A Critical Theoretical Approach to Cancer Disparities: Breast Cancer and the Social Determinants of Health

Abstract

Breast cancer is the most commonly experienced cancer among women. Its high rates of incidence and survival mean that a number of women will live it for periods of their lifetimes. Group differences in breast cancer incidence and mortality occur by race and ethnicity. For example, while white women are slightly more likely to be diagnosed with breast cancer, Black women are 40% more likely to die from the disease. In this article, rather than focusing the discussion on individual-level factors like health behaviors that have the potential to blame Black women and those living in poverty for their conditions, we view breast cancer disparities through the lens of Critical Race Theory, taking a historical perspective. This allows us to delve beyond individual risk factors to explore social determinants of breast cancer disparities at the population level, paying special attention to the myriad ways in which social factors, notably views of race and discriminatory public policies, over time have contributed to the disproportionate breast cancer mortality experienced by Black women. We suggest ways of addressing breast cancer disparities, including methods of training healthcare professionals and public policy directions, that include rather than marginalize Black and lower socioeconomic status women.

Impact of the COVID-19 Pandemic on Cancer Researchers in 2020: A Qualitative Study of Events to Inform Mitigation Strategies

“…Encouragingly, research focus on social disparities in cancer also seems to have persisted into 2021, with investigators continuing to make the case that “systemic structural socioeconomic disadvantages” produce risk factors for COVID-19 and cancer are similar ( 30 ) (p.25). It has further been argued recently that, up to now, “social determinants have received less attention than have genetics and individual health behaviours … we must refine medical training to root out both racial bias and the over-reliance on race over racism as a risk factor for illness” ( 31 ) (p.2–5). We agree with this statement and would furthermore advocate for a like-minded attitude to be taken toward gender-based cancer disparities ( 32 ).…”

Community-Level Analysis of Drinking Water Data Highlights the Importance of Drinking Water Metrics for the State, Federal Environmental Health Justice Priorities in the United States

“…The findings of our study, together with prior research, highlight how communities of color disproportionately face worse drinking water quality, which can increase their risk for adverse health impacts such as the elevated risk of cancer. These disparities in environmental contaminant exposure are further aggravated by the fact that communities and populations of color in the United States continue to experience greater health inequalities [ 23 ] in general. They also have less access to adequate health care compared to other populations [ 24 ].…”

Advancing Health Equity in Cancer-Related Distress: Lessons Learned From the COVID-19 Pandemic on Leveraging Digital Tools and Future Directions

“…Social work has more than 100 years of history assessing the social environment's impact on patient health and mitigating the impact of social factors on patient experience, behavior, and outcomes. 8 Conversely, the role of patient navigation in addressing barriers has a much shorter history, beginning in the 1990s with varying definitions and scope of responsibilities, yet patient navigators also contribute to care by evaluating and addressing barriers to timely treatment. 9 Quality cancer care depends on an entire team of healthcare providers who work collaboratively to address the varied conditions that influence patient outcomes.…”