Abstract A38: High levels of breast cancer mortality: Social determinants of health impact rural African American women and how they conceptualize health in the Arkansas Delta

2014 ◽  
Author(s):  
Nancy J. Greer-Williams ◽  
Kimberely S. Enoch ◽  
Athena Starlard-Davenport ◽  
Brandon Booth ◽  
Thomas Kieber-Emmons ◽  
...  
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
Health Impact ◽  
Determinants Of Health ◽  
Arkansas Delta

scholarly journals African American Women: Surviving Breast Cancer Mortality against the Highest Odds

2015 ◽  
Vol 13 (1) ◽  
pp. 6 ◽  
Author(s):  
Shelley White-Means ◽  
Muriel Rice ◽  
Jill Dapremont ◽  
Barbara Davis ◽  
Judy Martin
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Cancer Mortality ◽  
Breast Cancer Mortality ◽  
American Women

scholarly journals Breast cancer mortality disparities: Providers' perspective

2017 ◽  
Vol 7 (6) ◽  
pp. 46 ◽  
Author(s):  
Shelley White-Means ◽  
Jill Dapremont ◽  
Muriel Rice ◽  
Barbara Davis ◽  
Okoia Stoddard
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
White Women ◽  
Care Delivery ◽  
Breast Cancer Mortality ◽  
Breast Cancer Patients ◽  
American Women

This research is part two of a study to gain understanding of reasons for the large breast cancer mortality disparity between African-American and White women who live in Memphis, Tennessee. Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African-American women are twice as likely to die from breast cancer as White women. In part one of this study, we sought to gain the perspective of African-American breast cancer survivors. Now we explore the perspective from the providers of care who interface with breast cancer patients, health systems, and health insurers. This is a descriptive research study that used qualitative methodology to inteview seven medical, surgical and radiation oncologists who serve African-American breast cancer patients in Memphis. Data were collected using semi-structured in-depth interviews. Themes included: (1) socioeconomic factors; (2) lack of knowledge about treatment, progression and side effects, and diagnosis; (3) information/communication about the diagnosis; (4) support system: need for another person to process information given; (5) limited access and resources: no insurance and no available services for treatment in African-American neighborhoods; and (6) fear of the unknown: fear of cancer, fear of losing breast, and fear about the disease’s impact on personal relationships. These results suggest that resources that aid geographical access to services need to change in order for disparities to decrease. A new model for health care delivery for African-American women at high risk of or diagnosed with breast cancer needs to be developed to address these findings.

Neighborhoods, Racism, Stress, and Preterm Birth Among African American Women: A Review

2021 ◽  
pp. 019394592110411
Author(s):  
Giurgescu C. ◽  
Misra D.P. ◽  
Slaughter-Acey J.C. ◽  
Gillespie S.L. ◽  
Nowak A.L. ◽  
...  
Keyword(s):  
African American ◽  
Preterm Birth ◽  
African American Women ◽  
Social Determinants Of Health ◽  
Racial Discrimination ◽  
Social Determinants ◽  
White Women ◽  
Determinants Of Health ◽  
American Women ◽  
Vacant Housing

African American women are more likely to experience preterm birth (<37 completed weeks gestation) compared with White women. African American women are also more likely to live in neighborhoods characterized as disadvantaged (i.e., exhibiting higher rates of vacant housing, poorer property conditions, and more litter and crime) and to experience racial discrimination compared with White women. These chronic stressors have been related to preterm birth (PTB) among African American women. This review focuses on potential stress-related pathways by which neighborhood disadvantage and racial discrimination increase the risk for PTB among African American women. Specifically, we propose cortisol, systemic inflammation, proteome and lipidome profiles, and telomere shortening as potential mediators linking these social determinants of health with PTB among African American women. Examination of these factors and the signaling pathways they contribute to will increase our knowledge of the effects of social determinants of health on PTB for African American women.

