Why Is Breast Cancer More Lethal for Black Women?

Black women across the socioeconomic spectrum face an array of health care disparities. You may already be aware of the high maternal mortality rate for this demographic, an issue recently brought into stark relief by Serena Williams. But did you know that while black women are less likely to get breast cancer, they’re actually more likely to die of it?

There are a number of reasons why black women are at a disadvantage when it comes to fighting breast cancer – and many are due to wider health care disparities. Understanding why this issue isn’t as simple as being “aware” of breast cancer or seeking out a screening is important for Breast Cancer Awareness Month.

The numbers on breast cancer deaths underscore the gravity of this issue. In 1990, black women were 17 percent more likely to die of breast cancer than white women. By 2014, that number had skyrocketed to 43 percent.

Black women are at a genetic disadvantage, because they’re more likely to develop cancer earlier in life — sometimes before they hit the age for routine screening recommendations like mammograms. It can be hard to tailor screening recommendations to be broadly applicable to every single person with breasts, and the current generic guidance isn’t sufficient.

Black women also more prone to a type of breast cancer known as triple-negative cancer. It’s very aggressive and tends to spread quickly, but it’s also harder to treat — even though researchers are working on expanding the library of treatment options for breast cancer patients.

All of these contributing factors are bad news, but theoretically, research could help mitigate them, compensating for nature’s imbalances. The other reasons that black women face such poor outcomes with breast cancer are more sinister — and a lot more complicated to fix.

In a nutshell, they boil down to systemic racism that limits black women economically and socially, in addition to creating racial biases within the health care system – including a shortage of black doctors. Research shows that black patients have better health outcomes under the care of black physicians.

A phenomenon known as “health care gaslighting” affects all women, but it especially impacts black women. Patients who experience this issue report that when they go to the doctor for care, their concerns are dismissed or ignored, and they’re often denied access to diagnostic testing and screening. Black women particularly struggle with accessing care for pain, but also for perinatal health care issues. Biased attitudes may make it harder to get attention for concerns about breast health, too — and that creates an unnecessary barrier to earlier diagnosis and treatment.

Social disadvantages also play a role, something researchers are well aware of because they see differing rates from city to city. That suggests black women aren’t just losing the genetic lottery: Where they live can have a tremendous impact on their health care outcomes. It may determine when they access screening, how early the cancer is diagnosed and what kinds of treatment options are made available.

Timely provision of care is a big issue. Black women tend to be diagnosed later — as discussed above — and they’re are also frequently un- and underinsured, making it harder to afford screening and treatment. They’re less able to access follow-up care, whether they’re talking about aggressively pursuing treatment after a mammogram reveals a problem or they’re working with their physicians on care during remission – during which regular screening for recurrences and consistent medication therapy is critical.

Changing the health care landscape for black women is critical for addressing disparities in breast cancer treatment and other settings. That should include changing the way we educate medical providers and increasing diversity in the medical profession. But it also requires addressing the bigger socioeconomic problems for black women in society. Poor health outcomes for black women can’t be chalked up to not having enough money — although that can be a factor. Wealthy, educated women find themselves facing the same challenges as their low-income counterparts.

Photo Credit: Daniel McCullough/Unsplash

65 comments

Emily J
Emily J4 months ago

Thanks for sharing, it's shameful that black women are being disadvantaged in breast cancer treatment.

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Roslyn M
Roslyn McBride5 months ago

Noted.

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Dave f
Past Member 5 months ago

Noted .

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Elaine W
Elaine W5 months ago

Noted.

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Chad Anderson
Chad A5 months ago

Thank you.

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Dave f
Past Member 5 months ago

Thanks for sharing and signed .

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Lisa M
Lisa M5 months ago

Thanks.

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Lisa M
Lisa M5 months ago

Thanks.

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Dave fleming
Past Member 6 months ago

Thanks for sharing .

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Janis K
Janis K6 months ago

Thanks for sharing.

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