Exposure to structural racism has been shown to be a leading risk factor for adverse maternal and infant health outcomes among Black women. Yet, current measures of structural racism don’t fully account for inequity seen in maternal and infant health outcomes between Black and white women and infants.

In a new study led by Brittany Chambers, researchers held focus groups with Black women to define structural racism and how it shows up in their communities.

The women defined structural racism as a system that distributed unequal access to resources and opportunity. Nine domains of structural racism emerged from women’s stories:

Negative Societal Views. Black women described constantly being labeled as “dangerous” when navigating in public spaces.
Housing. Black women described experiencing structural racism through neighborhood segregation and inadequate housing through forceful evictions or overpricing of Black renters.
Medical Care. Black women reported encountering inadequate medical care, a direct result of a lack of culturally competent providers and staffs.
Law Enforcement. Black women described police harassment, highlighting a broken law enforcement system that endangers the health, wellbeing and livelihood of Black women and bodies.
Hidden Resources. Black women also expressed struggling and feeling alone due to a lack of resources tailored towards Black women and communities.
Employment. Black women reported experiencing racial discrimination during the hiring and promotion processes, revealing a multilevel structure of workplace discrimination that is used to limit Black women’s access to higher paying jobs and leadership roles.
Education. Black women described a system that doesn’t provide equal access to opportunities for Black children, adolescents and adults, that as well as unfair disciplinary treatments.
Community Infrastructure. Black women clearly described three ways that community infrastructure uphold systemic racism: widespread food deserts, hazardous parks, and the desensitization of perpetual violence in communities of color.
Policing Black Families. Black women described being policed when using medical and supportive services from the government.

This study supports the need for screening for social and structural determinants of health, especially when providing care to Black women. It also suggests the need for ongoing racial equity trainings for providers and diversifying the workforce. Findings from this study should be used to inform measurements of structural racism and policy recommendations to improve predominantly Black communities.