title: The influence of personal and group racism on entry into prenatal care among African American women.
abstract: BACKGROUND
  Racism has been hypothesized as a barrier to accessing health care. No quantitative study has directly assessed its influence on women's initiation of prenatal care (PNC). We examined the relationship between PNC entry and experiences of personal and group racism among low-income, African-American (AA) women. We also examined whether the use of denial of racism as a coping mechanism was associated with a delay in accessing PNC.
  
  
  METHODS
  Using a prospective/retrospective cohort design we collected data from 872 AA women (prenatally, n = 484; postpartum, n = 388). Multinomial logistic regression was used to assess the relationship between the overall denial of racism index and PNC initiation.
  
  
  RESULTS
  PNC entry was not associated with personal experiences of racism (p = .33); it was significantly associated with group experiences (p < .01).
  
  
  CONCLUSIONS
  Denial of racism experienced by other AAs was a barrier to early PNC among low-income, AA women. Delayed access to PNC may be rooted in the avoidance of racialized experiences among less empowered women when faced with discrimination. Our findings have important implication for the engagement of AA women into the PNC delivery system and the health care system postpartum.
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan. Electronic address: jslaughts@gmail.com.
authors.forename: Jaime C
authors.initials: JC
authors.lastname: Slaughter-Acey
authors.forename: Cleopatra H
authors.initials: CH
authors.lastname: Caldwell
authors.forename: Dawn P
authors.initials: DP
authors.lastname: Misra
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D015142:Baltimore; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016015:Logistic Models; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D011295:Prenatal Care / Q000523:psychology / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D063505:Racism; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
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