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      The Strong Black Woman: Insights and Implications for Nursing

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      Journal of the American Psychiatric Nurses Association
      SAGE Publications

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          Abstract

          OBJECTIVE

          This discussion paper describes the intricacies of the strong Black woman (SBW) construct and how understanding this construct is significant and relevant within nursing.

          METHOD

          This article is a discussion piece that provides a succinct conceptual and historical overview of the SBW construct. It then describes the impacts of this construct before presenting implications as they relate to nursing practice, education, policy, and research.

          RESULTS

          The SBW construct is exclusively and routinely applied to Black women. Typically, the SBW construct encompasses five components, which center on independence, caring, and strength. These five components include the obligation to (1) always maintain and present an image of strength, (2) suppress emotion, (3) be self-reliant, (4) succeed despite all odds, and (5) always place the needs [especially comfort] of others above those of oneself. Moreover, the SBW construct posits Black women as possessing superhuman capabilities. The nature of this construct is complex, with some Black women using it as a survival mechanism, and others finding empowerment through this image. Nevertheless, recent research has revealed the harms associated with this image including detriment to physical, mental, and spiritual well-being, with the implications extending to Black families and communities.

          CONCLUSION

          Understanding this topic is essential in providing support to all Black women in health care and within the Black community—including patients, nurses, faculty, staff, and students. Recognizing the implications of the SBW construct is essential toward ensuring that our care, practices, and policies are not only supportive but also antiracist.

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          Most cited references38

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          Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color

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            Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.

            Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., "black people's skin is thicker than white people's skin"). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient's pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient's pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.
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              "Weathering" and age patterns of allostatic load scores among blacks and whites in the United States.

              We considered whether US Blacks experience early health deterioration, as measured across biological indicators of repeated exposure and adaptation to stressors. Using National Health and Nutrition Examination Survey data, we examined allostatic load scores for adults aged 18-64 years. We estimated probability of a high score by age, race, gender, and poverty status and Blacks' odds of having a high score relative to Whites' odds. Blacks had higher scores than did Whites and had a greater probability of a high score at all ages, particularly at 35-64 years. Racial differences were not explained by poverty. Poor and nonpoor Black women had the highest and second highest probability of high allostatic load scores, respectively, and the highest excess scores compared with their male or White counterparts. We found evidence that racial inequalities in health exist across a range of biological systems among adults and are not explained by racial differences in poverty. The weathering effects of living in a race-conscious society may be greatest among those Blacks most likely to engage in high-effort coping.
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Journal of the American Psychiatric Nurses Association
                J Am Psychiatr Nurses Assoc
                SAGE Publications
                1078-3903
                1532-5725
                July 2022
                December 31 2020
                July 2022
                : 28
                : 4
                : 332-338
                Affiliations
                [1 ]Keisha Jefferies, MN, RN, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
                Article
                10.1177/1078390320983900
                0deae803-e6ee-42f5-a68f-998231a11b28
                © 2022

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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