Objectives. To quantify racial/ethnic differences in the relationship between state-level sexism and barriers to health care access among non-Hispanic White, non-Hispanic Black, and Hispanic women in the United States. Methods. We merged a multidimensional state-level sexism index compiled from administrative data with the national Consumer Survey of Health Care Access (2014–2019; n = 10 898) to test associations between exposure to state-level sexism and barriers to access, availability, and affordability of health care. Results. Greater exposure to state-level sexism was associated with more barriers to health care access among non-Hispanic Black and Hispanic women, but not non-Hispanic White women. Affordability barriers (cost of medical bills, health insurance, prescriptions, and tests) appeared to drive these associations. More frequent need for care exacerbated the relationship between state-level sexism and barriers to care for Hispanic women. Conclusions. The relationship between state-level sexism and women’s barriers to health care access differs by race/ethnicity and frequency of needing care. Public Health Implications. State-level policies may be used strategically to promote health care equity at the intersection of gender and race/ethnicity. (Am J Public Health. Published online ahead of print September 2, 2021: e1–e10. https://doi.org/10.2105/AJPH.2021.306455 )

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Black individuals face psychological distress resulting from lifetime experiences of racial discrimination, and these experiences may be especially harmful to Black college students as they forge their social identities. One way to examine psychological distress induced by racial discrimination is by assessing affect reactivity, or the degree to which aspects of individuals’ mood changes in response to a stressor. This quantitative investigation examines the association between lifetime racial discrimination frequency and stress responses to acute racial discrimination via two aspects of affect reactivity, valence and arousal, and if coping strategies moderate this association. A sample of 239 Black college students (Mage = 19.59, SDage = 2.15, 68.6% female) completed an online questionnaire that included measures of racial discrimination, coping, and demographics. They then attended a laboratory visit during which their affective responses to a stress task were collected. Regression analyses indicated an interaction between lifetime racial discrimination and social support coping on arousal reactivity in response to acute racial discrimination. For individuals who reported low levels of social support coping, more frequent lifetime racial discrimination was associated with a decrease in arousal. For individuals who reported high levels of social support coping, more frequent lifetime racial discrimination was associated with an increase in arousal. Implications for the mental health of Black college students exposed to racial discrimination and avenues for further investigation are discussed.