Who Cares for Black Women in Health and Health Care

Black women are often at the center of health disparities research. Black women face sociological, psychological, environmental, and political barriers to health and health care that leave them in a persistent cycle of poor health outcomes. Black women are more likely to (1) face racism, sexism, and other forms of discrimination which are linked to stress and other mental health concerns; (2) head households both financially and in terms of care; and (3) receive lower quality healthcare. Much health disparities research calls for a more inclusive and representative health care field. Evidence in support of recruiting, retaining, and centering Black women in health and healthcare is abundant. This call for representation ranges from medical professionals to individuals engaged in research on health and healthcare. What is less central to conversations around health disparities and representation, is burnout. Specifically, who cares for the Black women who serve others? How do they manage the worries of healthcare and related disparities, while also facing the same daily stressors that put Black women’s health at risk. As scholars engage in work aimed toward diversifying STEM, hospitals, and the academy, it is vital to also grapple with the costs of this push for representation. Grappling with the costs provides an opportunity to develop trainings, recruiting strategies, and retention plans that allow Black women in health and healthcare to thrive. The collection of articles in this special collection aims to provide a platform to amplify work on the Black women who work to decrease health disparities while also navigating structural inequalities themselves. Who Cares for Black Women in Health and Health Care Black women are often at the center of health disparities research. Black women face sociological, psychological, environmental, and political barriers to health and health care that leave them in a persistent cycle of poor health outcomes. Black women are more likely to (1) face racism, sexism, and other forms of discrimination which are linked to stress and other mental health concerns; (2) head households both financially and in terms of care; and (3) receive lower quality healthcare. Much health disparities research calls for a more inclusive and representative health care field. Evidence in support of recruiting, retaining, and centering Black women in health and healthcare is abundant. What is less central to conversations around health disparities and representation, is burnout. Specifically, who cares for the Black women who serve others? How do they manage the worries of healthcare and related disparities, while also facing the same daily stressors that put Black women’s health at risk. This session will introduce the special collection, "Who Cares for Black Women in Health and Health Care", highlighting health scholarship centering Black women in healthcare and Black women in the general population. Are Characteristics Associated with Strong Black Womanhood linked to Depression in Older Black Women? Background: Older Black women experience structural and intersectional disadvantages at the intersection of age, race, and gender. Their disadvantaged social statuses can translate into serious psychological health consequences. One concept that may aid in understanding psychosocial determinants of older Black women’s depression risk is the “Strong Black Woman,” which suggests that Black women have supernatural strength amidst experiencing adversity and are expected to “be strong” for others by providing self-sacrificial aid without complaint. Objectives: Drawing inspiration from the “Strong Black Woman” concept, the current study examined whether three psychosocial factors (i.e., mastery, anger suppression, and relational demands from spouse, children, relatives, and friends) were associated with depressive symptoms, clinically significant depressive symptoms, and lifetime professionally diagnosed depression among older Black women (i.e., ages 50 years and older). Design: This was a cross-sectional study. Data were drawn from the 2010-2012 waves of the Health and Retirement Study (N = 1,217). Methods: For past-week depressive symptoms, OLS regression analyses were conducted, and beta coefficients were reported. For clinically significant depressive symptoms (i.e., reporting three or more depressive symptoms in the past week) and lifetime professionally diagnosed depression, binary logistic regression analyses were performed, and odds ratios were reported. Results: Higher levels of mastery were associated with lower risk for depressive symptoms and depression. Anger suppression was associated with higher risk for depressive symptoms and depression. Demands from children and one’s spouse were associated with higher depressive symptoms while demands from family were associated with risk for lifetime depression diagnosis. Not having a spouse was associated with heightened risk of depressive symptoms and depression. Interestingly, demands from friends were not associated with depressive symptoms nor diagnosed depression. Conclusion: Study findings revealed important nuances in the determinants of depression among older Black women which, in turn, has implications for research and mental health care provision in this population. The Strong Black Woman Stereotype and Identity Shifting among Black Women in Academic and Professional Spaces Black women, due to the ‘double jeopardy’ or stigma of being both Black and a woman, may be more prone to experiencing racism and sexism in academic and professional settings, relative to their Black male and White male and female counterparts. Few researchers have quantitatively studied how Black women in academic and professional spaces may mitigate the oppressive circumstances experienced by engaging in a coping strategy called identity shifting. This research, grounded in an intersectional framework, investigates the relationships between the Strong Black Woman (SBW) stereotype, gendered racial identity centrality (GRIC), identity shifting, and mental health outcomes (anxiety and depression) among Black women. The importance of examining the gendered racial experiences of Black women is discussed, along with the importance of addressing SBW and identity shifting in academia and professional spaces. She's always made sure that we had Black doctors, particularly women doctors if we could… and how it can sometimes be the difference between life and death.” Black Women's Reflections on Medical Racism as a Determinant of Sexual Health Historical instances of medical racism and the impact of ongoing disparities are an understudied determinant of Black women’s sexual health. Here we use a Black feminist approach to engage Black women in a qualitative exploration of the impact of medical racism on their health-related decision making. Specifically, we explore the question, how has historical medical racism impacted Black women today? This qualitative study uses Black feminist approaches to study design including advisory boards, interviewer concordance, and focus group data collection with Black female college students ages 18-25. We held virtual meetings with a student advisory board to aid in interview guide creation as well as marketing advice. We also lead seven virtual focus groups which focused on dialogue around agents of sexual socialization including knowledge of historical and ongoing medical racism. Four themes emerged from our thematic analysis. Black women reported feeling distressed by the past and ongoing travesties, they spoke to a wealth and health paradox whereby income and education did not mitigate the impact of racism on health, they expressed medical distrust and spoke on vicarious racism, and they spoke to the role of Black Americans as guinea pigs, autonomous actors, and advocates. Medical racism, whether it is experienced firsthand, vicariously or as a part of one’s history, is a source of anxiety for Black women. This barrier to care must be addressed to promote health equity in the US.