Social determinants of health affecting treatment of pediatric brain tumors

2019 ◽  
Vol 24 (2) ◽  
pp. 159-165
Author(s):  
Jillian M. Berkman ◽  
Jonathan Dallas ◽  
Jaims Lim ◽  
Ritwik Bhatia ◽  
Amber Gaulden ◽  
...  
Keyword(s):  
African American ◽  
Health Disparities ◽  
Brain Tumors ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Determinants Of Health ◽  
Cns Tumor ◽  
Initial Symptoms ◽  
Caucasian Patients

OBJECTIVELittle is understood about the role that health disparities play in the treatment and management of brain tumors in children. The purpose of this study was to determine if health disparities impact the timing of initial and follow-up care of patients, as well as overall survival.METHODSThe authors conducted a retrospective study of pediatric patients (< 18 years of age) previously diagnosed with, and initially treated for, a primary CNS tumor between 2005 and 2012 at Monroe Carell Jr. Children’s Hospital at Vanderbilt. Primary outcomes included time from symptom presentation to initial neurosurgery consultation and percentage of missed follow-up visits for ancillary or core services (defined as no-show visits). Core services were defined as healthcare interactions directly involved with CNS tumor management, whereas ancillary services were appointments that might be related to overall care of the patient but not directly focused on treatment of the tumor. Statistical analysis included Pearson’s chi-square test, nonparametric univariable tests, and multivariable linear regression. Statistical significance was set a priori at p < 0.05.RESULTSThe analysis included 198 patients. The median time from symptom onset to initial presentation was 30.0 days. A mean of 7.45% of all core visits were missed. When comparing African American and Caucasian patients, there was no significant difference in age at diagnosis, timing of initial symptoms, or tumor grade. African American patients missed significantly more core visits than Caucasian patients (p = 0.007); this became even more significant when controlling for other factors in the multivariable analysis (p < 0.001). African American patients were more likely to have public insurance, while Caucasian patients were more likely to have private insurance (p = 0.025). When evaluating survival, no health disparities were identified.CONCLUSIONSNo significant health disparities were identified when evaluating the timing of presentation and survival. A racial disparity was noted when evaluating missed follow-up visits. Future work should focus on identifying reasons for differences and whether social determinants of health affect other aspects of treatment.

Am I My Brother’s Keeper? African American Men’s Health Within the Context of Equity and Policy

2014 ◽  
Vol 10 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Okechuku Kelechi Enyia ◽  
Yashika J. Watkins ◽  
Quintin Williams
Keyword(s):  
African American ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
African American Men ◽  
Men’S Health ◽  
Policy Implications ◽  
Determinants Of Health ◽  
Critical Examination ◽  
Men's Health

African American men’s health has at times been regarded as irrelevant to the health and well-being of the communities where they are born, grow, live, work, and age. The uniqueness of being male and of African descent calls for a critical examination and deeper understanding of the psycho-socio-historical context in which African American men have lived. There is a critical need for scholarship that better contextualizes African American Male Theory and cultural humility in terms of public health. Furthermore, the focus of much of the social determinants of health and health equity policy literature has been on advocacy, but few researchers have examined why health-related public policies have not been adopted and implemented from a political and theoretical policy analysis perspective. The purpose of this article will be to examine African American men’s health within the context of social determinants of health status, health behavior, and health inequalities—elucidating policy implications for system change and providing recommendations from the vantage point of health equity.

scholarly journals Who Can Help Us on This Journey? African American Woman with Breast Cancer: Living in a City with Extreme Health Disparities

2020 ◽  
Vol 17 (4) ◽  
pp. 1126
Author(s):  
Shelley White-Means ◽  
Jill Dapremont ◽  
Barbara D Davis ◽  
Tronlyn Thompson
Keyword(s):  
Breast Cancer ◽  
African American ◽  
African American Women ◽  
Thematic Analysis ◽  
Critical Role ◽  
Breast Cancer Mortality ◽  
American Woman ◽  
Community Based ◽  
American Women ◽  
Cancer Support

This qualitative descriptive research study looks at the services that community-based breast cancer support agencies provide to underserved and African American women who are at risk for or diagnosed with breast cancer in Memphis, Tennessee. We seek their understanding of breast cancer mortality disparities in Memphis. Data were collected using semi-structured in-depth focus groups with five breast cancer support agencies. Categories and patterns were established using thematic analysis and a deductive a priori template of codes. Thematic analysis is a method for identifying, analyzing, and reporting themes within the data. The main themes identified within support agencies for African American women with breast cancer who live in Memphis were barriers to the use of services, education, health system support, and emotional support. Numerous sub themes included cost of medications, support group supplemental programming, eligibility for mobile services, patient/provider communication, optimism about the future, and family advice. Procrastinating, seeking second options, fearfulness, insurance, childcare, and transportation were barriers to care. Community-based breast cancer support agencies play a critical role as connectors for women with breast cancer who live in medically underserved areas and must find their way within a fragmented medical care system.

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