Abstract
Purpose: Black women in the United States face poor outcomes across reproductive health measures—from pregnancy outcomes to gynecologic cancers. Racial health inequities are attributable to systemic racism, but few population studies of reproductive health outcomes integrate upstream measures of systemic racism, and those who do are limited to maternal and infant health outcomes. Advances in understanding and intervening on the pathway from racism to reproductive health outcomes are limited by a paucity of methodological guidance toward this end. We aim to fill this gap by identifying quantitative measures of systemic racism that are salient across reproductive health outcomes.Methods: We conducted a review of literature from 2000 to 2019 to identify studies that use quantitative measures of exposure to systemic racism in population reproductive health studies. We analyzed the catalog of literature to identify cohesive domains and measures that integrate data across domains. For each domain, we contextualize its use within population health research, describe metrics currently in use, and present opportunities for their application to reproductive health research.Results: We identified four domains of systemic racism that may affect reproductive health outcomes: (1) civil rights laws and legal racial discrimination, (2) residential segregation and housing discrimination, (3) police violence, and (4) mass incarceration. Multiple quantitative measures are available for each domain. In addition, a multidimensional measure exists and additional domains of systemic racism are salient for future development into distinct measures.Conclusion: There are quantitative measures of systemic racism available for incorporation into population studies of reproductive health that investigate hypotheses, including and beyond those related to maternal and infant health. There are also promising areas for future measure development, such as the child welfare system and intersectionality. Incorporating such measures is critical for appropriate assessment of and intervention in racial inequities in reproductive health outcomes.
Highlights
Black women in the United States face poor outcomes across most domains of reproductive health—from sexually transmitted disease to pregnancy to gynecologic cancers.[1]
The 1964 U.S Civil Rights Act (CRA) and other civil rights laws have changed the context in which racism operates, including by increasing access to resources.[21,26]
Any U.S.-born Black person 56 years of age and older in 2020 lived with Jim Crow laws, which mandated segregation of health care facilities, restricted access to health care, and provided federal funding of eugenics programs, which included coercive reproductive health procedures. Immigration policy is another form of legal racial discrimination that carries out systemic racism by prohibiting access to citizenship and associated rewards to groups considered nonWhite
Summary
Black women in the United States face poor outcomes across most domains of reproductive health—from sexually transmitted disease to pregnancy to gynecologic cancers.[1] Rigorous investigation of racial health inequities requires an analysis of racism,[2,3,4] which is well recognized as a fundamental cause and social determinant of racial health inequities.[3,5,6,7,8] Racism has adversely affected. Black women’s health since the enslavement of African people in North America.[9,10] Black women have been advocating for autonomy, dignity, and rights in reproductive health for as long.[11] Thanks to this long-standing labor, the clinical reproductive health field recognizes the role of racism as a structural determinant of health.[12]. While racism manifests at the institutional, interpersonal, and internalized levels,[2] systemic racism refers to the totality of constantly reconstituting and reinforcing social and political systems and their policies, practices, and ideologies that engender inequities.[4,5]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.