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Brünig L, Kahrass H, Salloch S. The concept of intersectionality in bioethics: a systematic review. BMC Med Ethics 2024; 25:64. [PMID: 38783289 PMCID: PMC11112950 DOI: 10.1186/s12910-024-01057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Intersectionality is a concept that originated in Black feminist movements in the US-American context of the 1970s and 1980s, particularly in the work of feminist scholar and lawyer Kimberlé W. Crenshaw. Intersectional approaches aim to highlight the interconnectedness of gender and sexuality with other social categories, such as race, class, age, and ability to look at how individuals are discriminated against and privileged in institutions and societal power structures. Intersectionality is a "traveling concept", which also made its way into bioethical research. METHODS We conducted a systematic review to answer the question of where and how the concept of intersectionality is applied in bioethical research. The PubMed and Web of Science databases were systematically searched and 192 articles addressing bioethical topics and intersectionality were finally included. RESULTS The qualitative analysis resulted in a category system with five main categories: (1) application purpose and function, (2) social dimensions, (3) levels, (4) health-care disciplines and academic fields, and (5) challenges, limitations, and critique. The variety of academic fields and health-care disciplines working with the concept ranges from psychology, through gynaecology to palliative care and deaf studies. Important functions that the concept of intersectionality fulfils in bioethical research are making inequities visible, creating better health data collections and embracing self-reflection. Intersectionality is also a critical praxis and fits neatly into the overarching goal of bioethics to work toward social justice in health care. Intersectionality aims at making research results relevant for respective communities and patients, and informs the development of policies. CONCLUSIONS This systematic review is, to the best of our knowledge, the first one to provide a full overview of the reference to intersectionality in bioethical scholarship. It creates a basis for future research that applies intersectionality as a theoretical and methodical tool for analysing bioethical questions.
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Affiliation(s)
- Lisa Brünig
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl- Neuberg-Str.1, 30625, Hannover, Germany.
| | - Hannes Kahrass
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl- Neuberg-Str.1, 30625, Hannover, Germany
| | - Sabine Salloch
- Institute for Ethics, History and Philosophy of Medicine, Hannover Medical School, Carl- Neuberg-Str.1, 30625, Hannover, Germany
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Erving CL, McKinnon II, Van Dyke ME, Murden R, Udaipuria S, Vaccarino V, Moore RH, Booker B, Lewis TT. Superwoman Schema and self-rated health in black women: Is socioeconomic status a moderator? Soc Sci Med 2024; 340:116445. [PMID: 38043442 PMCID: PMC10959495 DOI: 10.1016/j.socscimed.2023.116445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 10/12/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The Superwoman Schema (SWS) construct elucidates Black women's socialization to be strong, suppress their emotions, resist vulnerability, succeed despite limited resources, and help others at their own expense. Drawing from intersectionality and social psychological research on self-schemas, this study examined the extent to which SWS was associated with Black women's self-rated health. We also investigated whether socioeconomic status (SES) moderated the association between SWS, its five dimensions, and self-rated health. METHODS Data were from the Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women's Health Study, a cohort of African American self-identified women. SWS was assessed using Giscombé's 35-item Superwoman Schema Scale. Socioeconomic status was measured by household income and educational attainment. Ordered logistic regression models were used and statistical interactions were run to test for moderation (N = 408). RESULTS First, SWS dimension "obligation to help others" was associated with worse self-rated health (p < .05). Second, household income, but not education, moderated the association between SWS and self-rated health (p < .05): SWS overall was associated with worse self-rated health among higher income women but better self-rated health among lower income women. Third, income moderated the association between SWS dimension "obligation to present an image of strength" and self-rated health (p < .05): presenting strength was associated with better self-rated health for lower income women only. Fourth, moderation results revealed that SWS dimension "obligation to help others" was inversely associated with self-rated health particularly among higher income women. CONCLUSIONS Findings speak to the complex interplay between SES and SWS dimensions as they relate to Black women's perceived health.
