MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Structural Racism And Black Women's Employment In The US Health Care Sector Health Professionals

Citation Type: Journal Article

Publication Year: 2022

DOI: 10.1377/hlthaff.2021.01400

Abstract: The objective of this study was to describe how structural racism and sexism shape the employment trajectories of Black women in the US health care system. Using data from the American Community Survey, we found that Black women are more overrepresented than any other demographic group in health care and are heavily concentrated in some of its lowest-wage and most hazardous jobs. More than one in five Black women in the labor force (23 percent) are employed in the health care sector, and among this group, Black women have the highest probability of working in the long-term-care sector (37 percent) and in licensed practical nurse or aide occupations (42 percent). Our findings link Black women's position in the labor force to the historical legacies of sexism and racism, dating back to the division of care work in slavery and domestic service. Our policy recommendations include raising wages across the low-wage end of the sector, providing accessible career ladders to allow workers in low-wage health care to advance, and addressing racism in the pipeline of health care professions. T he COVID-19 pandemic has brought heightened attention to racial disparities in health outcomes as infections, hospitalizations, and deaths have had a disproportionate impact on Black populations, Indigenous populations , and populations of people of color. 1 In this article we focus on an aspect of racism and health that has gotten somewhat less attention: the role of racism in the stratification of the health care workforce. Specifically, we build on the insights of interdisciplinary scholarship about the gendered and racialized division of care to examine the unique role of Black women in health care.We argue that structural racism in the labor market, linked to historical legacies of slavery and domestic service, has had a strong impact on shaping the health care workforce. The stratification of the health care workforce and the concentration of women who are Black, Indigenous, and people of color in low-wage health care jobs is well established. 2-5 Scholars have also found that women of color in caregiv-ing jobs often experience discriminatory treatment and racist abuse from both employers and care recipients. 6,7 Our goal here is to broaden the focus beyond individual exposure to racism and discrimination to explore the role of racism at a macro level. Structural racism is defined as struc-turing opportunity and assigning value based on race, unfairly disadvantaging some individuals and communities and advantaging others. 8,9 Structural racism can only be understood by reference to historical processes, and we look to the history of care to understand contemporary patterns. Scholars of care define care broadly to include the paid and unpaid labor of caring for people who are young, old, ill, or disabled.

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Authors: Dill, Janette; Duffy, Mignon

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IPUMS NHGIS NAPP IHIS ATUS Terrapop