October 26, 2020
disparities in sleep health: are black people getting less sleep than white people?
Over the last few decades, sleep quality has reportedly gotten worse. In this time, researchers have further examined the relationship between sleep and health. They found an association between sleep and medical conditions such as depression, diabetes, stroke, and heart disease. Now, there is an entire field of study exploring the factors that contribute to this relationship. Some studies suggest that the differences over time may be dependent on race.
The CDC and most other healthcare leaders recommend at least 7 hours of sleep per night for adults. However, a CDC report estimates that a large portion of the United States population does not meet this sleep standard, especially black Americans. According to the same dataset, adults who were short sleepers were more likely obese, physically inactive, and current smokers compared to people who got the recommended amount of sleep.
Black people (45.8%) are more likely to sleep less than 7 hours a night than white people (33.4%).
Source: Short Sleep Duration Among US Adults
To look deeper into this disparity, researchers analyzed data from a United States health dataset. Within their review, they calculated the differences in insufficient sleep between black people and white people.
Preliminary analysis aggregating 1977–2009 data was conducted, indicating that overall blacks had 58 % greater odds of being insufficient sleepers [short or very short sleep; < 7 h] (OR = 1.58, 95 % CI = 1.52-1.63, p < 0.001) and a 62 % greater odds of being long sleepers (OR = 1.62, 95 % CI = 1.54-1.71, p <0.001) compared with whites.
Researchers concluded that black people had significantly higher odds of insufficient sleep compared to white people. In particular, black people were 58% more likely to sleep less than 7 hours a night, and 62% more likely to sleep more than 9 hours a night. Both short sleep and long sleep are considered less healthy than the recommended 7-9 hours per night.
For more insight, the researchers looked at demographic and social data. They observed that black participants were more likely to report insufficient sleep if they also reported smoking history, drinking history, physical inactivity, emotional distress, and other medical conditions such as obesity.
There is no simple answer as to why a sleep disparity exists. The best research available suggests that it is a mix of physical, social, and environmental stressors that affect the black population more heavily. With racial disparities and injustice still embedded in our culture, it is hard to ignore the kind of stress black Americans face on a daily basis. Specific research on disparities in areas such as employment, socioeconomics, and bias in health services paint a disturbing picture of the barriers up against black communities. At this time in history, the list of stressors on black Americans is endless.
The odds of short sleeping were highest for those who lived in central city environments with over 1 million people (OR=1.43, 95% CI=1.28-1.58), compared with residents of more rural, non-metropolitan environments (non-MSA areas) after adjusting for socioeconomic and health characteristics.
Source: Racial differences in self-reports of sleep duration in a population-based study
Moreover, a study of sleep in urban vs rural cities found that those living in inner cities had an increased risk of short sleeping time. At the time of this study, they reported that 36.6% of blacks lived in a central metropolitan area of greater than 1 million people, while only 11.8% of whites did. Therefore, a higher proportion of black communities would be impacted by poor sleep in inner cities than white populations. To be specific, they calculated a 43% increased odds of short sleep duration for populations living in central metropolitan areas compared to non-urban areas.
In the context of health disparities, insufficient sleep may be an important factor in understanding diseases that disproportionately hurt black people. It is crucial to monitor sleep and sleep disorders in populations with higher rates of medical conditions now known to be impacted by sleep.
Sleep benefits brain health, heart health, weight management, and longevity.