Applying a Black Feminist Framework to Explain Black Women’s Health Disparities
by Tierra Sanford
The racial stereotypes, degradation, and poverty that African Americans are often subjected to contribute to the health disparities and injustices that Black women face. These systematic oppressions often cause Black women to lead the statistics of many preventable diseases. Yet, Black women are frequently excluded from conversations regarding their own health and wellbeing. In this paper a Black feminist theoretical framework is used, providing a basis to examine problems impacting the lives of Black women. This framework supports the exploration of oppressive systems that uniquely affect Black women and the examination of the effects that such structures have on the health and well-being of Black women. Utilizing Black feminist thought is necessary because it is intersectional by nature and addresses questionable ideologies by replacing them with more inclusive thinking. This paper further looks to scholarship on covert and overt racism, polluting facilities, lack of healthy food choices, traditional gender roles, and distrust of medical care facilities to highlight the negative impact of gender and race oppression on the health of African American women.
As the United States has had a very long history of racial violence and genocide toward its African American citizens, the ethical and moral implications of such issues have often been at the forefront of socioeconomic and political debate. In contemporary American society, African Americans, and more specifically Black women, continue to experience the remnants of slavery and injustice in ways that contribute to the detriment of the health of those within these communities. In America, years of slavery and racial injustice has contributed to the illusion of Black women’s moral inferiority and subsequent perceived lack of need as compared to those within dominant groups, which allows the “continual victimization of Black women” (Willingham, 2018). The racial stereotypes, degradation, and poverty that Black women are subjected to daily contribute to the health disparities and injustices that continue to plague many Black women in America.
Using a Black Feminist Framework
It is imperative that we utilize a Black feminist framework in order to understand racially oppressive structures that have been established to reinforce the power and privilege of certain groups at the expense of women and people of color. At the same time, this framework will illustrate the detrimental impact these sources of oppression have on the health of African American women. Feminist theory, and more specifically Black feminism, focuses on the ways in which racial and class oppressions are inherently tied to gender. In American society, patriarchal institutions not only shape the ways in which Black women navigate the health care system, but they also influence how these women are able to care for their own bodies. Black feminism maintains that “social transformation of political and economic institutions” helps facilitate social justice (Collins, 1990), and thus utilizing Black feminism as a theoretical framework may benefit the discourse surrounding Black women’s health because it places an emphasis on examining the multifaceted oppressions of Black women. However, as Collins points out, “Black feminist thought is a partial perspective,” and is not intended to “proclaim its theories as the universal norm” (Collins, 1990). That is, Black feminism recognizes the unique needs of Black women and how they might be addressed.
A Black feminist perspective acknowledges the role that intersectionality, “the recognition that power, privilege, and oppression flow in multiple directions,” plays in the health disparities that Black women face (García, 2016). Providing an intersectional approach implies that “we understand all of these causes as interlocking pieces of a structure of domination that must be dismantled” (Kolmar and Bartkowski, 2010). The intersectional nature of a Black feminist perspective provides exactly the sort of methodology necessary to deconstruct patriarchal norms and address the specific concerns of Black women in order to reject notions of Black inferiority perpetuated by oppressive societal ideologies.
From a Black feminist perspective, it is apparent that Black women are not only oppressed as women, but also on the basis of race and even class, as well. These systematic oppressions serve as obstacles that not only hinder the growth and development of Black women to some extent, but also contribute to Black women leading the statistics of many preventable diseases in America. According to research conducted by the American Cancer society, African Americans are disproportionately affected by cancer. The study notes that “the death rate for all cancers combined was […] 14% higher in Black women […] than in White women,” and that “racial disparities for some cancers (e.g., breast) are increasing” (American Cancer Society, 2014). Not only are there disparities in cancer rates, but “Blacks bear a disproportionately high burden of other diseases,” and as a result of this, African Americans are expected to have shorter life-spans (2014).
The racism and sexism that Black women experience in their daily lives directly contribute to the detriment of their mental as well as physical health. According to psychologists at the University of Tennessee who used an intersectional framework to study the dynamics of racism and health, “gendered racial micro-aggressions significantly predicted both self-reported mental and physical health outcomes” of Black women who participated in the study (Lewis, 2017). The study even suggests that these offenses against Black women decrease heart health and immune system function (2017). These findings can be applied to the lives and experiences of many Black women since often they are the targets of racial and gendered aggression and hate, both online and in the real world. These threats are often experienced when Black women either speak out against discrimination that they themselves face or when calling attention to the injustices experienced by those within the specific groups to which they belong (e.g., groups based on race, class, gender, etc.).
