Keith and Brown present a conceptual model for understanding the way in which the interrelationships among race, gender, and socioeconomic status (SES) influence mental well-being for African American women. Mental well-being is affected by social, cultural, and psychological factors as well as by physical health and health behavior; in turn these factors are influenced by one's social status (i.e., race, gender, SES). African American women are subject to racism, sexism, and for some, heterosexism, which diminish their educational attainment, personal and household incomes, occupational status, wealth accumulation, and opportunities for socioeconomic advancement. Consequently, African American women have fewer resources than their white counterparts and are far more limited in their capacity to cope with crises and adversities. Stressors such as poverty and economic hardship also challenge the adaptive abilities of many African American women. They are less likely to be married and, if married, more likely to be employed and responsible for more household chores than white married women. Parenthood often is another source of stress as many African American women are single parents. The particular set of roles that African American women must fulfill may also expose them to more stressful life circumstances. Combining employment and parenthood roles increases the likelihood that they will experience role overload and role conflict, especially when coping resources are limited. A key argument made by Keith and Brown is that there is a strong connection between mental and physical health. African American women have poorer physical health with higher rates of diabetes, hypertension, HIV infection, and lupus, which lead to higher mortality rates than white women. Additionally, African American women are less likely to use health care, which may be due to a lack of access, among other factors. However, the extended social networks of African American women may provide important sources of social support. What other types of social support would help African American women cope with the many sources of stress in their lives and would immigrant and LGBT women need additional supportive resources?
African American women, including immigrants, are disproportionately challenged by a host of social conditions that are linked to higher risk for poor mental health, including low incomes, high levels of poverty and unemployment, single motherhood, poor physical health, and residence in economically disadvantaged neighborhoods where these problems are compounded (Murry et al., 2008; Schulz et al., 2000).