not grow content or complacent while such a huge swath of our population is kept from this cornerstone of a life well-lived. A better world, and better sleep, is possible.