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Affiliation(s)
- Christy L Erving
- The University of Texas at Austin, College of Liberal Arts, Department of Sociology, Population Research Center, USA.
| | - Izraelle I McKinnon
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Miriam E Van Dyke
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Raphiel Murden
- Emory University, Rollins School of Public Health, Biostatistics and Bioinformatics Department, USA
| | - Shivika Udaipuria
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Viola Vaccarino
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Reneé H Moore
- Drexel University, Dornsife School of Public Health, Department of Epidemiology and Biostatistics, USA
| | - Bianca Booker
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
| | - Tené T Lewis
- Emory University, Rollins School of Public Health, Department of Epidemiology, USA
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Mendenhall R, Lee MJ, Cole SW, Morrow R, Rodriguez-Zas SL, Henderson L, Turi KN, Greenlee A. Black Mothers in Racially Segregated Neighborhoods Embodying Structural Violence: PTSD and Depressive Symptoms on the South Side of Chicago. J Racial Ethn Health Disparities 2023; 10:2513-2527. [PMID: 36715821 PMCID: PMC9885931 DOI: 10.1007/s40615-022-01432-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 01/31/2023]
Abstract
This study employs multi-level and mixed-methods approaches to examine how structural violence affects the health of low-income, single Black mothers. We use multilevel regression models to examine how feeling "trapped" in racially segregated neighborhoods with high levels of violence on the South Side of Chicago affects mothers' (N = 69) reports of posttraumatic stress disorder and depressive symptoms. The relationship between feeling "trapped" and variations in expression of mRNA for the glucocorticoid receptor gene NR3C1 using microarray assays was also examined. The regression models revealed that feeling "trapped" significantly predicted increased mental distress in the form of PTSD, depressive symptoms, and glucocorticoid receptor gene regulation. The mothers' voices revealed a nuanced understanding about how a lack of financial resources to move out of the neighborhood creates feelings of being "trapped" in dangerous situations.
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Affiliation(s)
- Ruby Mendenhall
- Department of African American Studies, Carle Illinois College of Medicine, 702 S. Wright Ave, Urbana, IL 61822 USA
- Department of Sociology, University of Illinois, Urbana-Champaign, 702 South Wright St, Champaign, IL 61820 USA
| | - Meggan J. Lee
- Department of Sociology, University of Illinois, Urbana-Champaign, 702 South Wright St, Champaign, IL 61820 USA
| | - Steven W. Cole
- Department of Psychiatry & Biobehavioral Sciences and Medicine, UCLA School of Medicine, 11-934 Factor Building, Los Angeles, CA 90095 USA
| | - Rebecca Morrow
- Department of Criminal Justice, Tarleton State University, 1333 Washington Street, Stephenville, TX T-0665 USA
| | - Sandra L. Rodriguez-Zas
- Department of Animal Sciences, University of Illinois, Urbana-Champaign, 306 Animal Sciences Laboratory, 1207 W. Gregory Dr., Urbana, IL 61801 USA
| | - Loren Henderson
- School of Public Policy, University of Maryland, Baltimore County, Public Policy Building, Fourth Floor, 1000 Hilltop Circle, Baltimore, MD 21250 USA
| | - Kedir N. Turi
- Center for Asthma Research, Vanderbilt University School of Medicine, 1215 21ts Ave South, 6000 Medical Center East, North Tower, Nashville, TN 37232 USA
| | - Andrew Greenlee
- Department of Urban and Regional Planning, University of Illinois, Urbana-Champaign 611 Taft Drive, Champaign, IL 61820 USA
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4
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Perez-Brumer A, Salazar X, Nunez-Curto A, D'Amico L, Aguayo-Romero R, Reisner SL, Silva-Santisteban A. Intersectional stigma and the arc of intranational migration: experiences of transgender adolescents and women who migrate within Peru. BMC Public Health 2023; 23:1202. [PMID: 37344828 DOI: 10.1186/s12889-023-15985-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 05/25/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Migration is recognized as a key determinant of health. Yet, limited research addresses the arc of intranational migration and, even less, the experiences of transgender (trans) adolescents and women migrants and the associated health vulnerabilities. Using intersectional stigma as a theoretical frame, this study seeks to better understand the sexual health vulnerabilities and needs of trans women migrants in Peru. METHODS Between October and November 2016, in-depth interviews (n = 14) and two focus groups (n = 20) were conducted in Spanish with trans women in three Peruvian cities. To explore pre- and during migration experiences, focus groups were conducted in Pucallpa and Iquitos, key cities in the Amazon where trajectories often originate. To assess during migration and post-migration experiences, we conducted interviews in Pucallpa, Iquitos, and Lima to better understand processes of relocation. Audio files were transcribed verbatim and analysed via an immersion crystallization approach, an inductive and iterative process, using Dedoose (v.6.1.18). RESULTS Participants described migration as an arc and, thus, results are presented in three phases: pre-migration; during migration; and post-migration. Intersectional stigma was identified as a transversal theme throughout the three stages of migration. The pre-migration stage was characterized by poverty, transphobia, and violence frequently motivating the decision to migrate to a larger city. Exploitation was also described as pervasive during migration and in relocation. Many participants spoke of their introduction to sex work during migration, as key to economic earning and associated violence (police, clients). CONCLUSION Findings advance understandings of intranational migration and forced displacement as key determinants of trans women's health. Dimensions of violence at the intersection of classism and cisgenderism render trans women highly vulnerable at every step of their migratory journeys. Experiences of intranational mobility and relocation were described as uniquely tied to age, intersectional transphobic stigma, engagement in sex work, and multiple forms of violence, which impact and can magnify sexual health vulnerabilities for transgender women in Peru who migrated intranationally.
