Social justice and sleep: Policy implications of social disparities in sleep

Numerous studies reveal a strong positive association between sufficient sleep duration and good health. In addition, the same sociodemographic characteristics associated with restricted autonomy (less education, unemployment, for instance) are all positively associated with higher-risk sleep durations. Based on theoretical and empirical work, we argue that autonomy is likely an important underlying source of healthy sleep duration. Social epidemiologist Sir Michael Marmot has made a similar argument about autonomy as an underlying mechanism of social disparities in health more broadly, but we find sleep duration to be an instructive and novel example with which to make this point. Ultimately the implications for social and health policy are similar. The implication for sleep duration is that: “treatment” for sleep duration cannot be understood as an individual-level behavioral problem, but must instead be addressed in concert with larger-scale social factors that may be inhibiting adequate sleep in large segments of the population. When sleep duration is understood as a proxy for health, the implications extend even further. Policies and interventions that facilitate the autonomy of individuals therefore may not only help reduce individual sleep problems, but may have broader consequences for ameliorating social disparities in health.