Experiences of dehumanizing: Examining secondary victimization within the nurse-patient relationship among African American women survivors of sexual assault in the Upper Midwest.

Despite calls recognizing the need for culturally sensitive responses to minimize the occurrence of secondary victimization for African American women following an experience of sexual assault, few studies have focused on hearing from African American women survivors about their experiences receiving healthcare services in a hospital setting following sexual assault. Employing critical ethnography as our methodology and using intersectionality theory as a lens, we centered the voices of African American women survivors about their experiences receiving nursing care in urban acute care or hospital settings in the Upper Midwest of the United States following sexual assault. In this qualitative study, 30 African American women survivors were interviewed using in-depth, semi-structured interviews about their post-sexual assault care. Interviews were analyzed using thematic analysis. An important theme identified focused on survivors' experiences of dehumanization when receiving healthcare services following sexual assault. These experiences included: discrediting, dismissing, shaming, and blaming. To mitigate and prevent secondary victimization in the future, we present practice and education change recommendations for nurses, and healthcare providers more broadly, based on the voices of African American female survivors of sexual assault.

The Effect of Racism and Discrimination on the Health of Milwaukee's African American Population.

BACKGROUND: This scoping review focuses on the intersections of racism, health, and health care, as well as interventions for the African American population in Milwaukee, Wisconsin-one of the most hypersegregated regions in the country. We investigate what existing research provides about the impact of segregation and racism on health and consider how community setting informs health interventions, practice, and policy. METHODS: We analyzed studies that address racism and health in Milwaukee to assess the state of the science in this area. We searched databases using the terms "African American," "racism," "segregation," and "health." A total of 296 studies resulted, and 54 met the inclusion criteria. RESULTS: Racism is a known determinant of health. However, a lack of research investigating the impact of racism on health in Milwaukee County leaves a knowledge gap necessary for improving health among African American residents. The adverse effects of racism on health are compounded by the social, economic, and policy context of geographic and social segregation that limit access to care and resilience. Themes identified in the review include measures of physical and mental health, community factors related to health (eg, housing, environmental contamination, economic and social exclusion), intervention strategies, and theoretical gaps. DISCUSSION: Professionals must work across disciplines and social sectors to address the effects of racism on the physical and mental health of African American individuals in urban metropolitan environments. Health research and medical interventions in hypersegregated communities must center structural racism in their analysis.