Khayla Daniel

English 102-22-17

05/04/17

Breast Cancer: Disparities Within the African American Community

Breast Cancer is an invasive form of cancer that affects both women and men. It has been

predicted by the Breast Cancer Organization that within the United States, approximately one out

of every eight females will develop breast cancer, making such the most common form of cancer

developed by women. The odds are drastically different for men, as approximately one man out

of every thousand will develop breast cancer. Due to advancements within technology, including

improved treatment and detection measures, along with a variety of treatment options, the

survivorship rates of breast cancer have increased drastically within the United States since the

early 2000s. While the death rates for the general population has decreased, there are still

disparities within survivorship rates based on ethnicity. The survivorship rates for African

Americans are the lowest compared to any other ethnicity according to the Centers for Disease

Control and Prevention. The death rates associated with Breast Cancer amongst African

Americans are due to a variety of factors. The primary factors consisting of the social stigmas

associated with going in for routine check-ups and reporting health concerns, socioeconomic

status, and the lack of health insurance and therefore, limited access to healthcare.

Generally, most forms of cancer arise as a result of the abnormal growth and division of

somatic cells. The abnormalities of the cell function are caused by mutations that can be the

result of a variety of factors such as that of the environment, exposure to carcinogens, and so on.

Breast cancer arises from abnormalities in cell function within the breast tissues; specifically,

epithelial cells. The mutated cells are able to grow and divide at a rate faster than healthy cells.
There are risk factors that play a role in the development of breast cancer and the specific stage

of the cancer within women. Such factors include: gender, age, race/ethnicity, heredity, genetic

prepositions, hormonal imbalances, diet, and physical activity. There are six stages of breast

cancer, all of which are associated with the invasive branch of the cancer. Unfortunately, as the

stages progress, the chances of survival decrease and the risks and complications increase. Breast

cancer can affect women at any age, however the most common age range for infection is

between the ages of 35 and 60. In the African American population, women develop breast

cancer at a rate lower than other ethnicities (Breast Cancer Organization). However, its been

found that those diagnosed developed the cancer at younger ages, and are more likely to be

diagnosed at a later and more virulent stage, resulting in higher mortality rates. (Newman).

Within the African American community, there are social stigmas associated with going

to routine doctors visits and seeking help when there is medical concern. Within the community,

there is a lack of trust for doctors and physicians that causes inhibitions with seeking care and

reporting health concerns. This is in-part due to past historical research such as the Tuskegee

Syphilis study and the study of HeLa cells. Generally, women are more likely to visit healthcare

providers when concern arises, stigma behind visiting during times of need however is still a

contributing factor to there being a higher mortality rate within the African American population

as a result of breast cancer. Unfortunately, this is also true for many other diseases and health

concerns as well. The US National Library of Medicine National Institutes of Health sponsored

a study in which research was conducted regarding the issue. The study was conducted in a

public hospital in Chicago, Illinois. 9 focus groups were formed. Group members consisted of

African American men and women and ranged in age. Members were selected randomly. Within

the group, members were asked to identify common themes associated with physician care and
trust. In the results, it was found that factors that contribute to the lack of trust and the

unwillingness to seek medical attention include informed consent, the lack of interpersonal

interactions and competence, physicians being motivated by profit, underlying racism, and the

fear of unknown experimentation (Jacobs). According to the Washington Post, another reason

for the stigma behind seeking medical treatment is due to patients complaining about their pain

being undertreated. The study was conducted by the University of Virginia and contained

information from local hospital emergency departments. The gathered information contained

statistics on the administration of pain medications to African American patients with bone

fractures and appendicitis when compared to Caucasian patients. It was later found that in many

of the cases, the pain of the African American patients was underrated. Physician bias, along with

subconscious racism showed a playing role in such cases (Somashekhar). In the research paper,

data was also gathered on specific questions and medical stereotypes associated with ethnicity.

The medical stereotypes included questions regarding the brain sizes of blacks compared to that

of whites along with a comparison of the sensitivity of nerve endings. Answers were collected

from the general medical personnel population, along with first, second, and third year interns

and residents. The results were shocking as the general, first, and second year interns

(approximately 20 answers for each), believed in many of the medical stereotypes. In conclusion

to the research article, the author concluded that individuals who endorsed and believed in the

medical stereotypes were more likely to show bias with patient care and to have disparities

within the treatment options.

