April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: “We put everyone else before us”: A Mixed Methods Study of Sociocultural Stressors on Black Women’s Health
Unequal distribution of breast cancer (BC) subtype contributes significantly to racial disparities in breast cancer mortality. Black women have a 65% higher incidence rate of more aggressive hormone receptor (HR)-negative BC compared to non-Hispanic White women. Differences in genetic predisposition and socioeconomic status have not fully explained the unequal distribution of BC subtypes. A socially-constructed and communicatively-reinforced identity prevalent among Black women, the Strong Black Woman schema, may heavily influence both physiological processes and health behaviors relevant to breast cancer pathology. The study purpose is to explore the sociocultural stressors in Black women’s lives.
The study followed a concurrent parallel design, combining qualitative interviews with secondary data analysis of the HINTS survey. For the qualitative phase, we recruited Black women ages 18-49 to participate in interviews that explored the psychosocial and sociocultural factors associated with risk of breast cancer in 2023. For the quantitative phase, we analyzed 2022 HINTS6 data collected from non-Hispanic White, non-Hispanic Black, and Hispanic female respondents ages 18-49 living in the South (n = 458).
Qualitative analysis identified sociocultural stressors within three categories: raising children (provision, successful parenting, absence of father figures), caregiving for family (including parents and grandchildren), and overperforming in the workplace (prove themselves, suppress emotions, supporting coworkers, disproving stereotypes).
To test the hypotheses created from the qualitative data, we ran three separate ANCOVAs to test the effects of race/ethnicity and marital status on three dependent variables: depression, isolation, and purpose and meaning. Covariates included: age, number of children in household, income sufficiency, and general health. Marital status had a significant effect on depression (p<.05) and isolation (p<.05). Married women reported lower depression scores and less isolation than women who were never or previously married. Race/ethnicity (p < .001) and marital status (p<.01) had a significant effect on purpose and meaning. Black women who were previously but not currently married reported the highest meaning and purpose in life.
Integrated analysis revealed that the dissonance between avowed and ascribed identities reduced ability to pursue personal interests, a key measure of depression. Cultural norms associated with divorce and separation within the Black community contribute to lessened feelings of social connection. Similarly, the ascribed identity of Black women as nurturers affects their perception of purpose and meaning in life. Mothers identified their purpose in raising and providing well for children, especially single mothers. Women also described purpose associated with caring for grandchildren or disabled parents when others failed to do so. Lastly, women found meaning and purpose in the workplace as they performed tasks at work that are not included in the job duties.
Black women experience unique sociocultural and structural stressors connected to the Strong Black Woman identity that may increase their risk for developing cancer. Findings can inform health communication interventions aimed at addressing psychosocial effects of sociocultural experiences that reduce healthcare seeking and increase negative coping behaviors. Additionally, these findings raise questions about how Black women communicatively navigate these identity gaps in ways that might mitigate negative outcomes.
The study followed a concurrent parallel design, combining qualitative interviews with secondary data analysis of the HINTS survey. For the qualitative phase, we recruited Black women ages 18-49 to participate in interviews that explored the psychosocial and sociocultural factors associated with risk of breast cancer in 2023. For the quantitative phase, we analyzed 2022 HINTS6 data collected from non-Hispanic White, non-Hispanic Black, and Hispanic female respondents ages 18-49 living in the South (n = 458).
Qualitative analysis identified sociocultural stressors within three categories: raising children (provision, successful parenting, absence of father figures), caregiving for family (including parents and grandchildren), and overperforming in the workplace (prove themselves, suppress emotions, supporting coworkers, disproving stereotypes).
To test the hypotheses created from the qualitative data, we ran three separate ANCOVAs to test the effects of race/ethnicity and marital status on three dependent variables: depression, isolation, and purpose and meaning. Covariates included: age, number of children in household, income sufficiency, and general health. Marital status had a significant effect on depression (p<.05) and isolation (p<.05). Married women reported lower depression scores and less isolation than women who were never or previously married. Race/ethnicity (p < .001) and marital status (p<.01) had a significant effect on purpose and meaning. Black women who were previously but not currently married reported the highest meaning and purpose in life.
Integrated analysis revealed that the dissonance between avowed and ascribed identities reduced ability to pursue personal interests, a key measure of depression. Cultural norms associated with divorce and separation within the Black community contribute to lessened feelings of social connection. Similarly, the ascribed identity of Black women as nurturers affects their perception of purpose and meaning in life. Mothers identified their purpose in raising and providing well for children, especially single mothers. Women also described purpose associated with caring for grandchildren or disabled parents when others failed to do so. Lastly, women found meaning and purpose in the workplace as they performed tasks at work that are not included in the job duties.
Black women experience unique sociocultural and structural stressors connected to the Strong Black Woman identity that may increase their risk for developing cancer. Findings can inform health communication interventions aimed at addressing psychosocial effects of sociocultural experiences that reduce healthcare seeking and increase negative coping behaviors. Additionally, these findings raise questions about how Black women communicatively navigate these identity gaps in ways that might mitigate negative outcomes.