Skip to main content

Advertisement

Log in

“Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty

  • Published:
Race and Social Problems Aims and scope Submit manuscript

Abstract

Although racial/ethnic disparities in health have been well characterized in biomedical, public health, and social science research, the determinants of these disparities are still not well understood. Chronic psychosocial stress related specifically to the American experience of institutional and interpersonal racial discrimination may be an important determinant of these disparities, as a growing literature in separate scientific disciplines documents the adverse health effects of stress and the greater levels of stress experienced by non-white compared to white Americans. However, the empirical literature on the importance of stress for health and health disparities specifically due to racial discrimination, using population-representative data, is still small and mixed. In this paper, we explore the association between a novel measure of racially salient chronic stress—“racism-related vigilance”—and sleep difficulty. We found that, compared to the white adults in our sample, black (but not Hispanic) adults reported greater levels of vigilance. This vigilance was positively associated with sleep difficulty to similar degrees for all racial/ethnic groups in our sample (white, black, Hispanic). Black adults reported greater levels of sleep difficulty compared to white adults. This disparity was slightly attenuated after adjustment for education and income. However, this disparity was completely attenuated after adjustment for racism-related vigilance. We found similar patterns of results for Hispanic compared to white adults, however, the disparities in sleep difficulty were smaller and not statistically significant. Because of the importance of sleep quality to health, our results suggest that the anticipation of and perseveration about racial discrimination is an important determinant of racial disparities in health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Notes

  1. We draw from sociological traditions, particularly of Pearlin, Aneshensel, and others, when discussing the stress process. We conceptualize the stress process within the sociological framework with the following components: (1) social stressors, which are the “socio-environmental demands that tax or exceed the individual’s ordinary capacity to adapt and/or the absence of the means to attain sought-after ends” (Pearlin 2013); (2) stress, which refers to the “internal dysfunctions that result from these circumstances [social stressors]”; and (3) distress, which refers to the various health outcomes that result from stress. Psychosocial stress is the term used to describe psychological dysfunction with social origins. Biosocial stress is the term used to describe biological dysfunction with social origins. Stress is sometimes also called “stress response” or “strain” in the literature.

  2. Chronic stress refers to the chronic dysfunction resulting from stressors. Chronic stress may not necessarily be linked to a specific event (i.e., acute stressors), but to conditions that arise from more enduring circumstances (i.e., chronic stressors). An acute stressor may result in chronic stress is through rumination and perseveration about that stressor. In this case, the acute stressor is transformed into a chronic stressor through the rumination and perseveration (Brosschot et al. 2006; Brosschot 2010).

  3. Racism and discrimination are conceptually distinct. Racism has been defined as “a system of dominance, power, and privilege based on racial group designations … where members of the dominant group create or accept their societal privilege by maintaining structures, ideologies, values, and behaviors that have the intent or effect of leaving non-dominant-group members relatively excluded from power, esteem, status, and/or equal access to societal resources” (Harrell et al. 2011, p. 43). Racial discrimination is one by-product of racism and refers specifically to behaviors that result in the unfair treatment of one group over another based on racial designation.

  4. Although the study of sleep architecture in lab settings on small samples is relatively established, the study of sleep within large population representative samples is novel. Therefore, there is a lack of consensus on state-of-the-art survey measures of sleep quality and no clear recommendations have been made (See Knutson 2013 for example).

References

  • Adler, N. E., & Rehkopf, D. H. (2008). US disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252.

    Article  Google Scholar 

  • Akerstedt, T. (2006). Psychosocial stress and impaired sleep. Scandinavian Journal of Work, Environment & Health, 32(6), 493–501.

    Article  Google Scholar 

  • Akerstedt, T., Kecklund, G., et al. (2007). Impaired sleep after bedtime stress and worries. Biological Psychology, 76(3), 170–173.

    Article  Google Scholar 

  • Åkerstedt, T., Nordin, M., et al. (2012). Predicting changes in sleep complaints from baseline values and changes in work demands, work control, and work preoccupation–the WOLF-project. Sleep Medicine, 13(1), 73–80.

    Article  Google Scholar 

  • Ayas, N. T., White, D. P., et al. (2003a). A prospective study of self-reported sleep duration and incident diabetes in women. Diabetes Care, 26(2), 380–384.

