Structural Racism And Black Women’s Employment In The US Health Care Sector

Janette Dill, Mignon Duffy

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)265-272
Number of pages8
JournalHealth Affairs
Issue number2
StatePublished - Feb 2022

Bibliographical note

Funding Information:
Support was provided by the National Institute on Aging (Grant No. P30AG066613 to Phyllis Moen). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors thank Odichinma Akosionu J’Mag Karbeah, Chandra Waring, and Caitlin Carrol. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See by/4.0/.

Publisher Copyright:
© 2022, Project HOPE. All rights reserved.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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