Rachel R Hardeman
Biographic Data
| ID | 176718 |
|---|---|
| NAME | Rachel R Hardeman |
| GIVEN NAMES | Rachel R |
| FAMILY NAME | Hardeman |
| SIGNATURE | HARDEMAN R R |
| AFFILIATIONS | University of Minnesota |
| ORCID | 0000-0003-3913-5933 |
| VERIFIED | Yes |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 362 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2011 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 10 |
Perspectives from Black Women in the Midwest about Structural Racism and Reproductive Health
Background: The Midwestern United States is a region with both positive overall maternal health outcomes and extreme racial inequities. There is growing attention to the role of structural racism in creating these disparities, yet limited research on how Black women define and experience structural racism in the Midwest. Purpose: This qualitative study aims to understand how Black women in the Midwest experience structural racism, primarily relat…
The Place Where Danger Waits”
“Hang Ups, Let Downs, Bad Breaks, Setbacks”
Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as “hang ups, let downs, bad breaks, setbacks” that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized lands…
Interpersonal Discrimination, Neighborhood Inequities, and Children's Body Mass Index
Psychosocial stressors have been implicated in childhood obesity, but the role of racism-related stressors is less clear. This study explored associations between neighborhood inequities, discrimination/harassment, and child body mass index (BMI). Parents of children aged 5-9 years from diverse racial/ethnic backgrounds (n = 1307), completed surveys of their child's exposure to discrimination/harassment. Census tract data derived from addresses w…
Mechanisms Connecting Police Brutality, Intersectionality, and Women’s Health Over the Life Course
Police brutality harms women. Structural racism and structural sexism expose women of color to police brutality through 4 interrelated mechanisms: (1) desecration of Black womanhood, (2) criminalization of communities of color, (3) hypersexualization of Black and Brown women, and (4) vicarious marginalization. We analyze intersectionality as a framework for understanding racial and gender determinants of police brutality, arguing that public heal…
Neighborhood Proactive Policing and Racial Inequities in Preterm Birth in New Orleans, 2018‒2019
Objectives. To measure neighborhood exposure to proactive policing as a manifestation of structural racism and its association with preterm birth. Methods. We linked all birth records in New Orleans, Louisiana (n = 9102), with annual census tract rates of proactive police stops using data from the New Orleans Police Department (2018–2019). We fit multilevel Poisson models predicting preterm birth across quintiles of stop rates, controlling for se…
Introduction
Developing Tools to Report Racism in Maternal Health for the CDC Maternal Mortality Review Information Application (MMRIA)
Occupational Segregation And Hypertension Inequity
The online version contains supplementary material available at 10.1007/s41996-022-00098-5
Advancing the Measurement of Structural Racism Through the Lens of Antiabortion Policy
Where are the labor markets
Racist policies and practices that restrict Black, as compared to white workers, from employment may drive racial inequities in birth outcomes among workers. This study examined the association between structural racism in labor markets, measured at a commuting zone where workers live and commute to work, and low-birthweight birth. We found the deleterious effect of structural racism in labor markets among US-born Southern Black pregnant people o…
Stress and Mental Health
In the United States, COVID-19 unfolded alongside profound racial trauma. Drawing on a population representative sample of 20-60 year-olds who were married or cohabiting, the National Couples' Health and Time Study ( N =3,642), we examine two specific sources of stress: COVID-19 and racial trauma. We leverage the fully powered samples of respondents with racial/ethnic and sexual minority identities and find that COVID-19 and racial trauma stress …
Multidimensional structural racism predicts birth outcomes for Black and White Minnesotans
Multidimensional structural racism increases the risks of adverse birth outcomes for US-born Black Minnesotans. Policy interventions to dismantle structural racism and eliminate birth inequities must be multi-sectoral as changes in one or a few dimensions, but not all, will unlikely reduce birth inequities
Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy
Antiracist health policy research requires methodological innovation that creates equity-centered and antiracist solutions to health inequities by centering the complexities and insidiousness of structural racism. The development of effective health policy and health equity interventions requires sound empirical characterization of the nature of structural racism and its impact on public health. However, there is a disconnect between the conceptu…
The Impact of Culturally-Centered Care on Peripartum Experiences of Autonomy and Respect in Community Birth Centers
Our study confirms previous findings suggesting that giving birth at a community birth center is protective against experiences of discrimination when compared to care in the dominant, hospital-based system. Culturally-centered care might enhance the experience of perinatal care even further, by decreasing variance in BIPOC experience of autonomy and respect. Policies on maternal health care reimbursement should add focus on making community birt…
