“They don't care”: The implications of systemic racism on Black women's help-seeking during the COVID-19 pandemic

Objectives Black women in the United States experience disproportionately high rates of intimate partner violence (IPV) and persistent barriers to care. Guided by decolonial frameworks, this study examines how systemic racism shaped Black women's help-seeking during the COVID-19 pandemic. Methods This qualitative inquiry is part of a mixed-methods R01 study conducted in the Upper Midwest. Between 2021 and 2023, we conducted semi-structured interviews with 28 urban Black women who experienced IPV during the pandemic. Participants were recruited through community agencies using purposive and snowball sampling. Interviews examined help-seeking, system interactions, and perceptions of safety. Data were thematically analyzed using an interpretive approach informed by Black feminist thought. Results Three interrelated themes shaped help-seeking: (1) mistrust rooted in racialized harm; (2) mistrust reinforced through harmful interactions with institutions; and (3) conditions that supported trust. Help-seeking was shaped by individual histories, community context, and perceived safety. Conclusions Systemic racism shapes Black women's help-seeking following IPV. Public health responses must address structural drivers of mistrust, strengthen culturally responsive and trauma-informed care, and center lived experiences to advance trust, cultural safety, and accountability in policy and practice.