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癌症差异的批判理论方法:乳腺癌与健康的社会决定因素。

A Critical Theoretical Approach to Cancer Disparities: Breast Cancer and the Social Determinants of Health.

机构信息

Suzanne Dworak-Peck School, University of Southern California, Los Angeles, CA, United States.

Brown School, Washington University in St. Louis, St. Louis, MO, United States.

出版信息

Front Public Health. 2021 May 21;9:674736. doi: 10.3389/fpubh.2021.674736. eCollection 2021.

Abstract

Breast cancer is the most commonly experienced cancer among women. Its high rates of incidence and survival mean that a number of women will live it for periods of their lifetimes. Group differences in breast cancer incidence and mortality occur by race and ethnicity. For example, while white women are slightly more likely to be diagnosed with breast cancer, Black women are 40% more likely to die from the disease. In this article, rather than focusing the discussion on individual-level factors like health behaviors that have the potential to blame Black women and those living in poverty for their conditions, we view breast cancer disparities through the lens of Critical Race Theory, taking a historical perspective. This allows us to delve beyond individual risk factors to explore social determinants of breast cancer disparities at the population level, paying special attention to the myriad ways in which social factors, notably views of race and discriminatory public policies, over time have contributed to the disproportionate breast cancer mortality experienced by Black women. We suggest ways of addressing breast cancer disparities, including methods of training healthcare professionals and public policy directions, that include rather than marginalize Black and lower socioeconomic status women.

摘要

乳腺癌是女性最常见的癌症。其高发病率和存活率意味着许多女性将在一生中的某个阶段经历它。乳腺癌发病率和死亡率的群体差异因种族和民族而异。例如,虽然白人女性被诊断出患有乳腺癌的可能性略高,但黑人女性死于该疾病的可能性高 40%。在本文中,我们不是关注健康行为等有可能将黑人女性和贫困女性归咎于自身状况的个体层面因素,而是通过批判种族理论的视角来看待乳腺癌差异,从历史角度出发。这使我们能够超越个体风险因素,探索乳腺癌差异在人口层面的社会决定因素,特别关注社会因素(尤其是种族观念和歧视性公共政策)随着时间的推移如何导致黑人女性不成比例的乳腺癌死亡率。我们提出了解决乳腺癌差异的方法,包括培训医疗保健专业人员的方法和公共政策方向,这些方法包括而不是边缘化黑人和社会经济地位较低的女性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2663/8175790/4372c28eb321/fpubh-09-674736-g0001.jpg

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