Differences in physician prevention practice patterns for white and minority patients

Gemson, Donald H.; Elinson, Jack; Messeri, Peter

doi:10.1007/bf01321480

Cited by 97 publications

(44 citation statements)

References 7 publications

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“…Poverty has a negative impact on the behavior of health care providers and the availability of health services (40). Those who provide health care for minorities and people in lowincome areas, for example, are often less informed about preventive care services and are less likely to be board certified (84,85). Physicians who are not board certified show lower compliance with appropriate screening recommendations (86,87).…”

Section: Barriers Related To Povertymentioning

confidence: 99%

Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review

Gerend

Pai

2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

265

213

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Despite the recent decline in breast cancer mortality, African American women continue to die from breast cancer at higher rates than do White women. Beyond the fact that breast cancer tends to be a more biologically aggressive disease in African American than in White women, this disparity in breast cancer mortality also reflects social barriers that disproportionately affect African American women. These barriers hinder cancer prevention and control efforts and modify the biological expression of disease. The present review focuses on delineating social, economic, and cultural factors that are potentially responsible for Black-White disparities in breast cancer mortality. This review was guided by the social determinants of health disparities model, a model that identifies barriers associated with poverty, culture, and social injustice as major causes of health disparities. These barriers, in concert with genetic, biological, and environmental factors, can promote differential outcomes for African American and White women along the entire breast cancer continuum, from screening and early detection to treatment and survival. Barriers related to poverty include lack of a primary care physician, inadequate health insurance, and poor access to health care. Barriers related to culture include perceived invulnerability, folk beliefs, and a general mistrust of the health care system. Barriers related to social injustice include racial profiling and discrimination. Many of these barriers are potentially modifiable. Thus, in addition to biomedical advancements, future efforts to reduce disparities in breast cancer mortality should address social barriers that perpetuate disparities among African American and White women in the United States. (Cancer Epidemiol Biomarkers Prev 2008;17(11):2913 -23) During the last two decades, there has been a growing Black-White disparity in breast cancer mortality (1). Although the overall rate of mortality from breast cancer has been decreasing since the early 1980s, this decrease has occurred at a much faster pace for White women than it has for African American women (Fig. 1). This finding is especially noteworthy because the lifetime incidence of breast cancer is actually lower, not higher, among African American women than among their White counterparts (1).What factors might be responsible for this racial disparity in mortality from breast cancer? Poorer outcomes in African American women, in part, reflect the fact that breast cancer tends to be a more biologically aggressive disease in African Americans than in White Americans (2-6). In addition to biological factors, these disparities also reflect social, economic, and cultural barriers that disproportionately affect African American women. Barriers such as poverty and racism both hinder cancer prevention and control efforts and modify the biological expression of disease (7-10). The current review focuses on delineating the social, economic, and cultural factors potentially responsible for Black-White disparities i...

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Section: Barriers Related To Povertymentioning

confidence: 99%

Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review

Gerend

Pai

2008

Cancer Epidemiology, Biomarkers &Amp; Prevention

265

213

View full text Add to dashboard Cite

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“…Being poor and in poor health is a form of double jeopardy that affects many unemployed, underemployed, and black people lacking medical insurance who may use the health-care system only when faced with a crisis. One study indicated that physicians with predominantly black or Hispanic patient populations were significantly less likely to recommend preventive practices and screening tests compared with physicians with predominantly white patient populations (11). Cultural values and poverty.…”

Section: Potential Barriersmentioning

confidence: 99%

Barriers to Improving Diabetes Care for Blacks

Anderson

Herman

et al. 1991

Diabetes Care

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“…[37][38][39][40] In this study, women whose regular physician was an obstetrician-gynecologist reported a physician recommendation more often than did other women, although fewer than 10% of the women reported that their regular physician was an obstetrician-gynecologist. Recommendation likely varies by physician characteristics and attitudes, 41 but this analysis was not able to consider physicians'characteristics other than specialty. Women's preferences for mammography also may affect physician recommendation of the procedure, but this study did not measure women's preferences.…”

Section: Discussionmentioning

confidence: 99%

The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: who gets the message about breast cancer screening?

2001

Am J Public Health

221

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OBJECTIVES: This study investigated the association between physician recommendation for mammography and race/ethnicity, socioeconomic status, and other characteristics in a rural population. METHODS: In 1993 through 1994, we surveyed 1933 Black women and White women 52 years and older in 10 rural counties. RESULTS: Fifty-three percent of the women reported a physician recommendation in the past year. White women reported recommendations significantly more often than did Black women (55% vs 45%; odds ratio = 1.49). Controlling for educational attainment and income eliminated the apparent racial/ethnic difference. After control for 5 personal, 4 health, and 3 access characteristics, recommendation for mammography was found to be more frequent among women who had access to the health care system (i.e., had a regular physician and health insurance). Recommendation was less frequent among women who were vulnerable (i.e., were older, had lower educational attainment, had lower annual family income). CONCLUSIONS: Socioeconomic status, age, and other characteristics--but not race/ethnicity--were related to reports of a physician recommendation, a precursor strongly associated with mammography use. Efforts to increase physician recommendation should include complementary efforts to help women address socioeconomic and other barriers to mammography use.

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Differences in physician prevention practice patterns for white and minority patients

Cited by 97 publications

References 7 publications

Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review

Social Determinants of Black-White Disparities in Breast Cancer Mortality: A Review

Barriers to Improving Diabetes Care for Blacks

The association of race/ethnicity, socioeconomic status, and physician recommendation for mammography: who gets the message about breast cancer screening?

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