Structural racism, racial inequities and urban–rural differences in infant mortality in the US
BACKGROUND: While evidence shows considerable geographic variations in county-level racial inequities in infant mortality, the role of structural racism across urban-rural lines remains unexplored. The objective of this study was to examine the associations between county-level structural racism (racial inequity in educational attainment, median household income and jail incarceration) and infant mortality and heterogeneity between urban and rura…
White Supremacy and the Core Functions of Public Health
AffiliationsSirry Alang is with the Department of Sociology and Anthropology, and the Program in Health, Medicine, and Society, Lehigh University, Bethlehem, PA. Rachel Hardeman, J’Mag Karbeah, Odichinma Akosionu, Cydney McGuire, Hamdi Abdi, and Donna McAlpine are with the Division of Health Policy and Management, University of Minnesota School of Public Health Minneapolis
Testing a self‐affirmation intervention for improving the psychosocial health of Black and White medical students in the United States
Self‐affirmation interventions have been shown to mitigate the negative psychological effects of stereotype threat on Black students in secondary and undergraduate education. However, there is currently limited research testing whether Black students in medical schools may also experience the negative influences of stereotype threat. Until now, it has been unclear whether Black (vs. White) students experience a lower sense of belonging in medical…
Fighting for America's Paradise
Structural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. The inequality that Black people and communities of color face is the direct result of centuries of publ…
Physician–patient racial concordance and disparities in birthing mortality for newborns
Significance A large body of work highlights disparities in survival rates across Black and White newborns during childbirth. We posit that these differences may be ameliorated by racial concordance between the physician and newborn patient. Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved. Strikingly, these effects appear to manifest more str…
Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota
Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis-St. Paul airport. We tested …
Examining racism in health services research
Racial disparities in health have existed in the United States for centuries.1 In 1899, WEB Du Bois noted the prevalence of poor health among black people, describing it as an important indicator of societal racial inequality.2 Black Americans continue to have substantially worse health and shorter life expectancies than their white counterparts.1, 3 Particularly in health services research, evidence of black-white disparities in health and healt…
Police Brutality and Mistrust in Medical Institutions
Reproductive justice for incarcerated mothers and advocacy for their infants and young children
The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well‐being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research…
The Value of Interracial Contact for Reducing Anti-Black Bias Among Non-Black Physicians
Although scholars have long studied circumstances that shape prejudice, inquiry into factors associated with long-term prejudice reduction has been more limited. Using a 6-year longitudinal study of non-Black physicians in training ( N = 3,134), we examined the effect of three medical-school factors-interracial contact, medical-school environment, and diversity training-on explicit and implicit racial bias measured during medical residency. When …
Improving The Measurement Of Structural Racism To Achieve Antiracist Health Policy
Antiracist health policy research requires methodological innovation that creates equity-centered and antiracist solutions to health inequities by centering the complexities and insidiousness of structural racism. The development of effective health policy and health equity interventions requires sound empirical characterization of the nature of structural racism and its impact on public health. However, there is a disconnect between the conceptu…
Police Brutality and Black Health
We investigated links between police brutality and poor health outcomes among Blacks and identified five intersecting pathways: (1) fatal injuries that increase population-specific mortality rates; (2) adverse physiological responses that increase morbidity; (3) racist public reactions that cause stress; (4) arrests, incarcerations, and legal, medical, and funeral bills that cause financial strain; and (5) integrated oppressive structures that ca…
Multidimensional structural racism predicts birth outcomes for Black and White Minnesotans
Multidimensional structural racism increases the risks of adverse birth outcomes for US-born Black Minnesotans. Policy interventions to dismantle structural racism and eliminate birth inequities must be multi-sectoral as changes in one or a few dimensions, but not all, will unlikely reduce birth inequities
Declined care and discrimination during the childbirth hospitalization
Examining racism in health services research
