This article includes discussion of racism that may be challenging for some readers.

July 7, 2022
By Uchenna Okoji

Medical and technological advancements over the last century have resulted in substantial improvements in health for people of all genders in the United States. However, Black women continue to have poorer health outcomes and higher mortality rates than other U.S. women. According to Black Demographics, despite being younger (36.1 years) on average than U.S. women overall (39.6 years), Black women have a higher prevalence of acute and chronic health conditions, including heart disease, stroke, cancer, diabetes, obesity, stress and pregnancy-related morbidity (Chinn et al. 2021).

In fact, the life expectancy for Black women is three years shorter than that of non-Hispanic white women (77.9 versus 81 years of age), and pregnancy-related mortality rates for Black women are more than three times higher than for white women (42.4 versus 16.9 per 100,000 live births) (Chinn et al. 2021). What could be the cause of such significant disparities? There is not a simple answer to this question, but research continues to highlight the role of one very important factor that may explain these differences: structural racism.

What is structural racism?

Structural racism is defined as the historical and contemporary policies and practices that structure opportunity to benefit or provide an advantage to a particular race or ethnic group while unfairly disadvantaging another. These policies and practices ultimately make it more difficult for communities of color to access quality education, jobs, health care and other means that would allow upward social mobility.

How does structural racism impact the health outcomes of Black women?

It is now commonly accepted that health outcomes are heavily influenced by the social and economic conditions with which an individual exists. The systemic oppression and unequal treatment of Black people and women in the U.S. is well-documented. Black women, who have uniquely experienced and continue to experience both racism and sexism (i.e., intersectional oppression), exist in a society filled with structural inequities that have limited their social and economic opportunities. Compared to all U.S. women, Black women make on average $5,500 less per year, experience higher rates of poverty, and are more likely to live in racially segregated neighborhoods (Chinn et al. 2021). The accumulation of these adverse circumstances and disadvantages that persist across generations as a result of structural racism create the environment for health disparities to exist and may explain why Black women continue to experience worse outcomes.

What can be done to address structural racism?

The disproportionally poor health outcomes of Black women is a public health emergency that warrants a multi-pronged approach. Structural racism cannot be eliminated without the dismantling of oppressive laws and policies while simultaneously implementing programs and initiatives that create opportunities for Black women across the social, economic and political spheres of influence in the U.S. Clinical and health services research must also prioritize the inclusion of Black women in studies to better understand their needs as it pertains to health interventions. Structural racism and its impact on health outcomes will persist unless all policies are examined and modified with the goal of achieving intersectional equity.

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Sources/Resources:

• Black Demographics. The African American Population. https://blackdemographics.com/population/black-women-statistics/. Accessed February 15, 2022
• Chinn JJ, Martin IK, Redmond N. Health Equity Among Black Women in the United States. J Womens Health (Larchmt). 2021 Feb;30(2):212-219. doi: 10.1089/jwh.2020.8868
• Dill J, Duffy M. Structural Racism And Black Women's Employment In The US Health Care Sector. Health Aff (Millwood). 2022 Feb;41(2):265-272. doi: 10.1377/hlthaff.2021.01400
• Urban Institute. Features: Structural Racism in America. https://www.urban.org/features/structural-racism-america. Accessed February 15, 2022