Racism and the sexual and reproductive health of African American women: Historical evidence and implications for public health

Considerable progress has been made to improve the sexual and reproductive health of U.S. women. However African American women are disproportionately affected by multiple sexual and reproductive health conditions. African American women represented 64% of the estimated new HIV infections in 2010. Almost 36% of pregnancy-related deaths between 2006-2010 were among non-Hispanic black women. These negative sexual and reproductive health outcomes may be due to the historical context and current racism-related social and health care experiences among African American women in the U.S. Thus, a historical analysis through which racism shapes sexual and reproductive health might improve understanding of their current health outcomes. We reviewed a combination of significant historical events (i.e., peer-reviewed sources and books) from slavery through the post-civil rights eras that potentially play a role in current health outcomes. We also explored the link between the historical experiences, current sexual and reproductive health outcomes and the continuum of racism-related social determinants (i.e., poverty, limited education, and residential segregation) which began in slavery and currently influence the health status of African American women. Lastly, we discussed the need to develop new models for health promotion and strategies to address racism, which may improve African American women’s health across the life course and promote health equity. Comprehensive programs might facilitate long-term, sustainable improvements in health for the larger population of African American women.