Racial disparities in health have existed in the United States for centuries.1 In 1899, WEB Du Bois noted the prevalence of poor health among black people, describing it as an important indicator of societal racial inequality.2 Black Americans continue to have substantially worse health and shorter life expectancies than their white counterparts.1, 3 Particularly in health services research, evidence of black-white disparities in health and healt…
Police Brutality and Mistrust in Medical Institutions
Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries
Objectives. We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings. Methods. We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279 008) and births supported by doula care (n = 1079) in Minneapolis, Minn…
Beyond generalized sexual prejudice
The Impact of Everyday Discrimination and Racial Identity Centrality on African American Medical Student Well-Being
White Supremacy and the Core Functions of Public Health
AffiliationsSirry Alang is with the Department of Sociology and Anthropology, and the Program in Health, Medicine, and Society, Lehigh University, Bethlehem, PA. Rachel Hardeman, J’Mag Karbeah, Odichinma Akosionu, Cydney McGuire, Hamdi Abdi, and Donna McAlpine are with the Division of Health Policy and Management, University of Minnesota School of Public Health Minneapolis
The Value of Interracial Contact for Reducing Anti-Black Bias Among Non-Black Physicians
Although scholars have long studied circumstances that shape prejudice, inquiry into factors associated with long-term prejudice reduction has been more limited. Using a 6-year longitudinal study of non-Black physicians in training ( N = 3,134), we examined the effect of three medical-school factors-interracial contact, medical-school environment, and diversity training-on explicit and implicit racial bias measured during medical residency. When …
Stress and Mental Health
In the United States, COVID-19 unfolded alongside profound racial trauma. Drawing on a population representative sample of 20-60 year-olds who were married or cohabiting, the National Couples' Health and Time Study ( N =3,642), we examine two specific sources of stress: COVID-19 and racial trauma. We leverage the fully powered samples of respondents with racial/ethnic and sexual minority identities and find that COVID-19 and racial trauma stress …
Informal Training Experiences and Explicit Bias against African Americans among Medical Students
Despite the widespread inclusion of diversity-related curricula in US medical training, racial disparities in the quality of care and physician bias in medical treatment persist. The present study examined the effects of both formal and informal experiences on non-African American medical students' ( N =2922) attitudes toward African Americans in a longitudinal study of 49 randomly selected US medical schools. We assessed the effects experiences …
Mental Well-Being in First Year Medical Students
Mechanisms Connecting Police Brutality, Intersectionality, and Women’s Health Over the Life Course
Police brutality harms women. Structural racism and structural sexism expose women of color to police brutality through 4 interrelated mechanisms: (1) desecration of Black womanhood, (2) criminalization of communities of color, (3) hypersexualization of Black and Brown women, and (4) vicarious marginalization. We analyze intersectionality as a framework for understanding racial and gender determinants of police brutality, arguing that public heal…
Reproductive justice for incarcerated mothers and advocacy for their infants and young children
The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well‐being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research…
Developing a Medical School Curriculum on Racism
The process of employing PHCRP in the development of an intervention about racism led to new insights on what it means to discuss racism among those marginalized and those with privilege. Conversations in each phase yielded new insights and strategies to advance a conversation about racism in health care
Racial Identity and Mental Well-Being
Stigma, Discrimination, or Symptomatology Differences in Self-Reported Mental Health Between US-Born and Somalia-Born Black Americans
Objectives. We examined differences in self-reported mental health (SRMH) between US-born and Somalia-born Black Americans compared with White Americans. We tested how SRMH was affected by stigma toward seeing a mental health provider, discrimination in the health care setting, or symptoms of depression. Methods. Data were from a 2008 survey of adults in Minnesota and were limited to US-born and Somalia-born Black and White Americans (n = 938). R…
Neighborhood Proactive Policing and Racial Inequities in Preterm Birth in New Orleans, 2018‒2019
Objectives. To measure neighborhood exposure to proactive policing as a manifestation of structural racism and its association with preterm birth. Methods. We linked all birth records in New Orleans, Louisiana (n = 9102), with annual census tract rates of proactive police stops using data from the New Orleans Police Department (2018–2019). We fit multilevel Poisson models predicting preterm birth across quintiles of stop rates, controlling for se…
Where are the labor markets
