Skip to main content

Advertisement

Log in

Contextualizing Black Women’s Mental Health in the Twenty-First Century: Gendered Racism and Suicide-Related Behavior

  • Published:
Journal of Racial and Ethnic Health Disparities Aims and scope Submit manuscript

Abstract

Despite predictions from the Black-White and gender paradoxes in suicide risk, there has been a recent growth in suicide rates among Black women and girls that requires special attention from social and behavioral researchers. In this review, we demonstrate how and why an intersectional framework is needed to understand and contextualize Black women’s mental health and suicide risk. To begin, we outline data and existing literature on Black women’s mental health outcomes. Next, we provide insights from intersectional and Black feminist scholars on the uniqueness of Black womanhood and the necessity of centering racism and sexism in studies of Black women. Third, we present clear links between mental health, gendered racism experienced by Black women, and the Strong Black Woman schema which they adopt to navigate society. Fourth, and finally, we discuss practical and scholarly applications for this work. To this end, this research agenda is about advocating for the consideration of psychosocial and sociocultural factors in practice and research on suicide-related behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention. National Center for Health Statistics, 2020. https://www.cdc.gov/nchs/fastats/suicide.htm

  2. Centers for Disease Control and Prevention. Risk and Protective Factors, 2021. https://www.cdc.gov/suicide/factors/index.html

  3. Office of Minority Health. 2019. https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=24

  4. Roberts AL, Gilman SE, Breslau J, Breslau N, Koenen KC. Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychological Med. 2011;41(1):71–83. https://doi.org/10.1017/S0033291710000401.

    Article  CAS  Google Scholar 

  5. Bridge JA, Horowitz LM, Fontanella CA, Sheftall AH, Greenhouse J, Kelleher KJ, Campo JV. Age-related racial disparity in suicide rates among US youths from 2001 through 2015. JAMA Pediatr. 2018;172(7):697–9. https://doi.org/10.1001/jamapediatrics.2018.0263.

    Article  Google Scholar 

  6. Spates K, Evans NT, James TA, Martinez K. Gendered Racism in the lives of Black Women: a qualitative exploration. J Black Psychol. 2019;46(8):583–6068. https://doi.org/10.1177/0095798420962257.

    Article  Google Scholar 

  7. Rockett IRH, Samora JB, Coben JH. The black-white suicide paradox: possible effects of misclassification. Social Science & Med. 2006;63(8):2165–75. https://doi.org/10.1016/j.socscimed.2006.05.017.

    Article  Google Scholar 

  8. Spates K, Slatton BC. I’ve got my family and my faith: Black women and the suicide paradox. Socius: Sociological Res for a Dyn World. 2017; 3. https://doi.org/10.1177/2378023117743908

  9. Canetto SS, Sakinofsky I. The gender paradox in suicide. Suicide and Life-Threat Behav. 1998;28(1):1–23.

    Article  CAS  Google Scholar 

  10. Murphy GE. Why women are less likely than men to commit suicide. Comp Psychiatry. 1998;39(4):165–75.

    Article  CAS  Google Scholar 

  11. Hill SA. Teaching and doing gender in African American families. Sex Roles. 2002;47(11):493–506.

    Article  Google Scholar 

  12. Wallace DM. “It’s a MAN thang”: Black male gender role socialization and the performance of masculinity in love relationships. The J Pan Afr Stud. 2007;1(7):11–22.

    Google Scholar 

  13. Burton CM, Pederson SL, McCarthy DM. Impulsivity moderates the relationship between implicit associations about alcohol and alcohol use. Psych Addict Behav. 2012;26(4):766.

    Article  Google Scholar 

  14. Woods- Giscombe CL Superwoman schema: African American women’s views on stress, strength, and health. Qualitative Health Res. 2010; 668–683. https://doi.org/10.1177/1049732310361892

  15. Lewis JA, Williams MG, Peppers EJ, Gadson CA. Applying intersectionality to explore the relations between gendered racism and health among Black women. J Counseling Psychol. 2017;64(5):475–86. https://doi.org/10.1037/cou0000231.

