Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Duluth, MN, USA.
Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA.
Ethn Health. 2022 Aug;27(6):1290-1309. doi: 10.1080/13557858.2021.1899138. Epub 2021 Mar 18.
The disparities that Black/African-American women experience in health care are persistent and staggering. Findings from health outcomes research continue to demonstrate poorer outcomes for African-American women compared to women of other race/ethnicity in several conditions. These racial/ethnic and gender health disparities observed are complex, heavily nuanced and multi-factorial. To understand these, there is a need to apply an 'intersectionality' lens. Intersectionality refers to the experience of persons with multiple intersecting statuses. The objective of this exploratory study was to gain insight into the healthcare experiences of low-income African-American women.
In-depth one-on-one interviews were conducted with 22 women and 2 focus group discussions with community leaders and advocates. Investigators conducted a thematic analysis of the transcripts.
The thematic analysis revealed four major themes, which tell the story of the intersectional invisibility experienced by low-income AA women in the healthcare system. These included (1) the perception of 'not feeling heard'; (2) patient as 'expert of her own body'; (3) disregard of patient preferences; and (4) the need for self-advocacy.
Black/African-American women, and particularly those with socioeconomic disadvantage, experience resulting from provider implicit bias, stereotypical assumptions, and systemic structures that enable discriminatory practices in healthcare delivery. Healthcare provider education that more explicitly addresses these biases and stereotypes should be complemented with system-level interventions that aim to dismantle the structural racism inherent in healthcare policies and practices.
非裔美国女性在医疗保健方面所经历的差异是持续存在且惊人的。健康结果研究的结果继续表明，在几种情况下，非裔美国女性的结果比其他种族/族裔的女性更差。观察到的这些种族/族裔和性别健康差异是复杂的、微妙的和多因素的。为了理解这些差异，需要应用“交叉性”视角。交叉性是指具有多种交叉地位的人的体验。本探索性研究的目的是深入了解低收入非裔美国女性的医疗保健经历。
对 22 名女性进行了一对一的深入访谈，并对社区领导和倡导者进行了 2 次焦点小组讨论。调查人员对转录本进行了主题分析。
主题分析揭示了四个主要主题，这些主题讲述了低收入非裔美国女性在医疗保健系统中经历的交叉性不可见性的故事。这些主题包括：（1）“感觉不被倾听”的看法；（2）患者是“自身身体的专家”；（3）无视患者的偏好；以及（4）自我倡导的需要。
非裔美国女性，尤其是那些社会经济地位不利的女性，由于提供者的隐性偏见、刻板印象假设以及支持医疗保健提供中歧视性做法的系统结构，经历了不平等的待遇。医疗保健提供者的教育应更明确地解决这些偏见和刻板印象，同时还应辅以系统层面的干预措施，旨在消除医疗保健政策和实践中固有的结构性种族主义。
