Eliminating Sleep Health Disparities and Achieving Health Equity: Seven Areas for Action in the Behavioral Sleep Medicine Community

ABSTRACT

Racial and ethnically minoritized and under-resourced populations do not reap the same benefits of sufficient sleep as their white counterparts resulting in insufficient sleep and sleep health disparities. Research exploring these disparities have documented a plethora of factors including social determinants of health, community violence, and structural issues – all of which are associated with adverse sleep. There are robust evidence base behavioral intervention that can be leveraged to improve sleep health among racial and ethnic groups. However, EBIs are not well leveraged. In 2021, with participation from members of the society of behavioral sleep medicine, we conducted this report to bring together the field of behavioral sleep medicine including researchers, clinicians and trainees to discuss gaps and opportunities at the intersection of the COVID-19 pandemic, systemic racism, and sleep health. The goals were anchored around seven recommendations toward reducing disparities in the near-term and longer-term approaches to eliminating disparities. Furthermore, we acknowledge that reducing and eliminating disparities in sleep health requires a multifaceted approach that includes a focus on individual, community, health care and societal levels of influence with participation from diverse partners including federal, state and local.

Glossary of terms

health disparities: “Differences in health and well-being outcomes without an identified cause among groups of people” (Gómez et al., 2021).

health-care disparities: “Differences in quality of health care received that are not due to access-related factors or clinical needs, preferences, or appropriateness of intervention” (Gómez et al., 2021).

health inequalities: “Differences in health status, or in the distribution of health determinants among different population groups (e.g., differences in mobility between older and younger populations, or in mortality rates between people from different social classes)” (Gómez et al., 2021).

health inequities: “Differences in health and well-being outcomes that are avoidable, unfair, and unjust. Health inequities are affected by social, economic, and environmental conditions” (Gómez et al., 2021).

health equity: “a desirable goal/standard that entails special efforts to improve the health of those who have experienced social or economic disadvantage. It requires: (1) continuous efforts focused on elimination of health disparities, including disparities in health care and in the living and working conditions that influence health, and (2) continuous efforts to maintain a desired state of equity after particular health disparities are eliminated” (HealthyPeople.gov,).

sleep health equity: “Equal opportunities that are given to each individual and/or communities based on their need, no matter their age, sex, race/ethnicity, geographic location, and socio-economic status, to obtain recommended, satisfactory, efficient amount of sleep with appropriate timing that promotes physical and mental well-being” (Blanc et al., 2019).

Acknowledgments

We thank our colleagues of the Society of Behavioral Sleep Medicine Science and Research Committee and the Board of Directors for their feedback and review of an earlier draft. These views do not reflect that of the Society of Behavioral Sleep Medicine. We would also like to thank Kathryn Hansen from the Society of Behavioral Sleep Medicine.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

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Funding

The author(s) reported there is no funding associated with the work featured in this article.