This analytical essay examines the history of reproductive coercion and medical mistrust among Black women in the United States. Using historical and interdisciplinary literature, the essay presents evidence of racialized and gendered violence, colonial medicine, and structural inequities that have shaped the medical experiences of Black women. It contextualizes medical mistrust as a rational and protective response to generations of medical exploitation, including forced breeding, involuntary sterilization, and unethical experimentation. The essay also highlights how controlling images have normalized systemic injustices and perpetuated barriers to equitable care. Contemporary disparities in pain management, reproductive autonomy, and maternal mortality are also situated within this legacy of racialized medical abuse. The paper concludes by emphasizing the need to address health inequities and to foster trustworthy healthcare systems for marginalized populations.

Background: The COVID-19 pandemic has had a profound impact on societies and economies around the globe, and experts warn about the potential for similar crises in the future. Risk communication theories underscore that while the potential for harm is objective, risk perception is a subjective, socially derived interpretation. While there is broad literature on the social construction of risk, fewer studies examine the role of communities—online or offline—in developing and reinforcing distinct interpretations of the same risk event. During COVID-19, online communities emerged as individuals sought to make sense of the ongoing crisis. These communities offer an opportunity to gain important insights into how concerned public collectively interprets risk and create group identities, informing public health strategies. Objective: This study aims to, first, explore how online communities with distinct ideologies create and reinforce divergent conceptualizations of risk and, second, identify the role of group identity in shaping the development and communication of risk interpretations in these communities. Methods: We used computational grounded theory, a multistep approach that includes pattern detection, hypothesis testing, and pattern confirmation to explore interpretations of risk and group identity in about 500,000 comments from the subreddits r/LockdownSkepticism and r/Masks4All. In the pattern detection step of this study, we grouped comments by the post they were made on and then used latent Dirichlet allocation topic modeling to identify 10 topics based on the frequency of term co-occurrence. In the hypothesis refinement step, we conducted a qualitative thematic analysis of 30 posts under each topic using Braun and Clarke’s approach. Finally, in the pattern confirmation step, we trained a Word2Vec word embedding model to validate emerging themes from the second step. Results: This study found that Masks4All and LockdownSkepticism both centered risk in their conversations, but with divergent concerns related to the threat of COVID-19. While Masks4All emphasized the threat to health, LockdownSkepticism questioned the necessity of preventive measures and focused on other risks: the threat to the economy, educational disruptions, and social isolation. Group identity was also found to shape collective meanings around risk, as community members in both subreddits affirmed group positions and condemned the outgroup. Conclusions: This study demonstrated that while both communities were concerned about COVID-19, their perceptions of risk focused on different aspects of the same risk event. This underscores the need for targeted interventions that engage with divergent ideologies and value systems across groups of people.

Background: Globally, over 15 million preterm births (PTB) occur annually, with sub-Saharan Africa bearing a disproportionate burden. In Kenya, studies conducted between 2017 and 2021 at the hospital level show a PTB prevalence ranging from 15.9% to 20.2%. However, current PTB prevalence and associated factors remain underexplored despite their significant public health implications. Understanding the prevalence and factors associated with PTB is critical for effective interventions. Objectives: This study aimed to determine the prevalence of PTB and also to identify individual- and community-level factors influencing PTB among women of reproductive age in Kenya. Design: The study utilised a cross-sectional design, analysing data from the 2022 Kenya Demographic and Health Survey. Methods: A sample of 7291 women aged 15–49 was analysed using weighted multilevel logistic regression in Stata 17.0. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) and a significance threshold of p < 0.05 were used to identify predictors of PTB. Results: The prevalence of PTB was 7.14%. Women aged 25–34 (aOR = 0.67; 95% CI: 0.49–0.94) and 35+ (aOR = 0.86; 95% CI: 0.59–1.24) were less likely to experience PTB compared to younger women (15–24 years). Attending four or more antenatal care visits reduced PTB likelihood (aOR = 0.68; 95% CI: 0.53–0.88). Women in the richest wealth index had higher odds of PTB (aOR = 2.28; 95% CI: 1.39–3.74), while medium community literacy levels increased PTB risk (aOR = 1.56; 95% CI: 1.21–2.03). Conclusion: This study highlights that individual- and community-level factors significantly influence PTB in Kenya. Addressing disparities in socio-demographic and obstetric factors through targeted, multipronged strategies is essential for reducing PTB rates and improving maternal and neonatal outcomes.

Structural failures and systemic racism increase the likelihood of Black women having adverse outcomes during pregnancy, but little is known about the role of communication with healthcare providers in amplifying or attenuating perceptions of pregnancy risk. Using a Black Feminist metatheoretical approach and the Social Amplification of Risk Framework, this study assesses the role of communication with healthcare providers on Black women's perceptions of risk and provides recommendations for empowering pregnancy-related communication between Black women and their healthcare providers. This study's metatheoretical underpinning in Black Feminist Theory informed the use of reflexivethematic analysis in the qualitative analysis of the in-depth interviews in order to center the narratives, perspectives and lived experiences of Black women. This study found that in a context in which Black women unjustly face heightened likelihood of poor outcomes, healthcare providers attenuated Black women's pregnancy risk perceptions when they communicated with clarity, fostered patient agency, and demonstrated empathy toward patients. In contrast, unclear communication and obstetric violence led to the amplification of concerns and worries about pregnancy as well as erosion of trust in healthcare. This study therefore underscores the importance of healthcare providers' clear communication, demonstration of empathy and fostering of patient agency as critical factors to empowering communication that attenuates Black women's pregnancy-related risk perceptions.