Addressing Racial Health Disparities of Rural African American Women: Implications for Anti-Racist Social Work Research and Practice

Background and Purpose

Racial disparity gaps in urban centers are closing, however, in rural communities, especially in the Black Belt, the divide grows (Cross et al., 2021; Cross & Warraich, 2021) due to a limited understanding of the impact of racialization as a form of trauma and social determinant of health on African Americans in the rural south (Evans et al., 2016; Hemmings & Evans, 2018). Unresolved trauma is known to cause acute and chronic physical and mental health conditions, such as heart disease, high blood pressure, depression, anxiety, emotional distress, and psychological inconsistencies (Carr et al., 2014; Coogan et al., 2020; Grasser & Jovanovic, 2022; Hill-Jarrett & Jones, 2022; Jones et al., 2021; Peters, 2006; Schnurr et al., 2014). Research with vulnerable African American communities, including the Black Belt, has been harmfully exploitative and predatory (Scharff et al., 2010). Using archived oral histories, this project extends the capacity of social work researchers to avoid harmful research techniques that perpetuates racial trauma and toxic, chronic stress responses that cause disease in African Americans (weathering) (Geronimus, 2001, 2001; Geronimus et al., 2006).

Methods

Applying the Black Lives Matter Healing Justice framework to center the Black experience (Bartholomew et al., 2018; Ginwright, 2015), a secondary data analysis of fifteen archived oral history interviews was employed. The interviews were collected from three oral history projects archived in the Southern Oral History Program database (UNC-CH). The interviewees were African American women, age 57 to 99 years old, living in three different North Carolina communities during Jim Crow segregation from, 1954-1972. Only interviews with both audio recordings and complete transcripts were included. Using qualitative thematic analysis and critical historical discourse qualitative analysis, sensitizing codes were generated from the theoretical framework and the literature. The analysis relied heavily on researcher experiential knowledge and reflexivity to reveal the meaning making of racialization as a traumatic exposure.

Results

Data revealed the impact of racialization across the life course beginning before birth. Interviewees discussed the relevance of their anti-black racialization in context to their work experiences and how they experienced and witnessed the impact of anti-black racialization in their workplaces and opportunities for work. Interviewees also provided testimony to the impact of racialization on the places and spaces they occupy with respect to land ownership and loss and the ensuing grief. Oral history as a research methodology empowered interviewees to recall their racialized lived experiences without the intrusion or intimidation of the researcher and their research agenda. Consequently, their narratives also exposed known trauma symptomology related to their prolonged, life course exposure to anti-black racialization.

Conclusion and Implications

The findings of this study provide insights into the life course experiences of anti-black racism on African American women in rural Black Belt communities and how they define and make meaning of racial trauma. Interviewee narratives revealed trauma symptomologies that may contribute to racial health disparities observed in the Black Belt. This study advances social work’s understanding of racism, discrimination, and racialization as a social determinant of health.