Performing Black womanhood: a qualitative study of stereotypes and the healthcare encounter

The US health system remains fraught with racial, gender, and class biases that lead to health care inequities. Although Black middle-class women are rarely studied in the context of health care disparities, they continue to face stereotyping and differential treatment. I argue that Black middle-class women are aware of pervasive stereotyping which leads them to emphasize specific class and cultural resources, i.e. cultural health capital, to mitigate discrimination. Based on in-depth interviews of 19 middle-class African-American women and two focus groups, the study explores stereotyping, bias and the use of cultural health capital as a strategy to mitigate them. Respondents overwhelmingly endorsed the importance of implementing these strategies, noting they were necessary to avoid differential treatment. The findings highlight pervasive stereotypes Black women face in health care settings and in general. Finally, the findings refocus our attention to the durability of race and gender discrimination across socioeconomic status and point to fundamental social inequities as determinants of health care disparities.