'Aint We Women?' A Narrative Review of Intensive and Acute Care Experiences of Black Women Through an Intersectional Lens.

backgroundResearch on gender and racial disparities in intensive care is emerging. Women experience less intensity of care, less utilisation of critical care resources and poorer overall health outcomes. These disparities may become more pronounced when race is considered. Black women experience more barriers in accessing care, yet their unique needs, critical care experiences and illness trajectories are understudied. Intersectionality theory can help explore how overlapping systems of oppression contribute to greater health disparities and poorer health outcomes in Black women.

aimTo summarise evidence on the experiences of Black women receiving critical and acute care in high-income countries. STUDY

designA narrative review using an intersectionality of gender and race lens. Given the scarcity of studies in critical care, we included evidence from other acute care settings to emphasise the importance of intersectionality in understanding health disparities in critical care. Databases used included CINAHL, Cochrane, Embase, Medline, PsycINFO, Scopus, ProQuest Dissertations and Theses. The Scale for the Assessment of Narrative Review Articles guided reporting.

findingsTen studies, all conducted in the United States, were analysed. Four themes present the findings, including critical care outcomes in Black women through an intersectional lens, structural vulnerability of Black women, micro-aggressions and intersections of race and gender stress in Black women.

conclusionsThe paucity of literature on Black women's critical care experiences may cause further marginalisation in their care. RELEVANCE FOR CLINICAL PRACTICE: Critical care systems should collect data on patients' identities (i.e., race, gender, socio-economic status) to assist in analyzing health disparities across populations.