Black Americans get worse sleep — a study says the problem is getting worse

It might be another long aftereffect of the recession.

A close-up view of messy bed with comforter and pillows an hotel bedroom
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Sleep is yet another resource dispersed unevenly along racial lines in America. Studies consistently show that African-Americans get less sleep than white people, a deficit of 15 minutes a day in childhood that grows into almost an hour in adulthood. A recent study, published this month in JAMA Open Network, indicates the problem is getting worse.

How They Did It — Researchers at Yale University looked through 15 years of results from the National Health Interview Survey from 2004 to 2018. They analyzed data from 429,195 U.S. adults. Each year, participants were asked, “On average, how many hours of sleep do you get in a 24-hour period?”

What’s New — In 2004, at the start of the period studied, 35.3 percent of Black respondents said they got less than seven hours on average, compared to 27.8 percent of white respondents.

In the final year, 2018, the percentage of Black respondents reporting an average sleep duration of fewer than seven hours increased by six points, to 41.7 percent, while the rate of white individuals crept up by only three points, to 31 percent.

The paper also charted the rates for respondents who self-identified as Asian and Hispanic or Latino. In 2004, 31.4 percent of Asian and 27 percent of Latino respondents reported getting less than seven hours of sleep on average. The rate for Asians was about the same in 2018, but for Latinos it had jumped 6.6 points, to 33.6 percent, creating a meaningful difference from the average for white people that did not exist in 2004.

The researchers were expecting to find an overall improvement in sleep; in these years, the Affordable Care Act expanded healthcare coverage to 20 million people, creating the first substantial drops in the rates of uninsured Americans since the passage of Medicaid and Medicare in 1965.

President Barack Obama signs the Affordable Care Act into law. Researchers expected this would create a generally positive trend in sleep patterns.

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“It’s surprising that it hasn't been an improvement,” lead author César Caraballo, tells Inverse, “if we consider that there have been major improvements in our increases in healthcare expenditure.”

The authors noted that the gap was consistently higher between Black and white women. Also, the gap between Black and white individuals with low incomes was “substantially” narrower than the gap between middle- and high-earners, suggesting that a comfortable income may help white people sleep, but it “does not have such a protective association among Black individuals.”

Why It Matters — The Black/white sleep gap is one of many unequal health outcomes in the U.S. and similar to many other facets of inequality, the why’s around it have always been complex and an entryway into speculation. Such speculation-happy venues as The Atlantic and the Freakanomics podcast have dug in, proposing differences in stress levels, neighborhoods, access to medical care, underlining conditions, and sheer control over one’s life.

“The recession hit the most people of low income and racial minorities”

Noteworthy in this study: The numbers start to jump up for Black people in 2008 and for Latinos in 2010. These were some of the worst years of the great recession.

“The recession hit the most people of low income and racial minorities,” says Caraballo. “and certainly most likely had an influence on sleep duration.”

He adds, “We didn't statistically test for the influence of like the recession to see if there is a trend change there, before and after but at least graphically, there's a signal there.”

Just about every chronic health problem is linked to poor sleep, including obesity, depression, reduced immune system function, high blood pressure, diabetes, and heart disease.

Because it is tied to stress, underlining medical conditions, and overall health, the length of one’s average sleep can be a canary in the coal mine for general wellness, says Caraballo.

“It’s very important to increase our understanding of these priorities,” he says. “Overall sleep duration is just an imperfect indicator of overall health among populations. So there’s still much more to learn about the trends in sleep disparities. This is just one of those indicators, and we have found that the disparities haven't changed — even they are increasing — over 15 years.”

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