    Article  Google Scholar 

  • Ayas, N. T., White, D. P., et al. (2003b). A prospective study of sleep duration and coronary heart disease in women. Archives of Internal Medicine, 163(2), 205.

    Article  Google Scholar 

  • Baldwin, C. M., Ervin, A.-M., et al. (2010). Sleep disturbances, quality of life, and ethnicity: the sleep heart health study. Journal of clinical sleep medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 6(2), 176.

    Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.

    Article  Google Scholar 

  • Beatty, D. L., Hall, M. H., et al. (2011). Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project. Health Psychology, 30(3), 351–359.

    Article  Google Scholar 

  • Bertrand, M., & Mullainathan, S. (2004). Are Emily and Greg more employable than Lakisha and Jamal? A field experiment on labor market discrimination. American Economic Review, 94(4), 991–1013.

    Article  Google Scholar 

  • Bonilla-Silva, E. (2010). Racism without racists: Color-blind racism and the persistence of racial inequality in America. Lanham, MD: Rowman & Littlefield.

    Google Scholar 

  • Borrell, L. N., & Kiefe C. I. et al. (2012). “Racial discrimination, racial/ethnic segregation, and health behaviors in the CARDIA study.” Ethnicity and Health. doi:10.1080/13557858.2012.713092.

  • Brissette, I. (2002). The contribution of individual differences in hostility to the associations between daily interpersonal conflict, affect, and sleep. Personality and Social Psychology Bulletin, 28(9), 1265–1274.

    Article  Google Scholar 

  • Brosschot, J. F. (2010). Markers of chronic stress: Prolonged physiological activation and (un)conscious perseverative cognition. Neuroscience and Biobehavioral Reviews, 35(1), 46–50.

    Article  Google Scholar 

  • Brosschot, J. F., Gerin, W., et al. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60(2), 113–124.

    Article  Google Scholar 

  • Brosschot, J. F., Pieper, S., et al. (2005). Expanding stress theory: Prolonged activation and perseverative cognition. Psychoneuroendocrinology, 30(10), 1043–1049.

    Article  Google Scholar 

  • Burgard, S. A., & Ailshire, J. A. (2009). Putting work to bed: Stressful experiences on the job and sleep quality. Journal of Health and Social Behavior, 50(4), 476–492.

    Article  Google Scholar 

  • Buxton, O. M., & Marcelli, E. (2010). Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States. Social Science and Medicine, 71(5), 1027–1036.

    Article  Google Scholar 

  • Cappuccio, F. P., D’Elia, L., et al. (2010a). Sleep duration and all-cause mortality: A systematic review and meta-analysis of prospective studies. Sleep, 33(5), 585–592.

    Google Scholar 

  • Cappuccio, F. P., D’Elia, L., et al. (2010b). Quantity and quality of sleep and incidence of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 33(2), 414–420.

    Article  Google Scholar 

  • Clark, R., Anderson, N. B., et al. (1999). Racism as a stressor for African Americans—a biopsychosocial model. American Psychologist, 54(10), 805–816.

    Article  Google Scholar 

  • Clark, R., Benkert, R. A., et al. (2006). Large arterial elasticity varies as a function of gender and racism-related vigilance in black youth. Journal of Adolescent Health, 39(4), 562–569.

    Article  Google Scholar 

  • Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. (2003). Unequal treatment: Confronting racial and ethnic disparities in health care (with CD). Washington, DC: The National Academies Press.

    Google Scholar 

  • Crosby, B., LeBourgeois, M. K., et al. (2005). Racial differences in reported napping and nocturnal sleep in 2-to 8-year-old children. Pediatrics, 115(Supplement 1), 225–232.

    Article  Google Scholar 

  • Davis, S. K., Liu, Y., et al. (2005). Stress-related racial discrimination and hypertension likelihood in a population-based sample of African Americans: The Metro Atlanta Heart Disease Study. Ethnicity and Disease, 15(4), 585–593.

    Google Scholar 

  • de Lange, A. H., Kompier, M. A., et al. (2009). A hard day’s night: A longitudinal study on the relationships among job demands and job control, sleep quality and fatigue. Journal of Sleep Research, 18(3), 374–383.

