For centuries, the heightened awareness of police brutality has affected us disproportionately. But in the last few decades, when we can quantify the data, it’s a sobering reminder of how it is interpreted. And a growing body of evidence suggests sleeping problems are also an area of significant health disparities between racial and ethnic groups.
Data Can Sometimes Obscure Key Facts
The tendency to focus on public health data in aggregate can obscure the fact that the burdens of health problems are not equally distributed across society. Our lived experiences are different from those of white people.
People in disadvantaged groups of a certain race, ethnicity, gender, sexual orientation, and socioeconomic status frequently suffer from a greater share of health issues.
And a growing body of evidence suggests sleeping problems are also an area of significant health disparities between racial and ethnic groups. Sleep plays a critical role in overall wellness, so it stands to reason that sleep insufficiency can also help explain other health disparities, such as the higher rates of heart disease and diabetes, among Black folks.
Even if Race is a Social Construct, Its Effects Are Real
The root causes of racial disparities are still being studied. Experts admit that defining the concepts of race and ethnicity is complicated. Current theories hold that race and ethnicity are social constructs, not biological, and as such must be understood within a broader cultural context.
But “the effects of these social constructs are real,” according to Eliseo J. Pérez-Stable, director of the National Institute on Minority Health and Health Disparities. And these effects can be observed in a range of health outcomes.
Sleep Difficulties Exist Across Race, Ethnicity, and Gender Identity
So, as imperfect as the concepts of race and ethnicity are, they are a starting point for examining the differences in sleep and health problems.
Across races, ethnicities, and genders, sleeping difficulties are a significant issue in the United States. An estimated 30 percent of adults have insomnia, with an even higher percentage reporting they get less than seven hours per night.
But They Disproportionately impact Racial and Ethnic Minorities.
Researchers who have started to dig deeper into the data, however, have found that, although sleeping problems can affect people of all races, there are strong indications that they have a disproportionate impact on racial and ethnic minorities.
One recent study found that Black respondents reported the least amount of sleep on weekdays.
Several other health studies have found similar results with higher rates of short sleep among Black people than other groups. Sleep apnea, a breathing disorder with potentially serious health consequences, was more common and more severe in Black people, especially among Black young adults. Studies have also found higher rates of long sleep—more than nine hours per night—among Black folks. Like less than seven hours, more than nine hours can also cause health issues and has been associated with higher mortality rates.
The Stress Factor and Other Sleep Disruptors
Researchers suggest several potential causes of the higher rates of sleeping difficulties for people of color—a common theme: higher levels of physical and emotional stress.
Stress can induce an “on alert” state, known as hyperarousal, that is a key component of insomnia.
Other contributors to sleep-related health disparities include:
- Shift Work: People of color are more likely to work night shifts or irregular or extra hours, which can throw off their sleep schedule and their ability to sync their circadian rhythm with the local day-night cycle.
- Occupational Hazards: Many people of color report job stress from discrimination in the workplace. In addition, it’s more common for people of color to work in jobs with greater safety risks that can create stress or occupational exposures to allergens or irritants that may increase their susceptibility to sleep apnea.
- Racial Discrimination: The issue of police brutality is only one aspect of racial discrimination that can have far-reaching effects on a person’s health. Fear, anger, and sadness related to racial discrimination are major stressors for many people of color, and studies have found an association between perceived discrimination and lack of sleep.
- Financial Stress: A higher percentage of racial and ethnic minorities face unemployment and poverty, both of which can create economic pressure and significant daily stress.
- Environment: Neighborhoods with a higher percentage of racial and ethnic minorities often confront higher levels of pollution, noise, allergens, and other potential stressors and contributors to poor sleep and sleep apnea.
- Acculturation: For minority groups, especially those made up of significant immigrant communities, the process of interacting with the dominant culture in America can be a source of tremendous stress and anxiety that may influence sleep quality.
- Unequal Access to Quality Medical Care: Disparities in access to care have a broad effect on health outcomes for minority groups. Conditions like sleep apnea may be less likely to be diagnosed or treated, or people may be less likely to discuss sleeping problems with their physician.
How These Factors Impact Our Health
Many of these factors contribute to other chronic health conditions that occur with greater frequency in racial and ethnic minorities, such as a greater risk of obesity and diabetes.
Sleep is critical to every aspect of wellness. It promotes physical health and recovery, with direct effects on nearly all bodily systems. Sleep is vital for cognitive function, attention, memory, and emotional health.
Understanding how sleeping problems affect racial and ethnic minorities can help public health officials design better programs to address sleep and other related health disparities. That’s why effective strategies to improve sleep are necessary to reduce inequalities in the health system.
Better data about the extent of the problem is necessary, but that doesn’t go far enough. Most accepted insomnia treatments—cognitive behavioral therapy for insomnia or education about sleep hygiene—are based on research that didn’t include people of color. Studies need to have more diverse representation.
More substantial efforts to address solutions to broader issues, such as access to healthcare, racial discrimination, police brutality, environmental justice, and employment and economic opportunities, are also key, as they play a central part in addressing the underlying factors that drive differences in sleep patterns among racial and ethnic populations.
