"Strong black woman" script (SBW-S): The influence of strength embodiment on African American maternal health

Background. Despite the visibility of published reports about the association of various sociodemographics, contextual stressors, and prevalence of illness among women, less known in the health sciences is the ways in which embodiment of racialized gender scripts, particularly those embedded in the sociohistorical and cultural context of black womanhood, is linked to African American maternal health outcomes. The goal of the present study is to describe how the “strong black woman” script (SBW-S), a performance modality defined by self-sacrificial behaviors, silenced burdens and self-care neglect intersects with African American women's daily life management strategies, and to illustrate pathways through which these strategies influence African American maternal health outcomes. Methods. A secondary data analysis of focus group discussions querying African American women's perceptions of strength and a content analysis of African American women's popular media sources (e.g., Essence, Ebony and Heart & Soul) were compared to explore the intersection of the SBW-S with existing role management, stress-coping and self-care strategies; relevance to black women's health was also determined. Results and implications. Findings revealed that focus group data and popular media sources corroborated the visibility of the “strong black woman” script in African American women's lives. Existing role management, stress-coping and self-care strategies informed by the SBW-S (e.g., “please the masses”, “game face”, “last on the list”, respectively) distracted women from enlisting healthful behaviors and evinced negative health consequences. A heuristic model is presented illustrating how strength embodiment influences African American maternal health outcomes. Functional alternatives to the SBW-S are discussed.