    Article  Google Scholar 

  • Dimsdale, J. E. (2008). Psychological stress and cardiovascular disease. Journal of the American College of Cardiology, 51(13), 1237–1246.

    Article  Google Scholar 

  • Du Bois, W. E. B., & Eaton, I. (1899). The Philadelphia Negro : A social study. Philadelphia: Published for the University.

    Google Scholar 

  • Essed, P. (1990). Everyday racism: Reports from women of two cultures. CA, Hunter House: Claremont.

    Google Scholar 

  • Feagin, J. R. (1991). The continuing significance of race—antiblack discrimination in public places. American Sociological Review, 56(1), 101–116.

    Article  Google Scholar 

  • Feagin, J. R., & Sikes, M. P. (1994). Living with racism: The black middle-class experience. Boston: Beacon Press.

    Google Scholar 

  • Fiscella, K., & Holt, K. (2008). Racial disparity in hypertension control: Tallying the death toll. The Annals of Family Medicine, 6(6), 497–502.

    Article  Google Scholar 

  • Frisbie, W. P., Song, S. E., et al. (2004). The increasing racial disparity in infant mortality: Respiratory distress syndrome and other causes. Demography, 41(4), 773–800.

    Article  Google Scholar 

  • Gainous, J. (2012). The new “new racism” thesis limited government values and race-conscious policy attitudes. Journal of Black Studies, 43(3), 251–273.

    Article  Google Scholar 

  • Galster, G. (1990). Racial steering by real estate agents: Mechanisms and motives. The Review of Black Political Economy, 19(1), 39–63.

    Article  Google Scholar 

  • Geronimus, A. T., Bound, J., et al. (1996). Excess mortality among blacks and whites in the United States. New England Journal of Medicine, 335(21), 1552–1558.

    Article  Google Scholar 

  • Geronimus, A. T., Bound, J., et al. (2001). Inequality in life expectancy, functional status, and active life expectancy across selected black and white populations in the United States. Demography, 38(2), 227–251.

    Article  Google Scholar 

  • Geronimus, A., M. T., & Hicken, et al. (2010). “Do US Black women experience stress-related accelerated biological aging?”. Human Nature, 21(1), 19–38.

    Google Scholar 

  • Hale, L., & Do, D. P. (2007). Racial differences in self-reports of sleep duration in a population-based study. Sleep, 30(9), 1096.

    Google Scholar 

  • Hall, M., Buysse, D. J., et al. (1997). Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression. Depression and Anxiety, 6(3), 106–112.

    Article  Google Scholar 

  • Hall, M., Buysse, D. J., et al. (2000). Symptoms of stress and depression as correlates of sleep in primary insomnia. Psychosomatic Medicine, 62(2), 227–230.

    Google Scholar 

  • Hall, M., Buysse, D. J., et al. (2008). Financial strain is a significant correlate of sleep continuity disturbances in late-life. Biological Psychology, 77(2), 217–222.

    Article  Google Scholar 

  • Hall, M. H., Matthews, K. A., et al. (2009). Race and financial strain are independent correlates of sleep in midlife women: The SWAN sleep study. Sleep, 32(1), 73–82.

    Google Scholar 

  • Harrell, S. P. (2000). A multidimensional conceptualization of racism-related stress: Implications for the well-being of people of color. American Journal of Orthopsychiatry, 70(1), 42–57.

    Article  Google Scholar 

  • Harrell, C. J., Burford, T. I., et al. (2011). Multiple pathways linking racism to health outcomes. Du Bois Review, 8(1), 143–157.

    Article  Google Scholar 

  • Heraclides, A., Chandola, T., et al. (2009). Psychosocial stress at work doubles the risk of type 2 diabetes in middle-aged women: Evidence from the Whitehall II study. Diabetes Care, 32(12), 2230–2235.

    Article  Google Scholar 

  • Hertz, R. P., Unger, A. N., et al. (2005). Racial disparities in hypertension prevalence, awareness, and management. Archives of Internal Medicine, 165(18), 2098–2104.

