“Rochester is internationally known as ‘Med City.’ When my colleague told me that there were health disparities in Rochester, it blew my mind,” said University of St. Thomas Assistant Professor Dr. Starr Sage. “We’re in the shadow of Mayo Clinic, and you’re telling me that there are people who don’t have access to these resources when they’re in abundance?”
According to the American Cancer Society, Black women have a 30 percent lower incidence of breast cancer than White women, but Black women have an eight percent higher cancer-related mortality rate.
Black women also have a twofold risk of death caused by cervical cancer compared to White women despite having only a slightly increased risk of cervical cancer diagnosis. Even in Rochester, where people come from all over the world for health care, Black women down the street from the Mayo Clinic are not avoiding these disparities.
A new study done in Rochester came to this conclusion and researched factors causing these large disparities. They concluded that Black women may have a higher mortality rate of cervical and breast cancer due to a lack of engagement with their healthcare providers.
The study, titled “‘Girl, just pray …’: Factors That Influence Breast and Cervical Cancer Screening Among Black Women in Rochester, MN,” by researchers Sage, Chamika Hawkins Taylor, Rev. Andre Crockett Sr., and Joyce Balls-Berry was published in March by the Journal of the National Medical Association.
Supported by a pilot grant from the Program in Health Disparities Research at the University of Minnesota, they surveyed dozens of women over the course of several years in order to understand the health disparities Black women face when it comes to cancer mortality.
Attention was brought to the issue after Crockett, who previously researched health issues among Black men living in Rochester, was approached by women in his church who wondered if they could have their health concerns highlighted.
“What I really love about this research is that it tells Black women’s stories in their own voice. That was really important to me,” Sage said. All of the authors published in the research paper are Black, and three out of the four are women. Sage and her colleagues wanted to establish trust and build relationships through this study, understanding how important it was for the investigators to reflect the community, the actual subjects.
Researchers identified a number of factors as possible causes for cancer-related mortality disparities between Black and White women. Among the key factors was the lack of trust in medical institutions. Many participants in the study stated their aversion to healthcare professionals, and that disconnect may be a reason many Black women avoid screening for breast or cervical cancer.
Other barriers such as financial considerations have been identified in the past. Some participants spoke about their fear of being underinsured and not being able to afford the screenings. Others were aware of free screening options in the community but still feared hidden fees or simply could not afford the ride.
Cultural differences also caused a hindrance for some women to go through with cancer screenings. The study found many of the women of faith relied solely on the “power of prayer” instead of going through with a pap smear. Others mentioned a preference to interact with women healthcare providers instead of men as a reason for avoiding cancer screenings.
Some women mentioned their fear of being judged by healthcare providers. Because the human papillomavirus is the leading cause of cervical cancer, some participants worried they would be seen as seeking treatment for sexually transmitted infections. Several of the women who were of African descent also shared their apprehension with screening due to an “atypical anatomy” primarily due to female genital mutilation.
LaSonya Natividad worked as a community liaison during part of the research. Working as a nurse in the community and as a member of Rev. Crockett’s church, Natividad helped recruit participants to the study and set meetings at the church between researchers and women from the community.
She was surprised by the lack of knowledge about cervical cancer she saw from a number of the women who were surveyed for the research. “There were a few women that weren’t aware of where their cervix was, and these were women who had children,” she said.
“It was kind of eye-opening for me that people were not aware of what was going on with their bodies.”
Before publishing this study and presenting it to her peers, Sage and her fellow authors made sure to relay the findings to the community participants who helped make this research possible.
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