(768) Multidimensional identity and experiences of racism and discrimination among Black perinatal women

Intersectionality theory posits how multiple social identities (e.g. race, gender, class) interact to create systems where people experience discrimination differently. Existing work among Black women has not explored intersections beyond race, pregnancy status, and gender. This study aims to compare experiences of racism and discrimination by multi-dimensional identities in a sample of Black perinatal women.


 

Study Design:
 

This study uses 2021 survey data of individuals who self-identified as Black women >18 years old with a live birth at a university hospital system from 2019-2021. Surveys included demographic information, the Perceived Racism Scale, and the Perceived Discrimination Scale. Demographics included socioeconomic status (SES; low: < bachelor’s degree or < $20,000 annual income), marital status, and age (young: < 26). Latent class analysis identified four groups with additional marginalized identities beyond race and gender (Table 1). One-way Kruskal-Wallis tests determined whether scale medians differed by group. Modified Poisson regression calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the likelihood of scoring in the top quartile on scales.


 

 

Results:

Among 200 Black women 3-32 months post-delivery, median perceived racism score was 99.5 (IQR 71-137.5; possible range 0-337) and did not differ by group (p=0.3; Table 1). For experiences of discrimination, the median score was 29 (IQR 22-35; possible range 9-47) and did not differ by group (p=0.1). The likelihood of experiencing the top quartile of racism did not differ by group (Table 2). However, compared to Group 1 (no additional marginalized identities), Group 3 (PR 2.4, 95% CI 1.2-4.5) and Group 4 (PR 2.3, 95% CI 1.1-4.9) were twice as likely to report top quartile discrimination.


Conclusion:
In this sample of Black women, additional marginalized identities including low SES, being unmarried, and being younger heightened experiences of discrimination reported postpartum. Findings support the need for perinatal practices and policies to consider an intersectional lens.