    Article  Google Scholar 

  • Hicken, M., Gragg, R., et al. (2011). How cumulative risks warrant a shift in our approach to racial health disparities: The case of lead, stress, and hypertension. Health Affairs (Millwood), 30(10), 1895–1901.

    Article  Google Scholar 

  • Hicken, M. T., & Lee, H. et al. “Racial/ethnic disparities in hypertension prevalence: Reconsidering the role of chronic stress.” American Journal of Public Health.

  • Hughes, D. (2003). Correlates of African American and Latino parents’ messages to children about ethnicity and race: A comparative study of racial socialization. American Journal of Community Psychology, 31(1), 15–33.

    Article  Google Scholar 

  • Hughes, D., & Chen, L. (1997). When and what parents tell children about race: An examination of race-related socialization among African American families. Applied Developmental Science, 1(4), 200–214.

    Article  Google Scholar 

  • Hughes, D., & DuMont, K. (1993). Using focus groups to facilitate culturally anchored research. American Journal of Community Psychology, 21(6), 775–806.

    Article  Google Scholar 

  • Jackson, P. B. (2005). Health inequalities among minority populations. Journals of Gerontology Series B-Psychological Sciences and Social Sciences, 60, 63–67.

    Article  Google Scholar 

  • Jackson, J. S., Knight, K. M., et al. (2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal of Public Health, 100(5), 933–939.

    Article  Google Scholar 

  • James, S. A. (1993). Racial and ethnic differences in infant mortality and low birth weight. A psychosocial critique. Annals of Epidemiology, 3(2), 130–136.

    Article  Google Scholar 

  • Kaplan, M. S., & Nunes, A. (2003). The psychosocial determinants of hypertension. Nutrition Metabolism and Cardiovascular Diseases, 13(1), 52–59.

    Article  Google Scholar 

  • Kessler, R. C., Mickelson, K. D., et al. (1999). The prevalence, distribution, and mental health correlates of perceived discrimination in the United States. Journal of Health and Social Behavior, 40(3), 208–230.

    Article  Google Scholar 

  • Knudsen, H. K., Ducharme, L. J., et al. (2007). Job stress and poor sleep quality: Data from an American sample of full-time workers. Social Science and Medicine, 64(10), 1997–2007.

    Article  Google Scholar 

  • Knutson, K. L. (2013). Sociodemographic and cultural determinants of sleep deficiency: Implications for cardiometabolic disease risk. Social Science and Medicine, 79, 7–15.

    Article  Google Scholar 

  • Knutson, K. L., & Van Cauter, E. (2008). Associations between sleep loss and increased risk of obesity and diabetes. Annals of the New York Academy of Sciences, 1129, 287–304.

    Article  Google Scholar 

  • Knutson, K. L., Van Cauter, E., et al. (2011). Cross-sectional associations between measures of sleep and markers of glucose metabolism among subjects with and without diabetes: The coronary artery risk development in young adults (CARDIA) sleep study. Diabetes Care, 34(5), 1171–1176.

    Article  Google Scholar 

  • Kramer, M. R., & Hogue, C. R. (2009). What causes racial disparities in very preterm birth? A biosocial perspective. Epidemiology Reviews, 31, 84–98.

    Article  Google Scholar 

  • Krieger, N. (1990). Racial and gender discrimination: Risk factors for high blood pressure? Social Science and Medicine, 30(12), 1273–1281.

    Article  Google Scholar 

  • Lewis, T. T., Troxel, W. M., et al. (2012). Chronic exposure to everyday discrimination and sleep in a multiethnic sample of middle-aged women. Health Psychology,. doi:10.1037/a0029938.

    Google Scholar 

  • Lindstrom, M. (2008). Social capital, anticipated ethnic discrimination and self-reported psychological health: A population-based study. Social Science and Medicine, 66(1), 1–13.

    Article  Google Scholar 

  • Mallon, L., Broman, J. E., et al. (2002). Sleep complaints predict coronary artery disease mortality in males: A 12-year follow-up study of a middle-aged Swedish population. Journal of Internal Medicine, 251(3), 207–216.

    Article  Google Scholar 

  • McEwen, B. S. (2003). Mood disorders and allostatic load. Biological Psychiatry, 54(3), 200–207.

