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Intersectional invisibility experiences of low-income African-American women in healthcare encounters.

Authors
  • Okoro, O N1
  • Hillman, L A2
  • Cernasev, A3
  • 1 Department of Pharmacy Practice and Pharmaceutical Sciences, College of Pharmacy, University of Minnesota, Duluth, MN, USA.
  • 2 Department of Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA.
  • 3 College of Pharmacy, University of Tennessee Health Science Center, Nashville, TN, USA.
Type
Published Article
Journal
Ethnicity & health
Publication Date
Aug 01, 2022
Volume
27
Issue
6
Pages
1290–1309
Identifiers
DOI: 10.1080/13557858.2021.1899138
PMID: 33734922
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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 intersectional invisibility 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.

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