Racist policies and practices that restrict Black, as compared to white workers, from employment may drive racial inequities in birth outcomes among workers. This study examined the association between structural racism in labor markets, measured at a commuting zone where workers live and commute to work, and low-birthweight birth. We found the deleterious effect of structural racism in labor markets among US-born Southern Black pregnant people o…
Structural racism, racial inequities and urban–rural differences in infant mortality in the US
BACKGROUND: While evidence shows considerable geographic variations in county-level racial inequities in infant mortality, the role of structural racism across urban-rural lines remains unexplored. The objective of this study was to examine the associations between county-level structural racism (racial inequity in educational attainment, median household income and jail incarceration) and infant mortality and heterogeneity between urban and rura…
Testing a self‐affirmation intervention for improving the psychosocial health of Black and White medical students in the United States
Self‐affirmation interventions have been shown to mitigate the negative psychological effects of stereotype threat on Black students in secondary and undergraduate education. However, there is currently limited research testing whether Black students in medical schools may also experience the negative influences of stereotype threat. Until now, it has been unclear whether Black (vs. White) students experience a lower sense of belonging in medical…
Fighting for America's Paradise
Structural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. The inequality that Black people and communities of color face is the direct result of centuries of publ…
Where Would You Rather Live If You Were Insured? Assessing Community Uninsurance Spillover Effects on the Insured
Doula Care, Birth Outcomes, and Costs Among Medicaid Beneficiaries
Objectives. We compared childbirth-related outcomes for Medicaid recipients who received prenatal education and childbirth support from trained doulas with outcomes from a national sample of similar women and estimated potential cost savings. Methods. We calculated descriptive statistics for Medicaid-funded births nationally (from the 2009 Nationwide Inpatient Sample; n = 279 008) and births supported by doula care (n = 1079) in Minneapolis, Minn…
Stigma, Discrimination, or Symptomatology Differences in Self-Reported Mental Health Between US-Born and Somalia-Born Black Americans
Objectives. We examined differences in self-reported mental health (SRMH) between US-born and Somalia-born Black Americans compared with White Americans. We tested how SRMH was affected by stigma toward seeing a mental health provider, discrimination in the health care setting, or symptoms of depression. Methods. Data were from a 2008 survey of adults in Minnesota and were limited to US-born and Somalia-born Black and White Americans (n = 938). R…
Medical School Experiences Associated with Change in Implicit Racial Bias Among 3547 Students
BACKGROUND: Physician implicit (unconscious, automatic) bias has been shown to contribute to racial disparities in medical care. The impact of medical education on implicit racial bias is unknown. OBJECTIVE: To examine the association between change in student implicit racial bias towards African Americans and student reports on their experiences with 1) formal curricula related to disparities in health and health care, cultural competence, and/o…
Do Contact and Empathy Mitigate Bias Against Gay and Lesbian People Among Heterosexual First-Year Medical Students? A Report From the Medical Student CHANGE Study
PURPOSE: A recent Institute of Medicine report concluded that lesbian and gay individuals face discrimination from health care providers and called for research on provider attitudes. Medical school is a critical juncture for improving future providers' treatment of sexual minorities. This study examined both explicit bias and implicit bias against lesbian women and gay men among first-year medical students, focusing on two predictors of such bia…
Mental Well-Being in First Year Medical Students
Informal Training Experiences and Explicit Bias against African Americans among Medical Students
Despite the widespread inclusion of diversity-related curricula in US medical training, racial disparities in the quality of care and physician bias in medical treatment persist. The present study examined the effects of both formal and informal experiences on non-African American medical students' ( N =2922) attitudes toward African Americans in a longitudinal study of 49 randomly selected US medical schools. We assessed the effects experiences …
The Impact of Everyday Discrimination and Racial Identity Centrality on African American Medical Student Well-Being
Racial Identity and Mental Well-Being
Police Brutality and Black Health
We investigated links between police brutality and poor health outcomes among Blacks and identified five intersecting pathways: (1) fatal injuries that increase population-specific mortality rates; (2) adverse physiological responses that increase morbidity; (3) racist public reactions that cause stress; (4) arrests, incarcerations, and legal, medical, and funeral bills that cause financial strain; and (5) integrated oppressive structures that ca…
Alang et al. Respond
AffiliationsSirry Alang is with the Program in Health, Medicine, and Society and the Department of Sociology, Lehigh University, Bethlehem, PA. Donna McAlpine and Rachel Hardeman are with the Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis. Ellen McCreedy is with the Center for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, RI
