摘要：Objectives. Using African American women's insights on their own health experiences, we explored how their daily life management was linked to the “strong Black woman” (SBW) script, and the health implications of that script. Methods. Using the search term “strong Black woman,” we identified 20 articles from African American women's magazines and 10 blog sites linked to the SBW script and analyzed their content. We created thematic categories (role management, coping, and self-care) and extracted issues relevant to African American women's health. Results. Adherence to the SBW script was linked to women's daily life management and health experiences. Themes such as self-sacrificial role management (“please the masses”), emotional suppression (“game face”), and postponement of self-care (“last on the list”) incited internal distress and evinced negative health consequences. Conclusions. Scientists, activists, and health care professionals would be aided in forming initiatives aimed at reducing health disparities among African American women by heeding the insights on their health experiences that they express in popular media sources. African American women experience more chronic illness than White women—greater incidence, more associated secondary health problems, and higher resulting mortality. 1 – 4a Similar disparities are found for psychological health; although African American women are less often diagnosed with mental illness, they experience an increased rate of morbidity and a decreased rate of mental health access. 4b It remains unclear why African American women are at greater risk for poor health, despite research on the influence of personal and social stressors on health, 5 – 9 inadequate education about basic health behaviors, 10 – 12 and the disconnection between evidence-based practices and applicability to communities of color. 13 , 14 Although genetic determinants or lifestyle choices have often been suggested as causes of disparities, 15 – 18 fresh insight might be provided by a gender-critical approach in which African American women present their own insights into their health experiences. Beauboeuf-Lafontant's 19 – 22 research on strength and African American women offers guidance for understanding how accommodations to feminine ideals by these women manifest through strategies for what we call “daily life management” (e.g., role management, coping, and self-care). Hence, responses to mundane and critical responsibilities and stressors, 23a and the extent to which health and wellness are maintained and restored in the process, are the focus for daily life management in the present study. Relevant within the gender discourse for African American femininity is a historical expectation that African American women are the backbone of their communities and the cohesive force in their families as protection against racial, economic, and gender oppression. 19 , 23b In an attempt to embody this revered social position, African American women may adhere to attributes of the strong Black woman (SBW) script, “an imperative [for African American women] to constantly suppress one's desires and interests” 22 (p404) while maintaining and responding to those of everyone else, in an attempt to juggle multiple responsibilities and respond to stressors. Attributes of the SBW script—self-reliance, self-sacrifice, and self-silence—can be observed best through African American women's daily life-management experiences of role management, coping, and self-care. Beauboeuf-Lafontant 22 suggests that women's “strength performances” cause them distress, from both the overfunctioning necessary to maintain the script and the “active suppression of discourse-discrepant realities” 22 (p391)—that is, the desire to embody an alternative to the SBW script. Whereas Beauboeuf-Lafontant's approaches represent a behavioral path to compromised health among African American women, McEwen's 24 , 25 physiological explanation for disease onset provides insight on the pathways from distress emerging from strength performances in daily life management to African American women's health outcomes. Allostatic load, in which chronic cycles of increased psychological distress induce physiological arousal and overwhelm the stress-response system, triggers vulnerability to stress- and obesity-related disease. Hence, strength performances for daily life management generate stress that places African American women's internal stress mediators (e.g., cortisol, catecholamines) into overdrive, producing immunosuppression, obesity, hypertension, and atherosclerosis. 24 , 25 The following is a gender-critical review of the literature highlighting the pathways through which adherence to self-reliance, self-sacrifice, and self-silence for daily life management (e.g., managing role responsibilities, managing stressors, managing basic self-care) is linked to African American women's health outcomes. We include literature from women's studies, family science, and health sciences to capture diverse and intersecting contexts of African American women's lives.
