Healthcare barriers and supports for American Indian women with cancer

Abstract

Although American Indian (AI) women continue to experience cancer at higher rates and have not seen the same decline in cancer prevalence as the general U.S. population, little research examines how interactions with health care providers may influence and exacerbate these health disparities. The purpose of the study was to understand the experiences of AI women who receive cancer treatment, which is integral for eradication of AI cancer disparities among women. A qualitative descriptive methodology was used with a sample of 43 AI women with breast, cervical, colon, and other types of cancer from the Northern Plains region of South Dakota. Interviews were conducted from June 2014 to February 2015. Qualitative content analysis revealed that women experienced: (a) health concerns being ignored or overlooked; (b) lack of consistent and qualified providers; (c) inadequate healthcare infrastructure; (d) sub-optimal patient-healthcare provider relationships; (e) positive experiences with healthcare providers; and (f) pressure and misinformation about treatment. Results indicate the types of support AI women may need when accessing healthcare. Culturally informed trainings for healthcare professionals may be needed to provide high-quality and sensitive care for AI women who have cancer, and to support those providers already providing proper care.

“There Is a Lot of Practice in Not Thinking about That”: Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians

“…A lack of transportation to distant health care facilities has been previously identified as a prominent barrier to accessing healthcare in other AI/AN communities [ 20 , 21 ]. In small, close-knit, and remote communities, such as those that are involved in the current study, concerns regarding a lack of privacy while accessing health services is a legitimate concern [ 20 , 22 , 23 , 24 ]. Recognizing other community members in a healthcare facility serving the AI/AN community is a plausible experience, which raises concerns as to whether an individual might be able to maintain anonymity while obtaining HIV/STI-related health services.…”

Designing Inclusive HPV Cancer Vaccines and Increasing Uptake among Native Americans—A Cultural Perspective Review

“…These concerns stem from historical experiences, for example, healthcare providers have undermined the well-being of Native women by pathologizing holistic views of health and by general patronizing [ 17 ]. Further, Native women have been restricted access to healthcare and the right to bear and raise children [ 20 ], as evident in the sterilization of Native women without informed consent in the 1970s [ 19 ]. Broader government policies were designed to annihilate Native Americans in the 19th and early 20th centuries…”

“…In 2018, Native women diagnosed with cancer were surveyed and interviewed about their healthcare experiences. Results showed that many women struggled to be heard, to be taken seriously, or to have their legitimate healthcare concerns addressed; over 41% ( n = 18) reported struggling to have their initial concerns about cancer taken seriously and women consistently reported having to convince their doctors that something was wrong [ 20 ]. Women who were identified as having cancer early on usually reported finding out they had cancer through regular screening programs, highlighting the importance of these programs [ 20 ].…”

Cancer Biology and You: An Interactive Learning Event for Native American High School Students to Increase Their Understanding of Cancer Causes, Prevention, and Treatment, and to Foster an Interest in Cancer-Related Careers

“…Two types of cancer for which there is a need for more education among Native Americans are breast cancer and skin cancer. Northern Plains Native American women with breast cancer and other types of cancer reported having poor patient-healthcare provider relationships and misinformation about therapies (Liddell et al, 2018). Furthermore, in a study by Burnette et al (2019), 26% of surveyed American Indian women in the Northern Plains who were survivors of breast cancer and other cancers reported a desire for more cancer education.…”