Vinegar Jessica, Ericson Marissa, Espinoza Lilia, Dawkins-Moultin Lenna, Teteh-Brooks Dede K
Department of Public Health, California State University, Fullerton, USA.
Department of Psychology, California Lutheran University, Thousand Oaks, USA.
Sci Rep. 2024 Dec 28;14(1):30886. doi: 10.1038/s41598-024-81638-x.
Black women (BW) experience age-adjusted breast cancer mortality rates that are 40% higher than White women. Although, screening rates for breast cancer are similar between White and Black women, differences in mammography utilization exist among women with lower socioeconomic status (SES). Moreover, perceived everyday discrimination (PED) has been shown to have an inverse relationship on health screening behavior among BW. However, mammography behaviors of BW with low SES, who also report higher levels of PED, is not well known. This study aims to explore the relationship between perceived discrimination, SES, and mammography behavior. Participants were recruited between 2020 and 2022 through the Bench to Community Initiative, a community-based participatory research study, and completed a 41-item survey. Logistic regression was used to test the associations of mammography utilization with PED (assessed by a shortened version of the Everyday Discrimination Scale), SES, and race/ethnicity. Most participants (77%) identified as BW (African American, African, and Caribbean) followed by White (17%) and other groups (6%). Many respondents (87%) had health insurance; 67% reported having had a mammogram; and 41% were breast cancer survivors. Most respondents (63%) had a college education and income between $51,000 and $75,000. In an initial logistic regression model, race/ethnicity, income, and PED significantly predicted mammography behavior (χ (8) = 45.464, p < .01). In an additional stepwise logistic regression model that controlled for a history of breast cancer, race/ethnicity, income, PED, and education accounted for 35% of mammogram screening behavior (χ (12) = 112.410, p < .01). Race/ethnicity, income, education, and PED were associated with mammography behavior. Addressing these social determinants of health factors may improve our understanding of ways discrimination leaves BW vulnerable to disparate health outcomes, including breast cancer.
黑人女性（BW）的年龄调整后乳腺癌死亡率比白人女性高40%。尽管白人和黑人女性的乳腺癌筛查率相似，但社会经济地位（SES）较低的女性在乳房X光检查的利用率上存在差异。此外，日常感知歧视（PED）已被证明与黑人女性的健康筛查行为呈负相关。然而，SES较低且PED水平也较高的黑人女性的乳房X光检查行为尚不清楚。本研究旨在探讨感知歧视、SES和乳房X光检查行为之间的关系。通过“从实验室到社区倡议”（一项基于社区的参与性研究）在2020年至2022年期间招募参与者，并完成了一项包含41个项目的调查。使用逻辑回归来检验乳房X光检查利用率与PED（通过日常歧视量表的简化版评估）、SES和种族/族裔之间的关联。大多数参与者（77%）被认定为黑人女性（非裔美国人、非洲人及加勒比人），其次是白人（17%）和其他群体（6%）。许多受访者（87%）拥有医疗保险；67%报告曾进行过乳房X光检查；41%是乳腺癌幸存者。大多数受访者（63%）拥有大学学历，收入在51,000美元至75,000美元之间。在最初的逻辑回归模型中，种族/族裔、收入和PED显著预测了乳房X光检查行为（χ(8)=45.464，p<.01）。在控制了乳腺癌病史的额外逐步逻辑回归模型中，种族/族裔、收入、PED和教育解释了35%的乳房X光检查行为（χ(12)=112.410，p<.01）。种族/族裔、收入、教育和PED与乳房X光检查行为相关。解决这些健康因素的社会决定因素可能会增进我们对歧视使黑人女性易患包括乳腺癌在内的不同健康结果的方式的理解。
