Exploring the racial gradient in reproductive health: an examination of challenges to sexual health care faced by black female college students

OBJECTIVES

This study identifies and analyzes barriers to sexual and gynecological health care Black women face at a Historically Black College or University (HBCU) and a Predominantly White Institution (PWI) in southeastern America.

DESIGN

Participants identified as Black women who were sexually active, age 18-25, and undergraduate students. The research team conducted in-depth interviews across two campuses via Zoom. Interviews were coded using inductive thematic analysis.

RESULTS

We derived six specific themes that summarize Black female college students' barriers to care: Patient-provider Interactions, Economic Determinants of Health, Social Support, Access to Care, Lack of Primary Care, and No Challenges.

CONCLUSION

Reproductive and sexual health disparities can be mitigated with attention to diversity in medical school, affordable care, and teaching young women to prioritize their care for long-term reproductive health.

Womanism and Re-Imagining Black Women's Health Promotion

Black women have been historically disenfranchised by the healthcare system. We apply a Womanist framework-a social change model developed by Black women scholars, including Zora Neale Hurston, Alice Walker, Clenora Hudson-Weems, Layli Philips and many others- to health promotion, reimagining Black women's health grounded in a framework designed by Black women. Five modalities in particular-dialogue, harmonizing and coordinating, hospitality, mutual aid and social support, and mothering- present an opportunity for radical change within health promotion. We offer a consideration of how these modalities might be utilized to improve health promotion for Black women.

Womanist Ethics as a Contribution to Bioethics

This essay argues that womanism, a social theory focused on the embodied lives of Black women, can be useful to bioethicists as they consider health care ethics during a pandemic-and beyond. A general social justice-oriented ethical framework is helpful to begin a conversation on pandemic ethics, but it does not directly lead to the kind of on-the-margins-of-society framework that is necessary to increase health equity and justice. With particular concern for poor Black women, I discuss three main reasons that such an ethics framework needs to incorporate womanist ethics: the feminization of poverty, lack of access to high-quality health care, and rape and other historical violence against Black women. I conclude by proposing that an understanding of womanism as a correlative to the Black Lives Matter clarion call can create an ethical narrative in bioethics that can exist beyond times of pandemic.