    Article  Google Scholar 

  16. Kirkinis K, Pieterse AL, Martin C, Agiliga A, Brownell A. Racism, racial discrimination, and trauma: a systematic review of the social science literature. Ethnicity and Health. 2021;26(3):392–412. https://doi.org/10.1080/13557858.2018.1514453.

    Article  Google Scholar 

  17. Carter RT, Sant-Barket SM. Assessment of the impact of racial discrimination and racism: how to use the Race-Based Traumatic Stress Symptom Scale in practice. Traumatology. 2015;21(1):32. https://doi.org/10.1037/trm0000018.

    Article  Google Scholar 

  18. Assari S, Lankarani MM, Caldwell CH. Does discrimination explain high risk of depression among high-income African American men? Behav Sci. 2018;8(4):40. https://doi.org/10.4490/bs8040040.

    Article  Google Scholar 

  19. Assari S, Moazen-Zadeh E, Caldwell CH, Zimmerman MA. Racial discrimination during adolescence predicts mental health deterioration in adulthood: gender differences among Blacks. Frontiers in Public Health. 2017; 104. https://doi.org/10.3389/fpubh.2017.00104

  20. Williams DR. Stress and the mental health of populations of color: advancing our understanding of race-related stressors. J Health and Soc Behav. 2018;59(4):466–85. https://doi.org/10.1177/0022146518814251.

    Article  Google Scholar 

  21. Anderson RE, Stevenson HC. RECASTing racial stress and trauma: theorizing the healing potential of racial socialization in families. Am Psychol. 2019;74(1):63. https://doi.org/10.1037/amp0000392.

    Article  Google Scholar 

  22. Metzger IW, Anderson RE, Are F, Ritchwood T. Healing interpersonal and racial trauma: Integrating racial socialization into trauma-focused cognitive behavioral therapy for African American youth. Child Maltreat. 2021;26(1):17–27. https://doi.org/10.1177/1077559520921457.

    Article  Google Scholar 

  23. Chu JP, Goldblum P, Floyd R, Bongar B. The cultural theory and model of suicide. Appl and Prev Psychol. 2010;14(1–4):25–40. https://doi.org/10.1016/j.appsy.2011.11.001.

    Article  Google Scholar 

  24. Hooks B. Feminist theory: From margin to center. Pluto Press; 2000.

  25. Davis A. The approaching obsolescence of housework: a working-class perspective. Women, Race, and Class. 1983; 222–44.

  26. Collins PH. Black feminist thought: knowledge, consciousness, and the politics of empowerment. Routledge; 2002.

  27. Crenshaw K. Demarginalizing the intersection of race and sex: a black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. u. Chi. Legal f. 1989; 139.

  28. Collins PH. On intellectual activism. Temple University Press; 2013.

  29. Spates K. What don’t kill us makes us stronger: African American women and suicide. Routledge; 2015

  30. Burns SM, Mahalik JR. Suicide and dominant masculinity norms among current and former United States military servicemen. Prof Psychol Res and Pract. 2011;42(5):347. https://doi.org/10.1037/a0025163.

    Article  Google Scholar 

  31. Braswell H, Kushner HI. Suicide, social integration, and masculinity in the US military. Soc Sci Med. 2012;74(4):530–6.

    Article  Google Scholar 

  32. Garland-Thomson R. Integrating disability, transforming feminist theory. NWSA journal. 2002; 1–32.

  33. Szymanski DM, Stewart DN. Racism and sexism as correlates of African American women’s psychological distress. Sex Roles: J Res. 2010;63(3–4):226–38. https://doi.org/10.1007/s11199-010-9788-0.

    Article  Google Scholar 

  34. Baiden P, LaBrenz CA, Asiedua-Baiden G, Muehlenkamp JJ. Examining the intersection of race/ethnicity and sexual orientation on SI and suicide attempt among adolescents: findings from the 2017 Youth Risk Behavior Survey. J Psychiatr Res. 2020;125:13–20. https://doi.org/10.1016/j.jpsychires.2020.02.029.

    Article  Google Scholar 

  35. Ferlatte O, Salway T, Hankivsky O, Trussler T, Oliffe JL, Marchand R. Recent suicide attempts across multiple social identities among gay and bisexual men: an intersectionality analysis. J Homosex. 2018;65(11):1507–26. https://doi.org/10.1080/00918369.2017.1377489.

