Breast cancer mortality disparities: Providers' perspective

Abstract

This research is part two of a study to gain understanding of reasons for the large breast cancer mortality disparity between African-American and White women who live in Memphis, Tennessee. Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African-American women are twice as likely to die from breast cancer as White women. In part one of this study, we sought to gain the perspective of African-American breast cancer survivors. Now we explore the perspective from the providers of care who interface with breast cancer patients, health systems, and health insurers. This is a descriptive research study that used qualitative methodology to inteview seven medical, surgical and radiation oncologists who serve African-American breast cancer patients in Memphis. Data were collected using semi-structured in-depth interviews. Themes included: (1) socioeconomic factors; (2) lack of knowledge about treatment, progression and side effects, and diagnosis; (3) information/communication about the diagnosis; (4) support system: need for another person to process information given; (5) limited access and resources: no insurance and no available services for treatment in African-American neighborhoods; and (6) fear of the unknown: fear of cancer, fear of losing breast, and fear about the disease’s impact on personal relationships. These results suggest that resources that aid geographical access to services need to change in order for disparities to decrease. A new model for health care delivery for African-American women at high risk of or diagnosed with breast cancer needs to be developed to address these findings.