According to new research conducted at Ohio State, race might dictate the way women learn about breast cancer prevention.
Three Ohio State researchers explored racial differences in breast cancer prevention and found alarming variances between how white and African-American women are presented with preventive care, according to a paper published in December in Ethnicity & Health — a medical journal focused on the intersection of health and ethnicity.
Megan Hils, a master’s student in public health, said the motivation was not to further research behind already known inequalities in medical care, but to understand why they are happening in the first place.
“Access to care is so unequal [in this country]. It is really interesting to see where those issues are coming from,” Hils said.
According to the study, 50 women who were already aware of their genetic risks of breast cancer were interviewed about their exposure to the different types of preventive care. Thirty of the women were white, and 20 were African-American.
Tasleem Padamsee, assistant professor at the College of Public Health and the lead researcher on the study, said that it is a known fact, in general, that there are many women who are at a high risk for breast cancer. However, the question they sought to answer was why more women are not utilizing the many preventive care options available.
“We know that there are a variety of risk reduction strategies that women can use,” Padamsee said. “We also know, that a [low] proportion of women actually use [them].”
After the interviews were conducted, Padamsee said it became clear that race played an outsized role in how women were being educated on breast cancer prevention.
It was concluded that there are shocking differences between what and how much information African-American and white women knew about breast cancer prevention, Padamsee said. She also noted that all of these differences put African-American women at a disadvantage.
In simple terms, Padamsee said, “African-American women have [larger] burdens.”
She said that most information about cancer prevention is passed along by specialists, rather than primary care physicians (PCPs), and African-American women are far less likely to see a breast cancer specialist than white women. She attributes this to a simple lack of knowledge. According to Padamsee, African-American women are generally less aware of the benefits of seeing a specialist.
Rachel Meadows, a fourth-year Ph.D. student in epidemiology, said that, depending on their family history of cancer, most women learn about breast cancer prevention specialists from their PCPs. She explained that statistically, PCPs are less likely to take a detailed cancer history from African-American patients.
According to Padamsee, “Some people think breast cancer is a white women thing.”
Meadows said that this is due to their implicit bias — something that stems from generations of racism in this country. She said people are often unaware they even struggle with it, despite the fact that a large group of people fall victim to this subtle trend.
“From the very beginning black women are [deprived] from getting the information to be able to make a decision about [breast cancer prevention],” Meadows said.
According to Padamsee, this can be fixed by educating PCPs on these subconscious biases. She said simply desensitizing PCPs and explaining that African-American women are less likely to hear about breast cancer prevention can bring about immense change.
All three of the researchers behind this study are strong advocates for equality in the medical world, but they also emphasized the importance of these issues being addressed at the big-picture level.
“We know black women die of breast cancer at much higher rates than white women … And it’s not fair,” Meadows said. “It’s because of social systems.”
Both Padamsee and Meadows said these underlying societal issues have to be addressed at the source.
“[We live in] a society where race, which is a social construct, comes to have all these different meanings … it’s structural, it’s social, it’s interpersonal, and it’s psychological, and all of that results in different health outcomes,” Padamsee said. “Intervention needs to be upstream where race is creating all these social discrepancies.”