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Affiliation(s)
- Amaya Perez-Brumer
- Division of Social and Behavioural Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Ximena Salazar
- Center for Interdisciplinary Research in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Aron Nunez-Curto
- Center for Interdisciplinary Research in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Rodrigo Aguayo-Romero
- Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Sari L Reisner
- Brigham and Women's Hospital, Boston, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Alfonso Silva-Santisteban
- Center for Interdisciplinary Research in Sexuality, AIDS and Society, Universidad Peruana Cayetano Heredia, Lima, Peru
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Erving CL, Zajdel R, McKinnon II, Van Dyke ME, Murden RJ, Johnson DA, Moore RH, Lewis TT. Gendered Racial Microaggressions and Black Women's Sleep Health. SOCIAL PSYCHOLOGY QUARTERLY 2023; 86:107-129. [PMID: 38371316 PMCID: PMC10869115 DOI: 10.1177/01902725221136139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
Gendered racial microaggressions reflect historical and contemporary gendered racism that Black women encounter. Although gendered racial microaggressions are related to psychological outcomes, it is unclear if such experiences are related to sleep health. Moreover, the health effects of gendered racial microaggressions dimensions are rarely investigated. Using a cohort of Black women (N = 400), this study employs an intracategorical intersectional approach to (1) investigate the association between gendered racial microaggressions and sleep health, (2) assess whether gendered racial microaggressions dimensions are related to sleep health, and (3) examine whether the gendered racial microaggressions-sleep health association persists after accounting for depressive symptoms and worry. Gendered racial microaggressions were associated with poor sleep quality overall and four specific domains: subjective sleep quality, latency, disturbance, and daytime sleepiness. Two gendered racial microaggressions dimensions were especially detrimental for sleep: assumptions of beauty/sexual objectification and feeling silenced and marginalized. After accounting for mental health, the effect of gendered racial microaggressions on sleep was reduced by 47 percent. Future research implications are discussed.
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Affiliation(s)
| | - Rachel Zajdel
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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Kuhlemeier A. Measurement Invariance of Psychological Distress, Substance Use, and Adult Social Support across Race/Ethnicity and Sex among Sexual Minority Youth. JOURNAL OF SEX RESEARCH 2023; 60:674-688. [PMID: 35200066 PMCID: PMC9399311 DOI: 10.1080/00224499.2022.2038059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Research on intersectional differences among sexual minority youth (SMY) relies on population-level datasets to ensure sufficiently large samples to explore between-group differences and assess the influence of axes of oppression/privilege. I argue that a structural equation modeling framework for investigating intersectional differences among SMY increases the nuance with which we understand heterogeneity and provides tools for ensuring that variables measure comparable constructs across diverse populations - an assumption of traditional univariate methods that is rarely empirically verified. Using a subset of SMY that identified as either White or Hispanic/Latino and male or female from the New Mexico Youth Risk and Resiliency Survey (N = 3,654), this study tested invariance of three latent constructs: psychological distress, substance use, and adult support across sexual orientation, race/ethnicity, sex, and three-way intersections of those identities. Analyses established invariance across race/ethnicity and sex of all constructs among gay/lesbian youth. Partial invariance models were required to account for intersectional differences in substance use among bisexual youth and in psychological distress among questioning youth. This study models a novel strategy for examining how social location at the intersection of multiple axes of oppression/privilege shape behavioral health and social support and paves the way for significant advances in research on SMY.
