Part 2 of the Invisible Women series aims to highlight the dangers of using White people as the default reference group in research (Part I). I will use body ideal/image research to illustrate how a default White reference group can erase the experiences of racially marginalized folks.
It is also important to acknowledge that much of the research referenced in this piece uses gender-binary language, and more gender-inclusive research is needed.
For the purposes of this paper, when I use the term(s) body ideal/image, I am referring to research that has been done concerning societal standards of beauty (thinness, whiteness, colorism, and Eurocentric features) and the effects/health consequences these standards have on everyone, but particularly women. In other words, how do racialized beauty standards affect people? How has the way researchers have traditionally collected and analyzed data on this subject matter erased Black people and given an incomplete picture of the health burden Black women, in particular, face in this area? The prioritization of having the ideal body and its effects on body image has long been associated with negative health outcomes such as various eating disorders, anxiety, depression, etc. Most of the literature on body image is focused on White women and the health consequences they face as a result of body ideal/ image issues. Previous self-reported surveys report that Black women are essentially immune to the body ideal/image health effects because Black women report feeling confident in a larger range of body sizes (Awad et al., 2015).
Many nonwhite women, particularly Black women, have not historically been viewed as the body ideal in the U.S., so they have been ignored altogether, but it does not mean they are not affected. According to the National Association of Anorexia Nervosa and Associated Disorder (ANAD), Black Indigenous and people of color (BIPOC) are significantly less likely than White people to have been asked by a doctor about eating disorder symptoms. BIPOCs with eating disorders are half as likely to be diagnosed or to receive treatment for ANAD. Black people are less likely to be diagnosed with anorexia than White people despite experiencing the condition for longer periods. Black teenagers are 50% more likely than White teenagers to exhibit bulimic behavior, such as binge eating and purging (ANAD).
These statistics indicate that the research insinuating that Black women are immune from adverse health outcomes that result from the body ideal is harmful. We do not know how Black women are being affected because doctors are not asking Black women and teens about eating disorder symptoms, which could mean doctors internalize what the research has traditionally said about Black women’s health in relation to the body ideal. ANAD reports that 6% of people with eating disorders are not considered medically underweight. This data is important because it could point to some implicit bias unintentionally perpetuated by research. People often associate eating disorders solely with anorexia nervosa, which is characterized by extreme thinness (emaciation), relentless pursuit of thinness and unwillingness to maintain a healthy weight, and intense fear of gaining weight, among other criteria (Eating Disorder, National Institute of Mental Health). People (including some healthcare professionals) fail to acknowledge that individuals struggling with Bulimia nervosa and Binge-eating disorder may present across a spectrum as slightly underweight, average weight, or overweight (Eating Disorders, National Institute of Mental Health).
The erasure of Black women and the actual health burden they carry can also be seen in depression statistics and how they are collected. When assessing the prevalence of depression in the U.S., White people statistically have a higher burden of depression than Black people. Black people in the U.S. usually fare the same or better when assessing mental health in general, which is known as the “race paradox” in mental health. Still, few studies assess the heterogeneity within the Black population when it comes to mental health in general (Dhillon-Jamerson, 2018). When White people are removed as the reference group when assessing Black mental health, outcomes yield different and more representative results. The important point is not to exclude White people from the research, but to point out that when researchers attempt to assess the issues of a particular racial demographic, it might be more advantageous to compare that group to itself to reveal heterogeneity within the population. Part 1 of this piece discusses whiteness as the norm/default, and the assumption of whiteness as default can have negative consequences.
A study done on the mental health of Black people added skin tone as a self-report measure along with discrimination, SES, etc., yielding interesting findings. Self-reported skin color was associated with poorer mental health outcomes (Monk, 2015). Skin color remained a significant major predictor for poorer mental health even after controlling for other forms of discrimination (Monk, 2015). This study suggested it is worth looking into whether skin tone/color in the Black community is a more significant issue than it was once thought to be. A logistical regression analysis was done to examine the relationship between skin tone and depression specifically. It was found that dark-skinned individuals (self-reported skin tone) are 54% more likely to report being depressed than light-skinned individuals (Monk, 2015). Skin color discrimination from other Black people was also a significant predictor of depression (Monk, 2015). Lastly, the analysis showed that a spectrum of light skinned, medium skinned tone, and dark skinned tones experience different levels of depression. People with the lightest and darkest skin tones had the highest levels of depression, while medium tones showed low levels (Monk, 2015). Because depression data isn’t horizontal, those most vulnerable to depression are lost in the aggregate data. The darkest-skinned individuals have incidences comparable to White people on self-reported measures of depression (Monk,2015).
Dark-skinned Black people have higher rates of high blood pressure and poor general and psychological health, which is higher among dark-skinned Black women (Keyes, Small & Nikolova, 2020). Low-income, darker-skinned Black women were also more likely to attempt suicide (Keyes, Small & Nikolova, 2020). But the aggregate data obscures that light-skinned women’s experiences may be closer to White women’s than darker-skinned Black women’s. Earlier in this piece, national data reports that White people have a higher depression burden than Black people, which is generally accepted. The studies above that look at the heterogeneity of Black people in the U.S. show that different shades of Black people have different levels of burden. The studies didn’t use White people as a reference group to assess Black mental health, so they were able to see more nuance.
People get erased in some of our research practices. Generalizability is a tenet of research, but I’d argue particularity is important too. Research leads to different issues getting funded for interventions. If the research isn’t capturing the issues of already marginalized folks, we have to look at how we conduct research itself. There is much more to be said, but I hope this piece serves as a launching pad.
Work Cited
Awad, G. H., Norwood, C., Taylor, D. S., Martinez, M., McClain, S., Jones, B., Holman, A., & Chapman-Hilliard, C. (2015). Beauty and Body Image Concerns Among African American College Women. The Journal of black psychology, 41(6), 540–564. https://doi.org/10.1177/0095798414550864
Eating Disorder Statistics | ANAD – National Association of Anorexia Nervosa and Associated Disorders,” November 29, 2023. https://anad.org/eating-disorder-statistic/.
Dhillon-Jamerson, K. K. (2018). Euro-Americans favoring people of Color: Covert racism and economies of White Colorism. American Behavioral Scientist, 62(14), 2087-2100. doi:10.1177/0002764218810754
Keyes L., Small, E., & Nikolova, S. (2020). The complex relationship between COLORISM and poor health outcomes with African Americans: A systematic review. Analyses of Social Issues and Public Policy, 20(1), 676-697. doi:10.1111/asap.12223
Monk EP. The Cost of Color: Skin Color, Discrimination, and Health among African-Americans. American Journal of Sociology. 2015;121(2):396-444
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