    Article  Google Scholar 

  36. Essed P. Understanding everyday racism: an interdisciplinary theory. Thousand Oaks: Sage; 1991.

    Book  Google Scholar 

  37. Saguy AC, Gruys K. Morality and health: news media constructions of overweight and eating disorders. Soc Probl. 2010;57(2):231–50.

    Article  Google Scholar 

  38. Pyke KD, Johnson DL. Asian American women and racialized femininities: “Doing” gender across cultural worlds. Gend & Society. 2003;17(1):33–53. https://doi.org/10.1177/0891243202238977.

    Article  Google Scholar 

  39. Jones MS, Womack V, Jérémie-Brink G, Dickens DD. Gendered racism and mental health among young adult U.S Black women: the moderating roles of gendered racial identity centrality and identity shifting. Sex Roles: J Res. 2021. https://doi.org/10.1007/s11199-020-01214-1

  40. Ward EC, Heidrich SM. African American women’s beliefs about mental illness, stigma, and preferred coping behaviors. Res in Nurs & Health. 2009;32(5):480–92. https://doi.org/10.1177/0095798412438395.

    Article  Google Scholar 

  41. Woods-Giscombé CL. Superwoman schema: African American women’s views on stress, strength, and health. Qual Health Res. 2010;20(5):668–83. https://doi.org/10.1177/1049732310361892.

    Article  Google Scholar 

  42. Abrams JA, Maxwell M, Pope M, Belgrave FZ. Carrying the world with the grace of a lady and the grit of a warrior: deepening our understanding of the strong Black woman schema. Psychol Women Q. 2014;38(4):503–18. https://doi.org/10.1177/0361684314541418.

    Article  Google Scholar 

  43. Jackson JS, Knight KM, Rafferty JA. Race and unhealthy behaviors: chronic stress, the HPA axis, and physical and mental health disparities over the life course. Am J Public Health. 2010;100(5):933–9.

    Article  Google Scholar 

  44. Gibbs JT. African-American suicide: a cultural paradox. Suicide and Life-Threat Behav. 1991;27(1):68–79.

    Google Scholar 

  45. Manetta AA. Interpersonal violence and suicidal behavior in midlife African American women. J Black Stud. 1999;29(4):510–22.

    Article  Google Scholar 

  46. Abrams JA, Hill A, Maxwell M. Underneath the mask of the strong Black woman schema: disentangling influences of strength and self-silencing on depressive symptoms among US Black women. Sex Roles: A J of Res. 2019;80(9–10):517–26. https://doi.org/10.1007/s11199-018-0956-y.

    Article  Google Scholar 

  47. Green BN. Strong like my mama: the legacy of “strength”, depression, and suicidality in African American women. Women & Ther. 2019;42(3–4):265–88. https://doi.org/10.1080/02703149.2019.1622909.

    Article  Google Scholar 

  48. Watson-Singleton N. Strong Black woman schema and psychological distress: the mediating role of perceived emotional support. J Black Psychol. 2017;43(8):778–88. https://doi.org/10.1177/0095798417732414.

    Article  Google Scholar 

  49. Bowleg L. The problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am J Public Health. 2012;102(7):1267–73. https://doi.org/10.2105/AJPH.2012.300750.

    Article  Google Scholar 

  50. Donovan RA, West LM. Stress and mental health: moderating role of the strong Black woman stereotype. J Black Psychol. 2015;41(4):384–96. https://doi.org/10.1177/0095798417732414.

    Article  Google Scholar 

  51. Watson NN, Hunter CD. Anxiety and depression among African American women: the costs of strength and negative attitudes toward psychological help-seeking. Cult Divers Ethn Minor Psychol. 2015;21(4):604–12. https://doi.org/10.1037/cdp0000015.

    Article  Google Scholar 

  52. Diggins A, Woods-Giscombe C, Waters S. The association of perceived stress, contextualized stress, and emotional eating with body mass index in college-aged Black women. Eating Beh. 2015;19:188–92. https://doi.org/10.1016/j.eatbeh.2015.09.006.

    Article  Google Scholar 

  53. Wade JM. “Doing difference” and fast-food consumption: patterns among a sample of White and African American emerging adults. J Racial Ethn Health Dispar. 2018;5(2):398–409. https://doi.org/10.1007/s40615-017-0383-8.

