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Coping at the Intersection: a Transformative Mixed Methods Study

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COPING AT THE INTERSECTION: A TRANSFORMATIVE MIXED METHODS STUDY OF GENDERED RACISM AS A ROOT CAUSE OF MENTAL HEALTH CHALLENGES IN BLACK COLLEGE WOMEN by WANDA MARTIN BURTON DAVID A. BIRCH, COMMITTEE CHAIR ANGELIA M. PASCHAL, COMMITTEE CO-CHAIR KELLY W. GUYOTTE JAMES D. LEEPER ADAM P. KNOWLDEN A DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Health Science in the Graduate School of The University of Alabama TUSCALOOSA, ALABAMA 2017 Copyright Wanda Martin Burton 2017 ALL RIGHTS RESERVED ABSTRACT Background. Racism negatively impacts the mental health of people of color. Racial identity has been suggested as a buffer against racism. But women of color are at increased risk for mental health challenges due to gendered racism; it is based on intersectionality theory. The purpose of this study was to understand the impact of and coping strategies used to deal with gendered racism on the mental health of Black college women. Methods. The mixed methods design included a nonrandom sample of 213 Black college women. Mental health was operationalized as depression (PHQ-9) and psychological distress (K- 6). Correlation and regression analyses tested the impact of gendered racism on mental health; examined the role of racial identity; and, explored coping strategies. Through intensity sampling, the qualitative phase included individual interviews (n=12) and a focus group (n=6). Narrative inquiry was used to construct composite counter-narratives, using thematic narrative analysis. Findings. Quantitative results suggested that 84% of the sample require mental health treatment. Gendered racism negatively correlated with mental health; the most significant correlation was between depression and the frequency of gendered racism, r(95) = .405, p ≤ .01. Racial identity was not related to mental health and therefore could not be tested as a mediating factor. The qualitative phase revealed narratives of gendered racism across multiple levels. The institutional level helped to create the normative experience of gendered racism through lack of effective policy; it also impacted the individual and interpersonal levels. Belief in the SBW and acceptance of limitations to full humanity were the result of internalized gendered racism. The ii interpersonal level included narratives of sexual assault, being mistaken as ‘the help,’ and assumptions about communication style and educational level. The mixed methods results suggested that effective coping depends on increased education and the deconstruction of gendered racism followed by the use of humor and social support. Discussion. College mental health interventions should include an emphasis on gendered racism. Narratives revealed how Black college women accept and resist the normative experience of gendered racism. The mixed methods design provided a more nuanced understanding of how Black women cope with gendered racism. iii DEDICATION This dissertation is dedicated to my daughters, Kourtney & Khloe, with love and hope for tomorrow. iv LIST OF ABBREVIATIONS AND SYMBOLS ABW Angry Black Woman ideology ACHA-NCHA American College Health Association-National College Health Assessment APHA American Public Health Association Brief COPE Brief Coping Orientations to Problems Experienced: coping measure CDC Centers for Disease Control and Prevention CRT Critical race theory GRMS Gendered racial microagressions scale: gendered racism measure K6 Kessler-6: psychological distress measure n Sample size MIBI Multi-dimensional Inventory of Black Identity: racial identity measure p Probability QUAL Qualitative phase of mixed methods research QUAN Quantitative phase of mixed methods research r Pearson product-moment correlation PHCRP Public Health Critical Race Praxis PHQ-9 Patient Health Questionnaire-9: depression measure PWI Predominantly white institution SEM Social ecological model SBW StrongBlackWoman ideology v SD Standard deviation < Less than = Equal to vi ACKNOWLEDGMENTS First, I would like to thank my committee for their time, support, and expertise. Completing this dissertation has taught me about the importance of my own voice and my committee members’ encouragement and respect throughout this process have been invaluable. I am especially indebted to my co-chairs, Dr. Birch and Dr. Paschal, who allowed me to drop in anytime and not only provided support for this dissertation but for my own professional and personal growth over the last three years. Dr. Birch, as a mentor throughout this doctoral program, I have been privileged to learn from you as a leader in the field. I thank you for your inspiration to challenge when necessary and for your sense of humor. Dr. Paschal, you have been a mentor for me with both your words and actions and your presence has meant the world to me. I would not be here were it not for you. I have shared many laughs with you both and that made this process much easier. Dr. Guyotte, thank you for your words of encouragement, reminding me to be kind to myself and at the same time challenging me to reach deeper and say what remains to be said. Dr. Leeper, I do not know of a better teacher. You stressed the importance of context and that your piece of the puzzle is still only one piece. Dr. Knowlden, thank you for your attention to detail on this dissertation as well as your example as a newer professional in this field. You provide students with the tools you use to reach your goals, making your standard appear within reach. I genuinely appreciate each of you. Recruiting Black women at a PWI is not an easy feat. Therefore, I appreciate the assistance I received from various academic departments and student organizations that deemed vii this study worthy of their class and meeting time. While I cannot list them all, I would like to recognize the following academic programs and student orgs for their time and effort in recruitment: African American Graduate Student Association, Black Student Union, College of Human Environmental Sciences, Department of Gender and Race Studies, Future Black Law Students Association, National Council of Negro Women, School of Social Work, and the Women of Excellence. I could not have completed this study in such a short timespan without your assistance. I would also like to thank my family. To my best friend and husband Michael, I am forever grateful for your support throughout this process. Your commitment has allowed me the opportunity to complete this degree. Thank you for doing more than your share. I love you. To my sisters, Lisa and Michelle, you helped raise me and have always been my biggest cheerleaders. You have done way too much for me to put into words. All I can say is thank you and I hope that I have made you proud. To my mom, I will one day write a book to share your glory with the world. Your life is my inspiration. To Aunt Mamie and Cookie, your support as my other mothers is so appreciated. I can honestly say, that I have always been surrounded by Black women who give me everything I need. And in that sense, I would like to acknowledge Jackie, Debra (Ann), Linda, Brenda, Ms. Catherine, Nikki, Tyronica (Lady), Aunt Hattie, and Aunt Geneva. I knew that all I had to do was ask. In addition to my family, I have countless friends that have poured into my life. Thank you to Lacrystal, Angie, Stephaine, Shay, Paige, and Latronia. In your own unique ways, you have all made completing this dissertation more possible. Your actions and words of encouragement have meant so much and I thank you. More recently, I have been able to depend on the support of those in my cohort, Amanda, Ashley and Andrew. Our ongoing, countless viii inside jokes have made this bumpy journey seem smoother. I appreciate all of them as well as your friendship. I look forward to seeing how we grow professionally in the years to come. I would also like to thank the other mentors who have encouraged me. Elle, as director of the Women and Gender Resource Center, you gave me space to delve into theory that helped change my life. Your understanding and friendship have been invaluable. Dr. Hernandez-Reif, it was you who first opened the door for this to be considered a possibility. I sincerely thank the both of you! There are countless others, though not named here, who have encouraged me along the way and I am eternally grateful. And finally, to my babies, Kourtney, Khloe, Krystina, Justin, Kristopher, Jarmarcus, LeDarius, & MaKyia, each of you teach me the meaning of joy. I love you and thank you! ix CONTENTS ABSTRACT .................................................................................................................................... ii DEDICATION ............................................................................................................................... iv LIST OF ABBREVIATIONS AND SYMBOLS ........................................................................... v ACKNOWLEDGMENTS ............................................................................................................ vii LIST OF TABLES ....................................................................................................................... xiv LIST OF FIGURES ...................................................................................................................... xv CHAPTER 1. INTRODUCTION ................................................................................................... 1 Background ................................................................................................................................
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