Browsing by Subject "Intersectionality"

This thesis investigates the work and life experiences of an under-discussed and female-dominant Chinese diasporic community, Chinese immigrant teachers in American K12 education. I argue that, firstly, while being privileged as high-skilled professionals and enjoying more mobility compared to their domestic sisters, Chinese female immigrant teachers are also subject to the precarity and intersectionality deriving from the underfunded American education and their triple marginality of being women, Asian and first-generation immigrants. Secondly, the structural inequality of gendered labor performed in both the professional and domestic roles of female teachers tends to be reinforced in the diaspora. By adopting mixed approaches of interview-based ethnography and digital ethnography, this thesis offers a critical alternative to the masculine and material version of Chinese immigration and contributes to a more extensive intellectual effort to understand the systematic racial and gender inequality associated with globalization.

Black girls who attend elite, predominantly white schools face a host of unique challenges and tasks in achieving a positive, resolved gendered-racial identity; they must learn to reconcile external and potentially negative definitions of Black girlhood while making their own meaning of being a young, Black woman. I take an intracategorical approach to understanding the development and experience of this intersectional identity in a predominantly white, elite independent school. This study highlights Black girls lived experience in this specific context to reveal how their multidimensional identities develop, shape and are shaped by their schools. First, I explore the sources on which the girls relied to better understand their Black girl identities. Second, I examine the relationship between school context and the girls’ romantic experiences and romantic self-concept. Last, I investigate whether and in what manner school settings influence second-generation, Black immigrant girls’ identity development. Using data collected from fifty semi-structured, narrative style interviews, I find that in elite, white school settings, (i) Black girls were the most influential figures in one another’s identity development process; (ii) their white school contexts limited Black girls’ romantic opportunities in ways that contributed to a negative romantic self-concept; and (iii) in elite, white school settings, second-generation Black immigrant girls developed hybrid identities that integrated their ethnic heritage, their experiences in America as Black girls, and their experiences of difference and desire for racial community at school.

Behavioral health (BH) refers to emotional well-being and actions that affect wellness, and includes mental health (MH) and substance use (SU) disorders. Although estimates vary, it is generally agreed that about 50% of all individuals held in jails and prisons suffer from a BH disorder. Justice-involved (JI) adults under supervision in the community (i.e. parolees, individuals exiting prison, and probationers, individuals that may be exiting jail, or under correctional supervision in the community for a specified amount of time instead of incarceration) often have untreated BH needs, particularly co-occurring MH and SU disorders. Untreated BH disorders are a barrier to community re-integration, and contribute to risk taking behaviors, SU relapse, and recidivism post-release. However, rehabilitative reentry efforts typically focus on SU treatment alone, resulting in unmet MH treatment needs. Research also indicates differential rates of BH disorders among justice-involved adults by self-reported gender and race/ethnicity, but national estimates are limited. Likewise, the post-release BH care experiences for these individuals are poorly delineated.

The overall purpose of this dissertation was to develop a deeper understanding of the BH needs and community-based BH treatment utilization in justice-involved adults. Chapter one provides an overview of the research problem, background, and significance; identifies gaps in knowledge related to this dissertation study as identified by the literature; and provides a summary of the conceptual and theoretical frameworks that guided the aims of this dissertation. Chapter two provides the results of a systematic review of the extant literature on the unmet BH needs and barriers and facilitators to community-based BH treatment utilization among justice-involved adults. Chapters three and four present the results of a secondary analysis of data from the 2016 National Survey on Drug Use and Health (NSDUH). Chapter five summarizes and synthesizes dissertation results, and provides recommendations for future research and implications for nursing practice.

Chapter three details the results of a cross-sectional, descriptive, and correlational study to describe and compare the past-year prevalence of depression, serious psychological distress, and/or SU disorders among JI adults compared to a group of adults not on parole or probation at any point during the past year, adjusting for individual characteristics informed by the social determinants of health (SDOH) framework. Chapter four describes the employment of a modified version of the Meleis’ Transitions Theory to highlight the increased vulnerability of JI adults with these BH needs during community reentry. This dissertation treated community reentry as a situational transition and the pattern of transition as multiple and simultaneous in JI adults, as they often face multiple challenges related to community reentry and integration. Specifically, this chapter focused on the describing the impact of self-reported gender, race/ethnicity, and their intersectionality (factors that influence the pattern of transition) on past-year BH needs and BH treatment utilization among JI adults with BH needs. Chapter four also details the individual-level and community/societal-level barriers to BH treatment utilization among JI adults with BH needs.

