Abstract
Black people experience lower quality and lesser quantity of sleep than white people. Researchers, however, do not believe that racial disparities in sleep sufficiency are caused by biological differences, but rather by various social differences, such as differences in sleeping environments and socioeconomic status. Racial disparities in sleep sufficiency are a matter of social justice because sleep is important to mental and physical health, meaning racial disparities in sleep sufficiency can contribute to unequal and unjust disparities in overall health. Racial disparities in sleep may also be linked to other racial disparities in health that black people disproportionately experience such as hypertension and obesity. Sleep hygiene, common therapeutic advice given to help induce sleep, is often the first step to helping people sleep. Sleep hygiene, however, does not address the social, legal, cultural, and economic causes of racial disparities in sleep sufficiency. Sleep hygiene, as an ideal theory, addresses sleeplessness under ideal circumstances, only which a small group of privileged people live. Sleep hygiene ignores the unequal circumstances that contribute to some black people’s sleeplessness. Nonideal theory, however, acknowledges the less than ideal circumstances of certain groups, including people of color, and gives us a framework to develop solutions to racial disparities in sleep sufficiency.
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Notes
- 1.
In some instances Black people as well as Hispanic people and American natives’ health is far worse than white people’s health. In some instances Black people are not the worse off when compared to other people of color. This is the case with medical insurance coverage and its benefits. Hispanic and American natives are less likely to have medical insurance than Black and white people (Williams et al. 2010). However, in this paper I focus on Black people’s health.
- 2.
Since this paper heavily relies on epidemiology literature and most research on sleep uses the terms “Blacks” and “whites” I will also use these terms, however, to keep the integrity of the research used in this paper, when referring to specific research I will use the racial terms used in that particular research.
- 3.
The other concepts include an idealized social ontology, an idealized cognitive sphere, and strict compliance (usually with the principles of justice).
- 4.
Italics in text.
- 5.
Here Mills also notes that middle to upper class white males are over-represented in the philosophy profession.
- 6.
Grandner excludes occupations where people may work long hours and night shifts like nurses, doctors, and military personnel because these jobs typically come with access to health care and decent pay.
- 7.
Sleep disorders that cause sleeplessness are disproportionately abundant in racial minority groups. It is possible this is because of over-diagnosis based on untreated social factors.
- 8.
- 9.
- 10.
Rothstein rejects the idea that practices can only be unconstitutional after the Supreme Court has declared them unconstitutional.
- 11.
Additionally, the WHO posits that the wealth gap between the rich and the poor will continue to increase if the effects of noise pollutants on health and wealth is not addressed (2017).
- 12.
When considering medical remedies for sleeplessness we also have to consider issues of access, including disparities in who has access to health insurance and whether insurance companies will cover therapies for sleeplessness.
- 13.
This is not to say that we should not medicalize sleeplessness that is caused by social factors. But to do this we would have to consider whether any social deficiencies warrant medical intervention and whether there is a medically necessary distinction between enhancement and treatment. I have discussed this topic in “Not just ‘study drugs’ for the rich: Stimulants as moral tools for creating opportunities for socially disadvantaged students” (Ray 2016).
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Ray, K. (2021). Black and Sleepless in a Nonideal World. In: Victor, E., Guidry-Grimes, L.K. (eds) Applying Nonideal Theory to Bioethics. Philosophy and Medicine, vol 139. Springer, Cham. https://doi.org/10.1007/978-3-030-72503-7_11
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