    Article  Google Scholar 

  • McEwen, B. S., & Sapolsky, R. M. (1995). Stress and cognitive function. Current Opinion in Neurobiology, 5(2), 205–216.

    Article  Google Scholar 

  • McLaughlin Crabtree, V., Beal Korhonen, J., et al. (2005). Cultural influences on the bedtime behaviors of young children. Sleep Medicine, 6(4), 319–324.

    Article  Google Scholar 

  • Mensah, G. A., Mokdad, A. H., et al. (2005). State of disparities in cardiovascular health in the United States. Circulation, 111(10), 1233–1241.

    Article  Google Scholar 

  • Mezick, E. J., Matthews, K. A., et al. (2008). Influence of race and socioeconomic status on sleep: Pittsburgh SleepSCORE project. Psychosomatic Medicine, 70(4), 410–416.

    Article  Google Scholar 

  • Mezick, E. J., Matthews, K. A., et al. (2009). Intra-individual variability in sleep duration and fragmentation: Associations with stress. Psychoneuroendocrinology, 34(9), 1346–1354.

    Article  Google Scholar 

  • Milan, S., Snow, S., et al. (2007). The context of preschool children’s sleep: Racial/ethnic differences in sleep locations, routines, and concerns. Journal of Family Psychology, 21(1), 20–28.

    Article  Google Scholar 

  • Mirowsky, J., & Ross, C. E. (2003). Social causes of psychological distress. New York: Aldine de Gruyter.

    Google Scholar 

  • Mohseni, M., & Lindstrom, M. (2008). Ethnic differences in anticipated discrimination, generalised trust in other people and self-rated health: A population-based study in Sweden. Ethnicity and Health, 13(5), 417–434.

    Article  Google Scholar 

  • Morenoff, J. D., House, J. S., et al. (2007). Understanding social disparities in hypertension prevalence, awareness, treatment, and control: The role of neighborhood context. Social Science and Medicine, 65(9), 1853–1866.

    Article  Google Scholar 

  • National Center for Health Statistics. (2012). Healthy people 2010 final review. Hyattsville, MD: Centers for Disease Control and Prevention.

    Google Scholar 

  • Omi, M., & Winant, H. A. (1994). Racial formation in the United States: From the 1960s to the 1990s. Psychology Press: New York.

    Google Scholar 

  • Paradies, Y. (2006). A systematic review of empirical research on self-reported racism and health. International Journal of Epidemiology, 35(4), 888–901.

    Article  Google Scholar 

  • Patel, S. R., Ayas, N. T., et al. (2004). A prospective study of sleep duration and mortality risk in women. Sleep, 27(3), 440–444.

    Google Scholar 

  • Pearlin, L., & Bierman, A. (2013). Current issues and future directions in research into the stress process. In C. S. Aneshensel & J. C. Phelan (Eds.), Handbook of the sociology of mental health (2nd ed., pp. 325–340). New York: Springer.

    Google Scholar 

  • Phillips, B., & Mannino, D. M. (2007). Do insomnia complaints cause hypertension or cardiovascular disease? Journal of Clinical Sleep Medicine, 3(5), 489–494.

    Google Scholar 

  • Prahlad, A. (1996). African-American proverbs in context. Jackson: University Press of Mississippi.

    Google Scholar 

  • Press, Stata. (2011). STATA multiple imputation reference manual college station. TX: StataCorp.

    Google Scholar 

  • Ribet, C., & Derriennic, F. (1999). “Age, working conditions, and sleep disorders: A longitudinal analysis in the French cohort ESTEV.” Sleep: Journal of Sleep Research & Sleep Medicine, 22(4), 491–504.

    Google Scholar 

  • Rowe, M. A., McCrae, C. S., et al. (2008). Sleep pattern differences between older adult dementia caregivers and older adult noncaregivers using objective and subjective measures. Journal of Clinical Sleep Medicine, 4(4), 362–369.

    Google Scholar 

  • Rubin, D. B. (1987). Multiple imputation for nonresponse in surveys. New York: Wiley.

    Book  Google Scholar 

  • Sawyer, P. J., Major, B., et al. (2012). Discrimination and the stress response: Psychological and physiological consequences of anticipating prejudice in interethnic interactions. American Journal of Public Health, 102(5), 1020–1026.