Results from our systematic review of the literature support high rates of BH needs and psychosocial stressors among justice-involved adults. Sociodemographic and geographical location were critical influences on disparities in BH needs and BH treatment utilization, and justice-involvement was a significant facilitator of BH treatment utilization among justice-involved adults. Further, although rates of health insurance have increased among justice-involved adults, rates of BH treatment utilization have not significantly improved and considerable unmet need for BH treatment persists. Dissertation study results (chapters three and four) revealed that almost half (46%) of the justice-involve group were affected by a BH disorder, and self-reported gender, race/ethnicity, and their intersectionality, significantly impact the probability of being affected by a past-year BH need and BH treatment utilization. Justice-involvement was a significant predictor of being affected by a BH need, with higher prevalence rates among the JI group. Age (18-49 years), an annual income less than $20 thousand, not married, and reporting fair/poor health were SDOH that were found to significantly increase the risk factors for BH needs in the JI group in this dissertation study.

Justice health is integral to public health, and efforts to address the national BH crisis must include and prioritize justice-involved individuals. Study results contribute to the limited literature on the impact of gender, race/ethnicity, and their intersectionality on BH and BH treatment utilization in justice-involved adults. Further, inability to access BH treatment utilization due to cost remains a persistent barrier to community-based BH treatment utilization among justice-involved adults. Dissertation findings provide further evidence of the disproportionately higher prevalence of BH needs among justice-involved adults compared to the non-justice-involved adults. It provides the first examination of co-occurring MH and SUDs in justice-involved adults in a nationally representative sample, and contributes to overcoming the paucity of literature differentiating substance misuse and dependency, which have significant implications for community-based BH treatment service planning and provision. Findings can inform a public health approach to identifying and treating BH disorders that is population-based, aid in the development of effective BH transitional and post-release reentry efforts, and contribute to improved BH equity and community integration in justice-involved adults.

This dissertation examines the topic of social perceptions regarding political candidates at the intersection of race and gender. Within this project I analyze 1) the degree to which stereotypes are held at different points of this intersection; 2) the degree to which these stereotypes can be influenced by way of priming via common news reporting messages; and 3) the ways in which these stereotypes and perceptions influence evaluations of Black female political candidates and their electoral prospects. In order to examine these issues, I utilize data from two surveys I have designed: the 2011 Social Cognition and Evaluation Survey and the 2012 Political Candidate Evaluation and Social Beliefs Survey. The former gathers information regarding social and personal perceptions of "average" and "elite" Black women, White women, Black men, and White men, and the ways in which negative intersectional priming messages can influence the evaluation of each of these groups. The latter survey includes an embedded experiment in which respondents participate in two mock elections and candidate evaluations. One mock election includes a Black female with a relatively dark complexion as the fixed candidate and the other includes a Black female with a relatively light complexion as the fixed candidate, with each competing against either a White male, White female, or Black male opponent. Based on the data from the aforementioned surveys, I find that people engage in stereotyping in an intersectional, rather than a one-dimensional, manner. Consequently, Black women at different social status levels and with differing skin tones are subject to distinct intensities of the attribution of racialized, gendered, and intersectional stereotypes. In turn, the ways in which the voting public evaluates them as political candidates are influenced by these stereotypes.

Problem: The disparate health outcomes of African American mothers living with HIV functions at the intersection of gender-, race-, and class-inequality; HIV-related stigma; and motherhood, requiring multidimensional approaches to address the complex social and economic conditions of their lives, collectively known as the social determinants of health. African American women suffer significantly higher HIV infection rates and tend to die earlier from their infection than their White counterparts. Poverty is a significant precipitating factor for HIV infection and African American women are disproportionately poorer than other subpopulations in the United States. HIV-related stigma is linked to poorer mental and physical health outcomes across a broad range of demographic profiles. Being a mother adds an extra layer of social complexity to the lives of women living with HIV. This dissertation was designed to develop knowledge on the social determinants of health for African American mothers living with HIV by describing their social location at the intersection of gender-, race- and class – inequality; HIV-related stigma; and motherhood and exploring how their unique social identity influences their health-related experiences.

Methods: Using data from a literature review on intersectional approaches and other frameworks for examining vulnerable populations, an intersectional model for the study of the social determinants of health for African American mothers living with HIV was constructed. A pilot study exploring the methodological issues and ethical challenges of using photo elicitation with a highly stigmatized social group of women was conducted. The intersectional model and pilot study findings were then used to guide a qualitative descriptive study using storyline graphs, photo elicitation and in-depth qualitative interviewing as methods for exploring the intersection of the social determinants of health for eighteen (18) African American mothers living with HIV. Content, vector and frame analyses were used to describe the intersection of social determinants and identify potential process and structural level interventions.

Results: Findings from the pilot study include best practices for using visual methods with a highly stigmatized and potentially vulnerable group of women. Findings from the qualitative descriptive study include six additional social determinants of health - social support, religiosity, animal companions, physical environment, transportation and housing - not initially included in the conceptual model, a case for strength-based approaches, intersecting social determinants functioning as systems of oppression and the heterogeneous and fluid social locations as framed from the mother’s perspective. Three frames of social location for African American mothers living with HIV were proposed – emancipatory, situational, and internalized – as well as potential health implications and interventions. Each of the findings add to the literature on the configuration of intersecting social determinants health relevant to African American mothers living with HIV, expand the proposed intersectional model and help to generate hypotheses needed for intervention studies.