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Author ORCID Identifier

https://orcid.org/0000-0002-5879-7126

Date of Award

4-26-2026

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Global Inclusion and Social Development

First Advisor

Dr. Dolly Daftary, PhD

Second Advisor

Dr. Tahirah Abdullah, PhD

Third Advisor

Dr. Anya Wallace, PhD

Abstract

This research investigates the disproportionate impact of substance use disorders (SUD) on Black women, a population facing critically low treatment retention rates, evidenced by outpatient dropout rates averaging 55%. Despite the efficacy of sustained treatment, Black women consistently underutilize and prematurely exit services compared to other demographics. This study asserts that identifying the drivers behind these disparities requires a shift from traditional public health lenses toward a framework that centers racial oppression, systemic barriers, and cultural obstacles.

By integrating Critical Race Theory (CRT), Black Feminist Theory, Social Determinants of Mental Health, and Biopsychosocial Theory, this research explores the impact of racial hierarchy, stigma, and racial disparities as forces that adversely impact the psyche of Black women and directly impact SUD treatment retention of Black women. The study seeks to answer three core questions: What is the nature, and what are the drivers of these retention disparities? Through what mechanisms do these disparities transpire in behavioral health? And what specific gaps exist between current treatment models and the needs of Black women?

Utilizing an empirical case study design in the greater Boston area, the research triangulates primary data from semi-structured interviews with Black women in treatment, service providers, and healthcare practitioners, to include a critical analysis of outpatient policy and practice documents. By analyzing this data through a CRT and Black feminist perspective, the study aims to uncover the root causes of healthcare inequities and provide actionable insights into the biopsychosocial barriers that impede recovery for Black women in Boston.

Comments

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