    Article  Google Scholar 

  • Schulman, K. A., Berlin, J. A., et al. (1999). The effect of race and sex on physicians’ recommendations for cardiac catheterization. New England Journal of Medicine, 340(8), 618–626.

    Article  Google Scholar 

  • Seeman, T. E., Singer, B. H., et al. (1997). Price of adaptation–allostatic load and its health consequences. MacArthur studies of successful aging. Archives of Internal Medicine, 157(19), 2259–2268.

    Article  Google Scholar 

  • Steffen, P. R., & Bowden, M. (2006). Sleep disturbance mediates the relationship between perceived racism and depressive symptoms. Ethnicity and Disease, 16(Winter), 16–21.

    Google Scholar 

  • Sternthal, M. J., Slopen, N., et al. (2011). Racial disparities in health: How much does stress really matter? Du Bois Review, 8(01), 95–113.

    Article  Google Scholar 

  • Sue, D. W., Capodilupo, C. M., et al. (2007). Racial microaggressions in everyday life: implications for clinical practice. American Psychologist, 62(4), 271–286.

    Article  Google Scholar 

  • Surwit, R. S., Schneider, M. S., et al. (1992). Stress and diabetes mellitus. Diabetes Care, 15(10), 1413–1422.

    Article  Google Scholar 

  • Thomas, K. S., Bardwell, W. A., et al. (2006). The toll of ethnic discrimination on sleep architecture and fatigue. Health Psychology, 25(5), 635–642.

    Article  Google Scholar 

  • Tomfohr, L., Pung, M. A., et al. (2012). Racial differences in sleep architecture: The role of ethnic discrimination. Biological Psychology, 89(1), 34–38.

    Article  Google Scholar 

  • Turner, J. R. (2009). Understanding health disparities: The promise of the stress process model. In W. R. Avison (Ed.), Advances in the conceptualization of the stress process (pp. 3–21). New York: Springer.

    Chapter  Google Scholar 

  • Williams, D. R. (1997). Race and health: Basic questions, emerging directions. Annals of Epidemiology, 7(5), 322–333.

    Article  Google Scholar 

  • Williams, D. R. (1999). Race, socioeconomic status, and health. The added effects of racism and discrimination. Annals of the New York Academy of Sciences, 896, 173–188.

    Article  Google Scholar 

  • Williams, D. R., & Jackson, P. B. (2005). Social sources of racial disparities in health—Policies in societal domains, far removed from traditional health policy, can have decisive consequences for health. Health Affairs, 24(2), 325–334.

    Article  Google Scholar 

  • Williams, D. R., John, D. A., et al. (2012). Research on discrimination and health: An exploratory study of unresolved conceptual and measurement issues. American Journal of Public Health, 102(5), 975–978.

    Article  Google Scholar 

  • Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32(1), 20–47.

    Article  Google Scholar 

  • Williams, D. R., Mohammed, S., et al. (2010). Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities. Annals of the New York Academy of Sciences (The Biology of Disadvantage: Socioeconomic Status and Health), 1186, 69–101.

    Article  Google Scholar 

  • Williams, D. R., Yan, Y., et al. (1997). Racial differences in physical and mental health: Socio-economic status, stress and discrimination. Journal of Health Psychology, 2(3), 335–351.

    Article  Google Scholar 

  • Wyatt, S. B., Williams, D. R., et al. (2003). Racism and cardiovascular disease in African Americans. American Journal of the Medical Sciences, 325(6), 315–331.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Margaret T. Hicken.

Additional information

An African American proverb/saying derived from Blues Lyrics (but used widely in the African American community) to denote profound distrust, antagonism, or awareness in situations where someone might be deceived (Prahlad 1996).

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 14 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hicken, M.T., Lee, H., Ailshire, J. et al. “Every Shut Eye, Ain’t Sleep”: The Role of Racism-Related Vigilance in Racial/Ethnic Disparities in Sleep Difficulty. Race Soc Probl 5, 100–112 (2013). https://doi.org/10.1007/s12552-013-9095-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12552-013-9095-9

Keywords

Navigation