title: The Impact of Racism on the Sexual and Reproductive Health of African American Women.
abstract: African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health.
authors.affiliation: 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention , Centers for Disease Control and Prevention, Atlanta, Georgia .
authors.forename: Cynthia
authors.initials: C
authors.lastname: Prather
authors.affiliation: 2 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion , Centers for Disease Control and Prevention, Atlanta, Georgia .
authors.forename: Taleria R
authors.initials: TR
authors.lastname: Fuller
authors.affiliation: 3 Division of Violence Prevention, National Center for Injury Prevention and Control , Centers for Disease Control and Prevention, Atlanta, Georgia .
authors.forename: Khiya J
authors.initials: KJ
authors.lastname: Marshall
authors.affiliation: 1 Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention , Centers for Disease Control and Prevention, Atlanta, Georgia .
authors.forename: William L
authors.initials: WL
authors.lastname: Jeffries
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007398:Interpersonal Relations; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D036301:Qualitative Research; D063505:Racism; D012098:Reproduction; D060728:Reproductive Health / Q000208:ethnology*; D012725:Sexual Behavior / Q000208:ethnology*; D064890:Social Determinants of Health / Q000208:ethnology*; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology; D014481:United States