Beyond generalized sexual prejudice
Naming Institutionalized Racism in the Public Health Literature
Developing a Medical School Curriculum on Racism
The process of employing PHCRP in the development of an intervention about racism led to new insights on what it means to discuss racism among those marginalized and those with privilege. Conversations in each phase yielded new insights and strategies to advance a conversation about racism in health care
Reproductive justice for incarcerated mothers and advocacy for their infants and young children
The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well‐being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research…
The Value of Interracial Contact for Reducing Anti-Black Bias Among Non-Black Physicians
Although scholars have long studied circumstances that shape prejudice, inquiry into factors associated with long-term prejudice reduction has been more limited. Using a 6-year longitudinal study of non-Black physicians in training ( N = 3,134), we examined the effect of three medical-school factors-interracial contact, medical-school environment, and diversity training-on explicit and implicit racial bias measured during medical residency. When …
Declined care and discrimination during the childbirth hospitalization
Physician–patient racial concordance and disparities in birthing mortality for newborns
Significance A large body of work highlights disparities in survival rates across Black and White newborns during childbirth. We posit that these differences may be ameliorated by racial concordance between the physician and newborn patient. Findings suggest that when Black newborns are cared for by Black physicians, the mortality penalty they suffer, as compared with White infants, is halved. Strikingly, these effects appear to manifest more str…
Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota
Preterm birth (PTB) is common and has negative impacts on infant health. While some maternal risk factors have been identified, including age under 20 or over 40, substance abuse, low BMI, and racism, less is known about the impact of environmental exposures like high heat. We combined 154,157 records of live births occurring in Minnesota between 2009 and 2015 with hourly weather records collected from the Minneapolis-St. Paul airport. We tested …
Examining racism in health services research
Racial disparities in health have existed in the United States for centuries.1 In 1899, WEB Du Bois noted the prevalence of poor health among black people, describing it as an important indicator of societal racial inequality.2 Black Americans continue to have substantially worse health and shorter life expectancies than their white counterparts.1, 3 Particularly in health services research, evidence of black-white disparities in health and healt…
Police Brutality and Mistrust in Medical Institutions
The Impact of Culturally-Centered Care on Peripartum Experiences of Autonomy and Respect in Community Birth Centers
Our study confirms previous findings suggesting that giving birth at a community birth center is protective against experiences of discrimination when compared to care in the dominant, hospital-based system. Culturally-centered care might enhance the experience of perinatal care even further, by decreasing variance in BIPOC experience of autonomy and respect. Policies on maternal health care reimbursement should add focus on making community birt…
Structural racism, racial inequities and urban–rural differences in infant mortality in the US
BACKGROUND: While evidence shows considerable geographic variations in county-level racial inequities in infant mortality, the role of structural racism across urban-rural lines remains unexplored. The objective of this study was to examine the associations between county-level structural racism (racial inequity in educational attainment, median household income and jail incarceration) and infant mortality and heterogeneity between urban and rura…
White Supremacy and the Core Functions of Public Health
AffiliationsSirry Alang is with the Department of Sociology and Anthropology, and the Program in Health, Medicine, and Society, Lehigh University, Bethlehem, PA. Rachel Hardeman, J’Mag Karbeah, Odichinma Akosionu, Cydney McGuire, Hamdi Abdi, and Donna McAlpine are with the Division of Health Policy and Management, University of Minnesota School of Public Health Minneapolis
Testing a self‐affirmation intervention for improving the psychosocial health of Black and White medical students in the United States
Self‐affirmation interventions have been shown to mitigate the negative psychological effects of stereotype threat on Black students in secondary and undergraduate education. However, there is currently limited research testing whether Black students in medical schools may also experience the negative influences of stereotype threat. Until now, it has been unclear whether Black (vs. White) students experience a lower sense of belonging in medical…
Medicine (31 works) · Sociology (20 works) · Racial and Ethnic Identity Research (19 works) · Racism (19 works) · Psychology (18 works) · Public health (18 works) · Political science (16 works) · Nursing (15 works) · Demography (11 works) · Gender Studies (11 works)