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Affiliation(s)
- Alena Kuhlemeier
- Center on Alcohol, Substance Use, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM 87131
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7
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Bletscher C, Spiers S. "Step by Step We Were Okay Now": An Exploration of the Impact of Social Connectedness on the Well-Being of Congolese and Iraqi Refugee Women Resettled in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5324. [PMID: 37047940 PMCID: PMC10094254 DOI: 10.3390/ijerph20075324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
Little is known about the gendered impacts of the displacement and resettlement process. Women are known to struggle more with feelings of belonging and the creation of social networks to access essential information, resources, and social and emotional support to enhance their overall health and well-being. The purpose of the present study was to qualitatively explore female refugee perceptions of belongingness and social connectedness post-resettlement into their U.S. host community. Conducted between January and June of 2016, through the partnership of multiple governmental, nonprofit, and community-based organizations, two female focus groups were conducted among Congolese (n = 6) and Iraqi (n = 6) U.S. resettled refugees. Descriptive surveys were distributed to participants, providing valuable insights into participant demographics and indicators that could impact the integration process (i.e., age, language, country of origin, ethnicity, education, length of time spent in the U.S., housing). Participants discussed the social connections (individuals, communities, organizations) that acted as facilitators or inhibitors of developing social capital. The importance of building strong transformational bonding (family members, other refugees) and bridging (host community) relationships, alongside transactional ties with linking agencies (resettlement social services), was critical for a positive resettlement experience. The strength of their network ties among these social connections contributed to their perceptions of belongingness and well-being post-resettlement into their host community.
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Riley T, Zia Y, Samari G, Sharif MZ. Abortion Criminalization: A Public Health Crisis Rooted in White Supremacy. Am J Public Health 2022; 112:1662-1667. [PMID: 36223577 PMCID: PMC9558193 DOI: 10.2105/ajph.2022.307014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The Supreme Court decision to overturn Roe v. Wade and the growing onslaught of state laws that criminalize abortion are part of a long history of maintaining White supremacy through reproductive control of Black and socially marginalized lives. As public health continues to recognize structural racism as a public health crisis and advances its measurement, it is imperative to explicate the connection between abortion criminalization and White supremacy. In this essay, we highlight how antiabortion policies uphold White supremacy and offer concrete strategies for addressing abortion criminalization in structural racism measures and public health research and practice. (Am J Public Health. 2022;112(11):1662-1667. https://doi.org/10.2105/AJPH.2022.307014).
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Affiliation(s)
- Taylor Riley
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Yasaman Zia
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Goleen Samari
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Mienah Z Sharif
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
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Leath S, Butler-Barnes S, Haynes-Thoby L. "They Just Keep Coming": A Study of How Anti-Black Racial Violence Informs Racial Grief and Resistance Among Black Mothers. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:3450-3467. [PMID: 36105272 PMCID: PMC9461437 DOI: 10.1007/s10826-022-02421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Scholars have begun to address how exposure to vicarious racial violence influences stress and coping processes among Black families in the U.S. Yet, fewer scholars have considered the importance of racial grief as a component of the coping process. The current study drew upon semi-structured interview data from 31 Black mothers in the U.S. (25-52 years; M age = 35 years) to explore how mothers processed and responded to vicarious anti-Black racial violence. We used consensual qualitative research methods and identified the following themes: (a) recognizing the endemic nature of racial violence, (b) feeling frozen in fear after a new case of racial violence, and (c) transforming grief into grievance as a route to racial justice. The findings contextualize Black mothers' concerns about the racial violence that they and their children might experience during their lifetime, and how they channel this grief into actionable change against racial injustice. Authors discuss strengths-based ways to frame the role of grief and loss in the context of racism.
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Affiliation(s)
- Seanna Leath
- Psychological and Brain Sciences Department, Washington University in St. Louis, St. Louis, MO USA
| | - Sheretta Butler-Barnes
- School of Social Work, Brown School, Washington University in St. Louis, St. Louis, MO USA
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10
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Quinn KG. The relationship between syndemics and intersectionality: A response to the commentary by Sangaramoorthy and Benton. Soc Sci Med 2022; 295:113784. [PMID: 33678479 PMCID: PMC8410884 DOI: 10.1016/j.socscimed.2021.113784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 02/03/2023]
Affiliation(s)
- Katherine G Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit, Milwaukee, WI, 53202, USA.
