248994 Black Women's Health Care Project: Health and resilience among the black middle class

Sunday, October 30, 2011: 4:49 PM

Tina Sacks, PhD Candidate , School of Social Service Administration, University of Chicago, Chicago, IL
Background: Evidence of racial/ethnic disparities is remarkably consistent across a range of health conditions. Differences persist after controlling for socioeconomic status. This study explores how middle-class black women perceive health care providers and whether they use positive self-presentation strategies to avoid differential treatment based on race and gender. Method: The study uses in-depth interviews to explore the experiences of 20 black middle-class women between 35 and 65. Results: Respondents overwhelmingly endorsed the importance of positive self-presentation to mitigate differential treatment. They noted that they must demonstrate specific knowledge of their health, which was burdensome and distracting. In keeping with the literature on race concordance, respondents did not necessarily prefer a black provider. Rather, a trusting relationship with a competent provider was more important. They reported that they did not interpret their experiences in health care settings to be overtly discriminatory. However, all respondents agreed that discrimination against blacks continues to be pervasive, in health care settings and in general.

Conclusion: The study provides important information about an understudied group. Although black middle-class women have resources, they are not immune to bias. They have their own strategies for mitigating bias by emphasizing certain resources, i.e., specific knowledge of health care issues, demonstrating intelligence, etc. Although the women did not report overt instances of discrimination, they felt black women were subtly discriminated against in ways that often go unnoticed. Finally, because black middle-class women have many social identities, interventions based solely on increasing race-concordance are unlikely to completely reduce health disparities.

Learning Areas:
Advocacy for health and health education
Diversity and culture
Social and behavioral sciences

Learning Objectives:
To describe the health care experiences of Black middle class women. To discuss whether Black middle class women use positive self-presentation strategies to increase the likelihood they receive appropriate treatment or to avoid differential treatment based on race. To describe how class status affects black women's perception of health care providers.

Keywords: Health Disparities, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am solely responsible for the research and content of this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.