Socioeconomic status contributes to the higher mortality rates resulting from breast

cancer within the African American community when compared to other ethnic groups. Similar

to the stigmas associated with visiting health care providers, socioeconomic status is also a
primary contributing factor to the higher mortality rates amongst African Americans. An

individuals socioeconomic status acts as a bridge for access to healthcare along with the quality

of health care (Betancourt, Green). Within the United States, African Americans along with

Hispanics have the highest overall poverty rates (Williams). With that being said, having access

to healthcare isnt always easy, especially when an individual makes minimal income. The

constantly rising healthcare and insurance rates and fees make it even harder for such individuals

to have the access that they, along with their families may need. Receiving healthcare in any

form is difficult for uninsured individuals and families. Medical expenses are approximately

$2,400 more for uninsured individuals. Lacking healthcare benefits and insurance keeps many

individuals from going in for routine check-ups and from reporting health concerns, despite the

severity. In regards to breast cancer, such financial constraints are often the reason that breast

cancer along with many other diseases arent always detected early. Especially in cases in which

the individual may first be asymptomatic. This causes there to be a domino effect. The cancer

does not get detected, the symptoms and stages progress, and the individual suffers due to their

inability to get treated. Treatment options for breast cancer include surgery, chemotherapy,

radiation therapy, and mastectomy, all of which can be rather pricey, even for insured

individuals. In addition, free health care clinics can only provide so much to their patients with

regards to treatment and with keeping the patient comfortable under such conditions.

Luckily, there are future directions that can help to modify the social stigmas, improve

the socioeconomic status of the population, and to improve patient care and physician trust

within patients. All of which can lead to an increase in the survival rates of breast cancer within

the African American population. Future directions include physicians taking the presumed

stigmas into consideration when conducting patient interactions, along with coming off as
personable and sincere. Doing so can to build trust and a relationship between the patient and the

doctor. For the sake of breast cancer, this could lead to African American women going to

routine doctors visits and seeking help when concerns arise, which would further lead to the

prevention, early detection, and treatment of breast cancer. While difficult, future directions for

improving the socioeconomic status are possible. Such directions could involve making

insurance rates and access to healthcare more accessible to those who may be in financial need.

In addition, interventions could be held in which free breast cancer screening could be provided

in low-income neighborhoods. While funds are being raised to help find a cure, additional funds

could be raised in order to help pay for treatment and therapy options for those who are battling

breast cancer but are unable to pay for such treatment.

I have career aspirations of working within the medical field. As an African American

female, I have witnessed and experienced disparities in healthcare first hand, from both the social

and an economic stance. I believe that the first step in creating an environment in which quality

healthcare can be provided should involve a genuine patient-physician trust and understanding. I

also believe that in order to provide such healthcare, awareness should be spread. Awareness that

goes beyond posting flyers and messages on social media, however actually contains substance

and information that could benefit the public. As previously mentioned, Breast Cancer is the

most commonly diagnosed disease that affects women. Within the African American community,

the survival rates from breast cancer are the lowest. Its an unfortunate trend that demands

attention along with future plans. For these very reasons, I chose to write my research paper on

breast cancer. There are no major biological differences amongst ethnicities. However as

previously mentioned, social stigmas, socioeconomic status, and access to healthcare play a role

in the statistics behind treatment and survivorship in addition to the stage at detection and
virulence. All-in-all, by informing and encouraging the population to seek and provide easily

accessible routine health screenings, we can work to improve the rates of detection and the

spread of disease, which in turn will allow us to better formulate treatment options, that in-turn

can help to increase the likelihood of survivorship for breast cancer, along with other disease.
 Works Cited:

Breast Cancer Rates by Race and Ethnicity." Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention, 15 June 2016. Web. 04 May 2017.

Jacobs, Elizabeth A et al. Understanding African Americans Views of the Trustworthiness of

Physicians. Journal of General Internal Medicine 21.6 (2006): 642647. PMC. Web. 4 May
2017.
Joseph R. Betancourt, Alexander R. Green, J. Emilio Carrillo and Elyse R. Park Cultural
Competence And Health Care Disparities: Key Perspectives And Trends Health Affairs, 24, no.2
(2005):499-505

doi: 10.1377/hlthaff.24.2.499

Newman, Lisa A. "Breast Cancer in African American Women." The Oncologist. The Oncologist,
24 July 2004. Web.

Williams, David R. et al. Race, Socioeconomic Status and Health: Complexities, Ongoing
Challenges and Research Opportunities. Annals of the New York Academy of Sciences 1186
(2010): 69101. PMC. Web. 4 May 2017.

Simon, Stacy. "Report: Breast Cancer Rates Rising Among African-American Women."
American Cancer Society. American Cancer Society, 29 Oct. 2015. Web. 12 Feb. 2017.

Somashekhar, Sandhya. "The Disturbing Reason Some African American Patients May Be
Undertreated for Pain." The Washington Post. WP Company, 04 Apr. 2016. Web. 04 May 2017.
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"U.S. Breast Cancer Statistics." Breastcancer.org. Breast Cancer Organization, n.d. Web. 04 May
2017.
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