Black women are also subjected to harassment, sexual assault, and domestic violence from males, often at higher rates than White women. According to the Women of Color Network: Facts and Statistics Collection, “African American women experience higher rates of intimate partner homicide when compared to their White counterparts” (Women of Color, 2006). The publication also notes that there are historical implications such as racism, prejudice, and “African American men’s vulnerability to police brutality,” which might render Black women “less likely to report abuse” (2006). According to Kimberle Crenshaw in Intersectionality and Identity Politics: Learning from Violence against Women of Color, the institution of racism also perpetuates the violence that Black women endure as a result of “the stress that men of color experience in dominant society” (Crenshaw, 1997). Because of the stress and perceived powerlessness that racism and discrimination may cause, domestic violence may perhaps act as a way for Black men to assert some form of dominance and control. In turn, such violence can increase the amount of stress among Black women. Such stressors due to direct gendered and racialized oppressions often lead to the degradation of the psychological as well as physical well-being of Black women.
Beyond explicit experience with racism and sexism, Black women are also subjected to indirect, systematic oppression, which further contributes to negative health effects. This is specifically apparent within Black communities in which Black women and children comprise the majority. According to a study published in the New York Times, “There are 1.5 million fewer prime age Black men (25 to 54) living in their communities than Black women” in areas with high concentrations of African Americans because of “higher incarceration rates and higher mortality rates for Black men than for any other large demographic group” (Wolfers, 2015). Often, these neighborhoods suffer from higher rates of pollution as a result of municipal and industrial facilities placed in close proximity.
In Melanie Harris’s Ecowomanism: Black Women, Religion, and the Environment, she recognizes that Black feminist perspectives help to address “cases of environmental injustice by looking at the aspects of how racial discrimination, gender bias, or economic privileging may result in the unfair plotting of landfill facilities or the deliberate targeting of minority and low-income communities … [as] repositories for hazardous waste sites” (Harris, 2016). This might also be one of the causes of higher rates of breast cancer and other diseases among Black women and women of color. Often, studies involving the effects of environmental degradation neglect to consider race as a major determining factor of those who are affected by pollution. A study which surveyed residents on the air quality in Chicago demonstrated that a number of their respondents believe that there are no issues with air quality and pollution within marginalized communities (King, 2015). According to this study, those who took this survey “share a cultural bias that minorities cause social dysfunction, leading to over-reports of dysfunction in minority communities” (2015). This demonstrates the denial of the issues that those within marginalized groups face as well as the victim-blaming that they are often subjected to in terms of environmental pollution. In cases such as this, negative associations with people of color are revealed, which might provide an explanation for the prevalence of these polluting facilities within marginalized communities. If there is a generalized distrust of minorities, “who stand outside the circle of this society’s definition of acceptable” (Lorde, 1979), then their needs may be less likely to be met and their lives may be more likely to be taken for granted.
Ascribed negativity may be one of two reasons why the owners of such facilities, which are often maintained by the government and wealthy White men, target poor communities of color and Black neighborhoods. The second—and more significant factor—is that these communities are often powerless, possessing neither the funds nor the resources to prevent these facilities from being constructed near their neighborhoods. According to Environmental Health and Racial Justice in the United States, “poverty impacts health because it determines how many resources poor people have and defines the amount of environmental risks they will be exposed to in their immediate environment” (Bullard, et. al 2011). The publication notes that “race and ethnicity map closely with the geography of environmental and health risks” (2011). Again, this disregard for and rejection of the experiences of African Americans finds its foundations in the historically repressive aspects of American society. Even the environment is subject to the lingering influences of racism and discrimination, and in turn, negatively impacts the health of Black women.
While detrimental infrastructures are often constructed within Black communities, these neighborhoods also usually lack significant access to certain facilities. The most common example of this is a reduced presence of grocery stores and farmers markets that provide healthy and/or organic options from a variety of food groups. Typically, poor communities of color are situated within food deserts, which according to Angela Harmon’s entry in the Salem Press Encyclopedia of Science, is an area lacking “a supply of healthy foods” that is “within a convenient traveling distance” (Harmon, 2017). A study in the American Journal of Public Health also notes that “poorer areas and non-White areas also tended to have fewer fruit and vegetable markets” (Moore, 2006). Many people in poor Black communities are denied access to healthier options while, at the same time, being flooded with unhealthy alternatives. When traveling through low-income Black neighborhoods, this becomes apparent; usually, dollar stores, convenience stores, and liquor stores are liberally distributed throughout these areas. A study in the Journal of Studies on Alcohol and Drugs compiled data on businesses as well as demographics from the US Census and revealed that African Americans and other people of color “faced higher densities of liquor stores than Whites” (Romley, et. al 2007).
