Interpretative Repertoires That Shape Low-Income African American Women’s Reproductive Health Care Seeking: “Don’t Want to Know” and “Taking Charge of Your Health”

Abstract

In the context of reproductive and sexual health, African American women have higher incidence of disease and poorer outcomes on key indicators when compared with White women. In this study, we used discourse analysis to identify and examine the workings of two clusters of interpretive resources (“interpretative repertoires”) associated with reproductive/sexual health care seeking among low-income African American women who participated in semistructured interviews as part of a health promotion initiative. Interpretative repertoires are ways of accounting for engaging in or refraining from engaging in actions, which are shared by people in a community. We labeled the two interpretative repertoires “Don’t Want to Know,” and “Take Charge of Your Health.” Within the “Don’t Want to Know” repertoire, that testing would lead to threatening findings was assumed, a chain of devastating consequences was imagined, and a preference for uncertainty over certain knowledge was expressed. Conversely, the “Take Charge of Your Health” repertoire valued certainty over uncertainty, though in both interpretive frameworks, knowledge-based and emotion-based decision-making were intertwined. We conclude that health promotion initiatives—if they are to succeed in encouraging women to obtain valuable preventive health care services—must respond, in their choices of language and outreach strategies, to the expressed dilemma of wishing for reassurance but fearing bad news, to the intertwining of emotional reasoning and technorationality in health decision making, and to the particular relational experiences of African American women. Failure to do so will contribute to the continuation of reproductive and sexual health disparities.

Notes

¹ At 5.3 versus 2.4 deaths per 100,000 (National Institutes of Health, 2006).

² With 119.4 versus 149.4 incidence per 100,000, but 34.7 versus 26.2 deaths per 100,000 (National Institutes of Health, 2006).

Additional information

Funding

This research was supported by the National Institute on Minority Health and Health Disparities, National Institutes of Health (grant P20MD003373). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Minority Health and Health Disparities or the National Institutes of Health.