    Article  Google Scholar 

  54. Beauboeuf-Lafontant T. Strong and large Black women? Exploring relationships between deviant womanhood and weight. Gend & Society. 2003;17(1):111–21. https://doi.org/10.1177/0891243202238981.

    Article  Google Scholar 

  55. Wade JM. Is it race, sex, gender or all three? Predicting risk for alcohol consumption in emerging adulthood. J Child and Fam Stud. 2020;29(12):3481–92. https://doi.org/10.1007/s10826-020-01780-8.

    Article  Google Scholar 

  56. Sue DW, Capodilupo CM, Holder A. Racial microaggressions in the life experience of Black Americans. Prof Psych Res and Pract. 2008;39(3):329.

    Article  Google Scholar 

  57. Greer TM. Coping strategies as moderators of the relation between individual race-related stress and mental health symptoms for African American women. Psychol Women Q. 2011;35(2):215–26. https://doi.org/10.1177/0361684311399388.

    Article  Google Scholar 

  58. Curtin SC, HedegaardH. Suicide rates for females and males by race and ethnicity: United States, 1999 and 2017. NCHS Health E-Stat. 2019. Retrieved from https://www.cdc.gov/nchs/data/hestat/suicide/rates_1999_2017.htm

  59. Williams D, Williams-Morris R. Racism and mental health: the African American experience. Ethn & Health. 2000;5(3–4):243–68.

    Article  CAS  Google Scholar 

  60. Turner RJ, Avison WR. Status variations in stress exposure: Implications for the interpretation of research on race, socioeconomic status, and gender. J Health Soc Behav. 2003;44(4):488–505.

    Article  Google Scholar 

  61. Davidson CL, Wingate LR, Slish ML, Rasmussen KA. The greatblack hope: Hope and its relation to suicide risk among African Americans. Suicide and Life-Threat Behav. 2010;40(2):170–80.

    Article  Google Scholar 

  62. Perry, BL, Harp, KL, & Oser, CB. Racial and gender discrimination in the stress process: Implications for African American women's health and well-being. Soc Perspect. 2013; 56(1):25-48. https://doi.org/10.1525/sop.2012.56.1.25

  63. Carr ER, Szymanski DM, Taha F, West LM, Kaslow NJ. Understanding the link between multiple oppressions and depression among African American women: the role of internalization. Psychol Women Q. 2014;38(2):233–45. https://doi.org/10.1177/0361684313499900.

  64. Stevens-Watkins D, Perry B, Pullen E, Jewell J, Oser CB. Examining the associations of racism, sexism, and stressful life events on psychological distress among African-American women. Cult Divers Ethn Minor Psychol. 2015;20(4):561–9. https://doi.org/10.1037/a0036700.

    Article  Google Scholar 

  65. Erving CL, Thomas CS, Frazier C. Is the Black-White mental health paradox consistent across gender and psychiatric disorders? Am J Epidemio. 2019;188(2):314–22. https://doi.org/10.1093/aje/kwy224.

    Article  Google Scholar 

  66. Buchanan NT, Fitzgerald LF. Effects of racial and sexual harassment on work and the psychological well-being of African American women. J Occup Health Psychol. 2008;13(2):137–51. https://doi.org/10.1037/1076-8998.13.2.137.

    Article  Google Scholar 

  67. Lewis JA, Neville HA. Construction and initial validation of the Gendered Racial Microaggressions Scale for Black women. J Counsel Psychol. 2015;62(2):289–302. https://doi.org/10.1037/cou0000062.

    Article  Google Scholar 

  68. Woods KC, Buchanan NT, Settles IH. Sexual harassment across the color line: experiences and outcomes of cross- versus intraracial sexual harassment among Black women. Cult Divers Ethn Minor Psychol. 2009;15(1):67–76. https://doi.org/10.1037/a0013541.

    Article  Google Scholar 

  69. Perry BL, Stevens-Watkins D, Oser CB. The moderating effects of skin color and ethnic identity affirmation on suicide risk among low-SES African American women. Race Soc Probl. 2013;5(1):1–14. https://doi.org/10.1007/s12552-012-9080-8.

