Black Women's Perspectives on Structural Racism across the Reproductive Lifespan: A Conceptual Framework for Measurement Development
Black Women's Perspectives on Structural Racism across the Reproductive Lifespan: A Conceptual Framework for Measurement Development
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DOI：
10.1007/s10995-020-03074-3
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发表时间：
2021-01-04
影响因子：
2.3
通讯作者：
McLemore, Monica R.
中科院分区：
文献类型：
--
作者：
Chambers, Brittany D.;Arega, Helen A.;McLemore, Monica R.
背景暴露于结构性种族主义已被确定为黑人妇女母婴健康不良后果的主要风险因素之一；然而，目前的结构性种族主义措施并没有完全解释黑人和白人妇女和婴儿之间的不良孕产妇和婴儿健康结局中出现的不平等现象。对此，这项研究的目的是从黑人妇女整个生殖寿命的角度对结构性种族主义及其对产妇和婴儿健康不良后果的潜在影响进行概念化。方法我们对32名黑人妇女进行了一系列的焦点小组调查，这些妇女的生育期跨度不同(5名怀孕前、13名怀孕和14名产后)。研究标准包括自我认同为黑人，居住在奥克兰或加利福尼亚州弗雷斯诺，代表三种生殖生活轨迹之一(怀孕前、怀孕、产后)。我们咨询了研究参与者和一个专家咨询委员会，以验证结构性种族主义的新领域。结果通过一个基本理论的持续比较分析，得出了结构性种族主义的九个领域：消极的社会观点；住房；医疗保健；执法；隐藏的资源；就业；教育、社区基础设施和维持黑人家庭的治安。这项研究得出的实践结论表明，结构性种族主义与健康的社会和结构性决定因素之间存在相互作用，这对黑人妇女的性健康和生殖健康产生了负面影响。此外，这项研究的结果可用于制定更全面的医疗评估和政策，以解决黑人妇女在生育期间经历的结构性种族主义问题。
Background Exposures to structural racism has been identified as one of the leading risk factors for adverse maternal and infant health outcomes among Black women; yet current measures of structural racism do not fully account for inequities seen in adverse maternal and infant health outcomes between Black and white women and infants. In response, the purpose of this study was to conceptualize structural racism from the perspectives of Black women across the reproductive lifespan and its potential impact on adverse maternal and infant health outcomes. Methods We conducted a series of focus groups with 32 Black women across the reproductive lifespan (5 preconception, 13 pregnant, and 14 postpartum). Study criteria including self-identifying as Black, residing in Oakland or Fresno, California and representing one of three reproductive life tracks (preconception, pregnant, postpartum). We consulted with study participants and an expert advisory board to validate emergent domains of structural racism. Results Nine domains of structural racism emerged from a ground theory constant comparative analysis: Negative Societal Views; Housing; Medical Care; Law Enforcement; Hidden Resources; Employment; Education, Community Infrastructure; and Policing Black Families. Conclusions for Practice Findings from this study suggest that there is an interplay among structural racism, and social and structural determinants of health which has negative impacts on Black women's sexual and reproductive health. Furthermore, findings from this study can be used to develop more comprehensive medical assessments and policies to address structural racism experienced by Black women across the reproductive lifespan.