Aim
To examine factors that influence intrapartum health outcomes among Black childbearing persons, including cisgender women, transmasculine and gender‐diverse birthing persons.
Background
Black ...childbearing persons are three to four times (243%) more likely to die while giving birth than any other racial/ethnic group. Black birthing persons are not just dying from complications but also from inequitable care from healthcare providers compared to their white counterparts.
Design
Discursive paper.
Method
Searching national literature published between 2010 and 2021 in PubMed, CINAHL, Embase and SCOPUS, we explored factors associated with poor intrapartum health outcomes among Black childbearing persons.
Discussion
Several studies have ruled out social determinants of health as sufficient causative factors for poor intrapartum health outcomes among Black birthing persons. Recent research has shown that discrimination by race heavily influences whether a birthing person dies while childbearing.
Conclusions
There is a historical context for obstetric medicine that includes harmful stereotypes, implicit bias and racism, all having a negative impact on intrapartum health outcomes. The existing health disparity among this population is endemic and requires close attention.
Impact on Nursing Practice
Nurses and other healthcare professionals must understand their role in establishing unbiased care that promotes respect for diversity, equity and inclusion.
No Patient or Public Contribution
There was no patient or public involvement in the design or drafting of this discursive paper.
Aim
The purpose of this article is to summarize research targeting hypertension and healthcare access among adults living in rural Haiti.
Background
Hypertension is a significant public health ...problem that impacts one in five persons globally. It is the leading cause of cardiovascular‐related conditions such as stroke and myocardial infarction and accounts for most global non‐communicable disease‐related deaths. Limited healthcare access and social determinants of health are known contributors to poor health outcomes among persons with hypertension. Among Haitians, there are stark health disparities between those who live in urban versus rural areas.
Design
A discursive review.
Results
Several issues are identified as barriers to proper hypertension prevention and management. However, after examining the effective interventions, we found that social determinants of health such as transportation costs, lack of field care facilities close to patients, roadway conditions, political disturbance, and ineffective leadership and policies are major barriers to controlling hypertension in Haiti. Although Haiti has received help from international organizations, strengthening its internal infrastructure is paramount in improving healthcare access.
Discussion
The review concludes that Haitians living in rural parts of Haiti are less likely to receive healthcare to manage non‐communicable diseases such as hypertension. Similar to other developing countries, a heightened awareness is needed to address the lack of healthcare access for those living in rural communities.
Impact to Nursing Practice
Nurses and other healthcare professionals working with populations in Haiti should become aware of the barriers and facilitators that promote sufficient healthcare access. To achieve this goal, nurses must understand the social determinants and other factors that serve as barriers for achieving access to quality care for this vulnerable population.
No Patient or Public Contribution
There was no patient or public involvement in the design or drafting of this discursive paper.
Aim
To examine the intergenerational impact of systemic racism on mental health, depicting the evolution and patterns of anxiety symptoms and the application of the Bowenian family therapy to ...understand the interrelatedness and long‐standing impact of intergenerational trauma in African American families. This article highlights interventions that increase awareness of and promotes physical and mental health for African American populations.
Design
Discursive Paper.
Method
Searching literature published between 2012 and 2022 in PubMed, SCOPUS, EBSCO Host and Google Scholar, we explored factors associated with systemic racism and generational anxiety.
Discussion
Evidence‐based literature supports the application of the Bowenian family therapy theoretical framework to understand the intergenerational impact of systemic racism and to address the transmission of anxiety symptoms in African American populations.
Conclusion
Culturally appropriate interventions are needed to decrease anxiety symptoms in an attempt to heal intergenerational trauma and to improve family dynamics in African American populations.
Impact to Nursing Practice
Nurses play an integral role in providing holistic quality patient‐centred care for African American populations who have experienced racial trauma. It is critical for nurses to implement culturally responsive and racially informed care with patients that focuses on self‐awareness, health promotion, prevention and healing in efforts to address racial trauma. Application of Bowenian family therapy can aid in the reduction of both intergenerational transmission of racial trauma and generational anxiety.
No Patient or Public Contribution
There was no patient or public involvement in the design or drafting of this discursive paper. The authors reviewed the literature to develop a discussion.
Racial discrimination in health care: An “us” problem Baptiste, Diana‐Lyn; Josiah, Nia A.; Alexander, Kamila A. ...
Journal of clinical nursing,
December 2020, 2020-12-00, 20201201, Volume:
29, Issue:
23-24
Journal Article
Physical characteristics used to identify racial groups vary with geography and do not correspond to underlying biological traits” (Cerdeña et al., 2020). ...race is not a biological reality but a ...social construct. During the study, penicillin was later identified as an appropriate treatment for syphilis; however, treatment was withheld while researchers continued observing the progression of the disease among participants. Throughout the study, the boys were placed on a low-protein diet, not allowed water intake during overnight sessions and were not given any prescribed maintenance medications for underlying chronic conditions, such as asthma (Brown, 2003). ...HeLa cells have been used for human genome studies, virology and for the development of the COVID-19 vaccine (Johns Hopkins Medicine, 2022).
...simply experiencing pregnancy as a Black woman poses a higher risk for maternal death (Burke, 2020; Howell, 2018). Evidence-based literature supports that social determinants of health such as low ...socioeconomic status, low levels of educational attainment and limited access to healthcare as contributing factors to health disparities. ...research unearths that non-Black providers' racial biases, specifically in pain perception, are also associated with racial biases in pain treatment and management resulting in negative maternal health outcomes for Black patient populations (Gillette-Pierce et al., 2022; Hoffman et al., 2016; Saluja & Bryant, 2021). ...this myth was a foundational tenet upon which the field of gynaecology was developed—Black women were routinely the unanaesthetized test subjects of novel gynaecological surgical interventions performed by physicians in the 19th century (Chinn et al., 2021; Gillette-Pierce et al., 2022).
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