Review of Black Women’s Health: Paths to Wellness for Mothers and Daughters By Michele Tracy Berger, New York: NYU Press. 2021. pp. 256.

Carolyn Mason

Michelle Tracy Berger’s Black Women’s Health: Paths to Wellness for Mothers and Daughters follows the recent trend of close interrogation of the health of Black women. However, this book constitutes the next step in the framing of and discussions about the experience of health for Black women. The purpose of this book is not only to describe Berger’s research with Black mothers and daughters but also to describe how mothers and daughters talk to each other about their health values in the face of health inequity. While the research project originally focused on sexual health and HIV risk, this book demonstrates that Black women have holistic views of their health. Berger’s ability to pull out themes and micro-theories in her focus group research attests to a career’s worth of experience as a qualitative researcher and professor. Her emphasis on sexual health is clear throughout the book and adds to her overall description of how Black women communicate their health experiences or desires with their daughters.

Berger uses the introduction to establish her methods and ways of framing the recent social focus on the health experiences of Black women and girls. These include academic and popular discourses, which Berger identifies as being most influential in the areas of policy, media, and activism/social movements. Her examples include Michelle Obama’s Let’s Move Campaign, the film Precious and TV show How to Get Away with Murder, and activist movements like #MeToo and #BlackLivesMatter. She goes on to discuss her method of focus groups, where groups of mothers and groups of daughters spoke amongst themselves about their health values. Mothers came in all shapes and forms, whereas the daughters’ groups were made up of 12- to 18-year-old young women, each with a mother participating. While the focus groups were conducted separately, mothers and daughters were intimately connected throughout the book in both categories and questions asked.

In the first chapter, Berger contextualizes the health narratives that emerge within her focus groups by describing the narrative typologies that she uses to describe and interpret the groups themselves. For the mother focus groups, the groups were identified as Experts, Transitioners, Revealers, Nostalgics, and Strategists; the daughter focus groups were identified as Romantics, Loners, Moderates, Equalizers, and Distrusters. Each group was identified with a key trait that characterized their conversations or something they valued, such as personal and family history for the Nostalgics mother group or idealism for the Romantic daughter group. Berger also includes a table for both mothers’ and daughters’ categories, comparing the groups based on their worldviews, the flow of conversation, perceptions of health, and communication about sex. Having an easy reference for the key traits and standouts for each group is a good resource for better understanding what Berger identifies as micro-theories that emerge related to overall well-being, pleasure, and sexuality in subsequent chapters.

The second and third chapters describe health narratives and inheritances with mothers and daughters, respectively. In chapter 2, health is defined by mothers using an integrated approach that incorporates behaviors such as regular checkups and eating right, as well as maintaining spiritual or religious behaviors to nurture health. Health is difficult to achieve and maintain in the face of the barriers that the focus groups identify, including difficulties with diet and exercise, low investment in the self in favor of caring for others, and being required to take on personal responsibility within the racialized and gendered healthcare system. These issues are also interrogated in chapter 3, as the daughters discuss their health and the health of their mothers. For the daughters, health was described as a set of behaviors, which oftentimes lined up with the performance of gender. It also seemed to reflect the values passed down by the mother, with significance given to spiritual and physical health and personal responsibility. Daughters also described how their mothers communicated these ideas to them with varying degrees of success and consistency.

Berger continues to discuss these communicative techniques in the following chapters’ discussions of sexual health and intimacy. As analyzed in chapter 4, mothers often saw themselves as being more knowledgeable and open than their mothers, but this information was blurred by their relationships to sexuality. References to single motherhood—either being the child of a single mother or being a single mother herself—often came up during the focus groups and reflected varying perspectives on intimacy and the intention behind the strategies to control their daughters’ sexual health. These techniques included scaring their daughters away from the consequences of sexual activity (including STDs and children) and providing as much information as possible. These efforts seem to be of mixed success when comparing the perspectives of daughters in chapter 5. The daughters’ ideas about intimacy differed from their mothers, as sex was seen as not only physical but also as an emotional and social action. However, the fears about sex were often shared by mothers and daughters, often based on religious and traditional viewpoints about women being ultimately responsible for their sexual choices and reputation. The conclusion brings these things together by pointing out the parallels in the difficulties faced by Black mothers and daughters related to health and wellness.

This book emphasizes the experiences of Black women and how they are foregrounded by the ways that the Black family operates. It challenges top-down scholarship that looks only at how society affects Black families and their health. While the focus groups were conducted in the late 2000s, the introductory chapter discusses contemporary events like the Black Lives Matter movement. Beginning the book this way shows how the roots of these national movements can be found in the everyday values and conversations being had by Black women with their families. To this point, however, the discussion of only focus groups seems like a missed opportunity for discussing participant observation with the families of these Black women. Analyzing another method would have allowed for discussion of not just what Black mothers think about the conversations they are having with their daughters and vice versa but how these conversations unfold in the moment and the contexts in which they occur.

Overall, this book is an excellent example of how to do research that uplifts Black women. Berger brings a multidimensional perspective to the study of Black women and girls that is not always present when observing the health of Black women from a numerative perspective. This allows her to reframe national conversations about health and wellness into ones that better suit the intimate and personal ways that information is passed from mother to daughter. This framing is not just based on individual ways of thinking about health but also the needs of the family as a way of thinking about health behaviors for Black women. This perspective is especially useful for public health considerations, which often fail to address the perspectives of Black women themselves when trying to understand constraints to their health. Black Women’s Health shows how Black women are talking about health and caring for themselves and their daughters, and the ways that these conversations shape the behaviors of mothers and daughters today.