While many medical researchers and social theorists have most often focused on the plight of underclass black women, three notable researchers have turned their attention to the impact of racial and gender stressors on African-American expectant mothers who present the image of the "American dream" by virtue of their educational, professional and economic attainment.
The results of this pioneering, three-year study, "Contextualized Stress, Global Stress, and Depression in Well-Educated, Pregnant, African-American Women," published by Fleda Mask Jackson, Ph.D., Diane L. Rowley, M.D., M.P.H., and Tracy Curry Owens, Ph.D., reveal that the shroud of blackness and the mantle of gender are no less impactful on the psyche of middle- and upper-class African-American women, despite the prestige and security associated with university degrees, corner offices and money in the bank. The findings suggest that well-educated, pregnant, African-American women are as disproportionately at risk for adverse birth outcomes as their less fortunate "sisters," and that the depression linked to their stress has been established as a significant contributor to poor birth outcomes. The research was supported by generous funding from the Ford Foundation and W.K. Kellogg Foundation.The 101 women who collaborated in the study were recruited from private practice ob-gyn offices and categorized on the basis of the demographic variables of relationship status, the presence of other children and annual household income. Age was divided into two categories: 20 to 29 and 30 years and older. Education categories included non-college educated (having no college degree) and college-educated (having graduated from a 4-year college). Relationship variables were separated by partner status: married, partnered and non-partnered. Participants also indicated if they had other children under 18 years of age, or no children. Employment variables were divided into currently employed (full- or part-time job), or unemployed. Lastly, annual household income was divided into three categories: $10,000 to $30,000, $31,000 to $50,000, and above $51,000.
The majority of the subjects were college educated, employed, and married or partnered. A cross-sectional study was then conducted utilizing the Jackson, Hogue, Phillips Contextualized Stress Measure (JHP), a measurement of racial and gendered stress, and the Perceived Stress Scale (PSS), an assessment of global stress, to detect their associations and predictions for depression as measured by the Beck Depression Inventory II (BDI-II). The results indicated that 35% of the women had high levels of contextualized stress, 40% reported high levels of global stress, and 23% were deemed to be depressed.
Race and gender matter in the lives of African-American women. Their significance provides the context for how these women experience stress in the places where they live, work, and go about their daily lives. This study further demonstrates the level to which these experiences are inextricably linked to race, gender, and class inequities. While expectant mothers of all persuasions are driven to contemplate the role of parenting, pregnant African-American women also bear the additional and horrendous burden of considering the world into which their children will be born - a world that offers little black and brown babies fewer opportunities for growth and development and greater opportunities to confront the evils of prejudice, bigotry, discrimination and racial profiling.
The evidence appears to be indisputable – that African-American women from all socioeconomic backgrounds experience higher rates of poor pregnancy outcomes, preterm births, small-for-gestational- age babies, and infant mortality than women from other racial and ethnic groups who are less educated, unemployed, and uninsured. The link between the stress experienced by African American women and depression has implications for postpartum depression and depression across the life course.What is most important about this newest research is that its findings issue a clarion call to health care professionals and local communities about the importance of being responsive to the unique individual and environmental-level stressors that jeopardize the health of an entire community - the expectant mothers, unborn babies, and families of all African-American women, regardless of their educational, professional, social or economic standing.
About FLEDA MASK JACKSON, Ph. D., Principal Investigator
Scholar, educator and activist, Fleda Mask Jackson, Ph.D., is president and CEO of the national research firm and think tank MAJAICA, LLC, and the leader and creator of Save 100 Babies, a cross-sector network devoted to a social determinants approach to eliminate racial disparities in birth outcomes. Dr. Jackson currently serves as a senior fellow at the National Center for Health Behavioral Change, Urban Medial Institute, Morgan State University. Her most recent affiliations also include professorships at the Rollins School of Public Health and the Women's Studies Program, Emory University.
A highly regarded lecturer and guest speaker, Dr. Jackson is an alumna of Spelman College with an M.S. in human development and family ecology from the University of Illinois, where she published her thesis on "Socialization Practices Related to Racial Identity Among Black Middle-Class Mothers," and her doctoral dissertation, "The Role of The Black Church in the Socialization and Education of Black Children." With academic preparation in education, psychology, and anthropology, Dr. Jackson has been working with public health departments, private physicians and social agencies across the country to bring attention to the importance of addressing stress and depression in the ways they are experienced by African-American women and toward developing remedies for closing the racial gap in birth outcomes.
Dr. Jackson has served as a consultant and advisor for a wide range of organizations that include the Joint Center for Political and Economic Studies; Center for Excellence in Women's Health, Harvard University Medical School; Ford Foundation (SisterSong); Rhea and Lawton Chiles Center for Healthy Mothers and Babies, University of South Florida; and Children's Defense Fund. Dr. Jackson currently serves as a member of the National Advisory Committee on Health Disparities for the director of the Centers for Disease Control, and recently has been approved by the White House and the U.S. Department of Health and Human Services to serve on the Secretary's Advisory Committee on Infant Mortality.