Kimberly’s Korner : Investigating the Health and Racial Disparities in Breast Cancer (Part II)
Background: There seems to be a gap in both access and treatment for black women when it comes to breast cancer treatment, and I am interested in understanding why that is. There are many reasons as to why I choose this topic; firstly, having a grandmother who has battled breast cancer twice. Sadly, it was not until I was well into adulthood that I truly understood her experience and her illness and the way in which my family, an immigrant family at that, viewed her treatment process. Secondly, interning for a few Breast Cancer advocacy groups has allowed me to push aside my cultural perception of cancer and illness, and give access to the more realistic and honest approach to it. In this 3-part series (Screening, Diagnosis/Treatment, and Survivorship), I aim to guide you through the screening process all the way to survivorship, and the barriers that black women may encounter when diagnoses with Breast Cancer.
---------------------------------------------------------------------------------------------------------------------
In Part I of Kimberly’s Korner, we explored some of the reasons for screening discrepancies. They not only included low socioeconomic status and lack of insurance, it also includes cultural and relational reasons; even specific biological characteristics of the tumor can account for differences in screening results for women of color. Together, all these pieces, and so much more, can contribute to the late stage diagnosis for African American cancer patients during the screening process.

DIAGNOSIS AND TREATMENT
There has also been a considerable amount of discussion around the argument as to whether differences in diagnosis and treatments are based on race or socioeconomic status. The effect of race and socioeconomic status on breast cancer diagnosis and treatment leave African American women at a greater risk of dying from the disease. There is considerable evidence suggesting that economic disparities or disparities in insurance coverage are the cause of breast cancer diagnosis, treatment, and survival more than the assumed construct of race (1). However, most of the current literature around this topic propose that racial disparities occurring in breast cancer diagnosis and survival persevere even when socioeconomic status is controlled.
Though we touched on it in Part I, the type of insurance, or lack thereof, a woman has plays a major role in the way that she seeks treatment. And to many poor, under-served women of color battling with breast cancer, lacking insurance coverage may even be the reason why they discontinue treatments or chemotherapy. Both the presence and type of health insurance can be an important determinant of ones’ cancer stage at diagnosis. Access to health care, the most appropriate kind, is a privilege. Irregular breast cancer screenings and failure to detect and respond to the symptoms are all outcomes to socioeconomic factors like poverty and access to healthcare.
A 2015 study[1] found that in non-Hispanic whites with government insurance, there was a significant shorter diagnostic time than non-Hispanic African Americans with government insurance, with the average times being 12 and 39 days correspondingly. The research also found that privately insured non-Hispanic whites also had considerably shorter diagnostic times than privately insured non-Hispanic African Americans. At the end of the study the authors concluded that other barriers associated with race and ethnicity influenced access to quality and timely healthcare For African Americans than lack of health insurance alone.