The Impact of Multiple Forms of Racism-Related Stress on the Health of Mothers

Through attention to understudied forms of racism, this dissertation provides a more comprehensive understanding of how racism acts a stressor impacting the health of mothers through three separate but related quantitative studies. Study #1 (Ch. 2), considers how understudied forms of racism-related stress such as racism-related vigilance— attention to, rumination, and worry about experiences of racism that are not immediately present—and vicarious racism— unfair treatment because of race experienced by a family member, close friend, or community member—intersection to produce a unique racism-related stressor for Black mothers—fear their children may experience unfair treatment because of their race—what I have term vicarious racism related vigilance. I ask: What is the relationship between vicarious racism-related vigilance, measured as a mother’s fear her child or children may experience racism, and allostatic load? What is the relationship between racial discrimination experienced during adolescence and childhood and allostatic load? And is the relationship between vicarious racism-related vigilance and allostatic load independent of racial discrimination experiences during adolescence and childhood? Using a subsample of Black mothers from the African American Women’s Heart & Health Study (AAWHHS; N=148), which includes detailed maternal health information on a community sample of African American women residing in the San Francisco Bay Area and Ordinary Least Squares (OLS) regression, this chapter’s findings indicate vicarious racism-related vigilance is associated with an increased in allostatic load, while self-reported experiences of racial discrimination experienced during adolescence and childhood are associated with a decrease in allostatic load. Yet, vicarious racism-related vigilance remains associated with an increase in allostatic load when accounting for self-reported racial discrimination during adolescence and childhood, highlighting vicarious racism-related vigilance as a health harming stressor for the health of Black mothers.Study #2 (Ch. 3) examines how exposure to structural racism may induce health harming stress by investigating the relationship between community exposure to police killings of Black Americans and the pregnancy health outcomes of Black women. Conceptualizing highly publicized incidents of police violence as an outcome of structural racism because they are the consequence of institutionalized practices in law enforcement and housing practices, this study asks: what is the relationship between exposure to highly publicized police violence events and the pregnancy health outcomes, as measured by low birthweight and preterm birth, of Black mothers in the affected communities? This chapter I specifically look at community exposure to: 1) the death of Michael Brown in St. Louis County, Missouri and 2) the death of Tamir Rice in Cuyahoga County, Ohio. This study uses difference-in-differences analyses of Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS) data to compare the difference in the change in pregnancy health outcomes before and after incidents of police violence, net of covariates, comparing the affected areas to a control comparison location. Findings indicate compared to the control-comparison—Jackson County—St. Louis County had a greater increase in preterm birth and low birthweight among Black women in the 9 months after Brown’s death, net of covariates. In this chapter I provide preliminary insights into the relationship between racism stress exposure from highly publicized race-related events and pregnancy health, underscoring the need to consider the “collateral effects” exposure to major race-related traumatic events can have on health. Study #3 (Ch. 4) investigated the relationship between different forms of discrimination and pregnancy health, as measured by pregnancy miscarriage, among a racially diverse sample of women, asking: what is the relationship between different forms of discrimination, including racial discrimination, gender discrimination, class discrimination, sexuality discrimination, and general (non-group-based) discrimination and pregnancy miscarriage among Black, Latina, Asian, and White women in the United States? I also ask, does this relationship vary by race? Using Wave 1 (1996-7) of the Study of Women’s Health across the Nation (SWAN)and separate logistic regression models assessing the relationship between each form of discrimination and miscarriage among Black, Latina, Asian, and White women, this chapter’s findings indicate gender and non-group based discriminations were associated with a marked increase in miscarriage among Black women, while income discrimination was associated with an increase in miscarriage for White and Latina women, and no form of discrimination was associated with miscarriage among Asian women. Non-grouped based discrimination was associated with miscarriage in the full analytic sample. I theorize the reason two forms of discrimination are impactful for Black women’s health, compared to one form for White and Latina women and non for Asian women, is because of Black women’s already disadvantaged position in the U.S. racial hierarchy which results in a greater toll from discrimination. The current state of racism and health research does not comprehensively measure the many complex ways racism impacts health. This dissertation helps to lessen this gap in order to better understand how racism acts as a health harming stressor, driving racial health disparities which disfavor racially minoritized Americans