Sleep Health Disparity and Race/Ethnicity, Socioeconomic Status, and Gender: A Systematic Review

Abstract

Despite improvement in US healthcare, racial and ethnic minorities have experienced health disparities including sleep health disparities. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched three electronic databases (PubMed, Embase, Web of Science) from the earliest available date to September 2023 using the keywords sleep inequity, gender, race, and socioeconomic status. Studies published in languages other than English were excluded. Meta analysis, case reports, and editorials were also excluded. Medical Subject Headings (MeSH) of the National Library of Medicine and Keywords were used to search PubMed, Embase, and Web of Science. We also searched the reference lists of the selected articles. Using the search strategy, we identified 52 articles. After excluding 11 duplicate studies, we screened 41 articles. The studies not relevant to our search were further excluded and we finally assessed 16 full-text articles. Twelve of the 16 studies were cross sectional and 4 were prospective studies. Compared to Whites, increased prevalence of shorter sleep duration was found among people of diverse racial background. Similarly, individuals with lower socioeconomic status have been shown to have a disproportionate increase in insufficient sleep (1.62 times). Additionally, compared to White women, Black women were more likely to report short sleep (37% vs. 27%) and were less likely to obtain the recommended amount of sleep (52% vs. 64%). This review demonstrates disparities in sleep based on race/ethnicity as well as the effect of gender and socioeconomic status on the quality of sleep.

Keywords

• sleep health disparity
• race and ethnicity
• socioeconomic status