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Jason K, Erving CL. The Intersecting Consequences of Race-Gender Health Disparities on Workforce Engagement for Older Workers: An Examination of Physical and Mental Health. SOCIAL CURRENTS 2022; 9:45-69. [PMID: 36199976 PMCID: PMC9531847 DOI: 10.1177/23294965211053835] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The dramatic growth of older adults' labor participation over the past 25 years, including women and people of color, is reshaping the American labor force. The current study contributes new knowledge concerning why individuals over age 50 years may be working longer despite negative impacts of deteriorating physical and mental health associated with aging. Inquiries regarding who continues to work and why can be answered, in part, by addressing how workforce engagement and health are shaped by notable social inequities along the dimensions of age, race, and gender. Guided by cumulative advantage/disadvantage and intersectionality frameworks, we examine whether having multiple chronic conditions (MCC)-two or more physical conditions-and depression affect workforce participation. Using multinomial logistic regression models, we analyze the 2014-2016 waves of the Health and Retirement Study (N = 4250). Findings reveal that having multiple chronic illnesses increase the likelihood of labor force exit, especially among workers who also have depression. We also discover intersectional nuances which illuminate complex race-gender dynamics related to health and work processes in later life. We conclude with recommendations for workplace policy that promote the retention of older workers with chronic illness and depression and aim to decrease disparities in older workers' work engagement.
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Affiliation(s)
- Kendra Jason
- Department of Sociology, University of North Carolina at Charlotte, Charlotte, NC, USA
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12
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Chard S, Henderson L, Wallace BH, Roth EG, Eckert JK. 'How I Can Help Me': Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes. THE GERONTOLOGIST 2021; 62:751-761. [PMID: 34698832 DOI: 10.1093/geront/gnab157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disparities in Type 2 diabetes mellitus (diabetes) represent an ongoing public health challenge. Black older adults are at high risk of diabetes and diabetes' complications. Diet, physical activity, and medication can control these risks, yet disease rates remain elevated. Utilizing an Intersectionality framework, we seek to extend understanding of the social dimensions of diabetes through an examination of the diabetes self-care process from the perspective of Black older adults. RESEARCH DESIGN AND METHODS This project involved a thematic analysis of diabetes illness narrative interviews with Black participants (N=41) in our National Institute on Aging-funded study of diabetes. In a narrative approach, the participant communicates the significance of actions and events. RESULTS The findings suggest that diabetes self-care involves interconnected struggles across four domains of care: 1) multimorbidity management, 2) financial well-being, 3) family support, and 4) formal health care. DISCUSSION AND IMPLICATIONS Black older adult self-care reflects an active process of pursuing meaningful social goals and critical health needs. An Intersectional framework, however, reveals the ongoing histories of inequity that shape this process. Further intervention to address the racist policies and practices found in Black older adults' communities and clinical care is needed to make true progress on diabetes disparities.
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Affiliation(s)
- Sarah Chard
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Loren Henderson
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Brandy Harris Wallace
- Department of Sociology, Anthropology and Public Health, University of Maryland Baltimore County, Baltimore, Maryland, USA
| | - Erin G Roth
- PATIENTS Program, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - J Kevin Eckert
- Department of Sociology, Anthropology and Public Health, Center for Aging Studies, University of Maryland Baltimore County, Baltimore, Maryland, USA
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At the intersection of gender and discrimination: Experiences of Congolese refugee women with social and cultural integration in the United States. WOMENS STUDIES INTERNATIONAL FORUM 2021. [DOI: 10.1016/j.wsif.2021.102517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Merz S, Jaehn P, Mena E, Pöge K, Strasser S, Saß AC, Rommel A, Bolte G, Holmberg C. Intersectionality and eco-social theory: a review of potentials for public health knowledge and social justice. CRITICAL PUBLIC HEALTH 2021. [DOI: 10.1080/09581596.2021.1951668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sibille Merz
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany
| | - Philipp Jaehn
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Potsdam and Cottbus, Germany
| | - Emily Mena
- , Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Kathleen Pöge
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit 24 - Health Reporting, Berlin, Germany
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Unit 34 - HIV/AIDS, STI and Blood-borne Infections, Berlin, Germany
| | - Sarah Strasser
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit 24 - Health Reporting, Berlin, Germany
| | - Anke-Christine Saß
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit 24 - Health Reporting, Berlin, Germany
| | - Alexander Rommel
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Unit 24 - Health Reporting, Berlin, Germany
| | - Gabriele Bolte
- , Department of Social Epidemiology, University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- Health Sciences Bremen, University of Bremen, Bremen, Germany
| | - Christine Holmberg
- Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Brandenburg, Germany
- Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Potsdam and Cottbus, Germany
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