In addition to readily accessible alcohol, these communities have access to unhealthy foods that are high in sugars and fats but low in essential vitamins and minerals. Consumption of such foods over time has caused disparities in health among members of these communities, such as higher rates of heart disease, diabetes, and obesity. A study on Black women’s dietary habits published in the Journal of Obesity found, “Black women in the Deep South experience excess morbidity/mortality from obesity-related diseases, which may be partially attributable to poor diet” (Carson, et. al, 2015). The study also states that “one reason for poor dietary intake” could be the increased levels of stress that Black women tend to be subjected to (2015). Since the burden of preparing meals and feeding the family is often placed upon female family members, a lack of healthful food options disproportionately affects Black women. That is, they are often held responsible for any ills that befall themselves and their families as a result of serving such foods.
Along with a lack of fresh food, traditional gender roles may also take their toll on Black women’s health. Many Black women continue to be primary caretakers in the home, and some must act as both caretaker and provider while even struggling with poverty. Crenshaw notes that this is “largely the consequence of gender and class oppression” which are then amplified through “racially discriminatory employment and housing practices” (Crenshaw, 1997). These aspects of Black women’s lives play into notions of the strong and independent Black woman stereotype that is often perpetuated by the media and sometimes even by Black women themselves. Often, Black women endorse this stereotype because it “provid[es] Black women protection against the numerous stressors they must contend with daily” (Donovan, 2015).
There is nothing inherently wrong with possessing such qualities, but maintaining such limiting ideas of Black womanhood puts an undue amount of stress on Black women to try to preserve this exterior appearance so as not to appear weak or in need of too much assistance. As noted in Race, Gender, and Career: A Critical Look at Marriage and Motherhood among Black Professional Women, “Black career women strive to combine their familial obligations and professional work lives” and “simultaneously [navigate] the stereotype of the strong Black superwoman who can do it all” (Eshun and Boburka, 2016), which has been shown to have a direct correlation with “stress and depressive symptoms” in Black women (Donovan, 2015). With all of these responsibilities to contend with, some Black women may not take the time to consider their health or indulge in self-care. Their own health issues may rank lower on their list of priorities compared to caring for other members of their families.
Beyond the low priority placed on their own health, a general distrust of the American healthcare system may discourage Black women from visiting the doctor. In the past, numerous unethical research studies and medical experiments have been conducted on African Americans. Historically, Black women have experienced health and reproductive injustices such as “sterilization abuse” in which poor women and women of color were sterilized “with the full financial support of the government” during eugenics campaigns that occurred throughout the country (Davis, 1991). Such occurrences contribute to misgivings about doctors among African Americans. In the 20th century, a fundamental component of the Black Panther Party’s agenda was “improving the health-care delivery for inner-city blacks who suffered from both inadequate and racist health-care facilities and delivery”(Michael, 2015), and In Eliminating Racial Discrimination in Healthcare: A Call for State Healthcare Anti-Discrimination Law, lawyer Randall Vernellia confirms the ongoing “racial disparity in health status, institutional racism in healthcare, and inadequate legal protection” experienced by Black Americans within the health care system (Randall, 2007). Again, the effects of racism, sexism, and discrimination all contribute to skepticism of and refusal to utilize the healthcare system, which ultimately leads to detrimental health effects and late detection of illnesses.
We exist within a culture which justifies racism, sexism, classism, and other forms of discrimination through the subjugation of Black women and other people of color. It has been noted that these infractions against Black women lead to the degradation of their mental and physical health and reduce their ability to be equitable participants in society, while contributing to the system of beliefs that benefit those within dominant patriarchal culture. In order to create social change, there must be a paradigm shift that not only takes into account the interconnected systems of oppression that Black women and other women of color face, but also one that acknowledges their worth as people first.
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Acknowledgments: I would like to express my appreciation for the women in my life who motivate me to make their experiences known and to the UGA Women’s Studies Department, which has given me the courage to do so.
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