    Article  Google Scholar 

  70. Moradi B, Subich LM. A concomitant examination of the relations of perceived racist and the sexist events to psychological distress for African American women. The Counsel Psychol. 2003;31(4):451–69. https://doi.org/10.1177/0011000003031004007.

    Article  Google Scholar 

  71. King KR. Racism or sexism? Attributional ambiguity and simultaneous memberships in multiple oppressed groups. J Applied Soc Psychol. 2003;33(2):223–47. https://doi.org/10.1111/j.1559-1816.2003.tb01894.x.

    Article  Google Scholar 

  72. Castle K, Conner K, Kaukeinen K, Tu X. Perceived racism, discrimination, and acculturation in suicidal ideation and suicide attempts among Black young adults. Suicide and Life-Threat Behav. 2011;41(3):342–51. https://doi.org/10.1111/j.1943-278X.2011.00033.x.

    Article  Google Scholar 

  73. Spicer RS, Miller TR. Suicide acts in 8 states: Incidence and case fatality rates by demographics and method. Am J Public Health. 2000;90(12):1885–91. https://doi.org/10.2105/AJPH.90.12.1885.

    Article  CAS  Google Scholar 

  74. Borrill J, Burnett R, Atkins R, Miller S, Briggs D, Weaver T, Maden A. Patterns of self-harm and attempted suicide among white and black/mixed race female prisoners. Crim Behav and Ment Health. 2003;13(4):229–40. https://doi.org/10.1002/cbm.549.

    Article  Google Scholar 

  75. Cooper J, Murphy E, Webb R, Hawton K, Bergen H, Waters K, Kapur N. Ethnic differences in self-harm, rates, characteristics, and service provision: three-city cohort study. Br J Psyciatry. 2010;197(3):212–8. https://doi.org/10.1192/bjp.bp.109.072637.

    Article  Google Scholar 

  76. Kaslow NJ, Jacobs CH, Young SL, Cook S. Suicidal behavior among low-income African American women: a comparison of first-time and repeat suicide attempters. J Black Psych. 2006;32(3):349–65. https://doi.org/10.1177/0095798406290459.

    Article  Google Scholar 

  77. Buchanan NT, Wiklund LO. Why clinical science must change or die: integrating intersectionality and social justice. Women Ther. 2020;43(3–4):309–29.

    Article  Google Scholar 

  78. Sue DW, Rasheed MN, Rasheed JM. Multicultural social work practice: a competency-based approach to diversity and social justice. John Wiley & Sons; 2015

  79. Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA, Mann JJ. The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry. 2011;168(12):1266–77. https://doi.org/10.1176/appi.ajp.2011.10111704.

    Article  Google Scholar 

  80. Chu J, Floyd R, Diep H, Pardo S, Goldblum P, Bongar B. A tool for the culturally competent assessment of suicide: The Cultural Assessment of Risk for Suicide (CARS) Measure. Psychol Assessment. 2013;25(2):424. https://doi.org/10.1037/a0031264.

    Article  Google Scholar 

  81. Davis SP, Arnette NC, Bethea KS, Graves KN, Rhodes MN, Harp SE, Dunn SE, Patel MN, Kaslow NJ. The Grady Nia Project: a culturally competent intervention for low-income, abused, and suicidal African American women. Prof Psychol: Res and Pract. 2009;40(2):141–7. https://doi.org/10.1037/a0014566.

    Article  Google Scholar 

  82. Heron, RL, Twomey, HB., Jacobs, DP, Kaslow, NJ. Culturally competent interventions for abused and suicidal African American women. Psycho: Theory Res.Pract. Train. 1997; 34(4), 410–424. https://doi.org/10.1037/h0087639

  83. Zastrow C, Kirst-Ashman KK, Hessenauer SL. Empowerment series: understanding human behavior and the social environment. Cengage Learning; 2019

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michelle M. Vance.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vance, M.M., Wade, J.M., Brandy , M. et al. Contextualizing Black Women’s Mental Health in the Twenty-First Century: Gendered Racism and Suicide-Related Behavior. J. Racial and Ethnic Health Disparities 10, 83–92 (2023). https://doi.org/10.1007/s40615-021-01198-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40615-021-01198-y

Keywords

Navigation