The Influence of Social Determinants on Late Stage Breast Cancer for Women in Mississippi

J Racial Ethn Health Disparities. 2017 Feb;4(1):104-111. doi: 10.1007/s40615-016-0207-2. Epub 2016 Feb 22.

Abstract

Introduction: Breast cancer is the most common diagnosed cancer in women exacting an emotional and economic hardship for them and their families. There are no known causes of breast cancer, but there are certain genetic, social, and environment risk factors that pre-dispose women to this disease. Also, diagnosis at later stages of disease has been shown to have adverse outcomes for many as compared to early stages. The social determinants researched to examine their influence on breast cancer outcomes were race, health insurance, and income. The results of this study confirmed that race and health insurance were the two major factors that negatively impacted stages of breast cancer diagnoses.

Purpose: The purpose of this study was to investigate the influence that social determinants have on stage of breast cancer diagnoses. This research focused on three social determinants that research demonstrated had an influence on stages of breast cancer diagnoses (race, income, and lack of health insurance).

Methods: Bivariate analyses were conducted to examine the relationships between race and income, race and health insurance, and race and stage of diagnosis. The findings confirmed what was suspected for Mississippians; more African Americans had lower incomes, had less health insurance coverage, and were diagnosed at later stages of breast cancer disease.

Results: Only race and health insurance directly affected late stage diagnosis in analyses for this study. The influence of income on stage of breast cancer diagnosis was not statistically significant. The results of these analyses demonstrated that African American women in Mississippi were disproportionately diagnosed at late stage breast cancer as opposed to early stage.

Conclusions: An individual cannot alter the genetic factor of race, but some of the disparate health outcomes that appear to be associated with race may be behavioral or socio-economically based and can be addressed, which could impact health outcomes. Adequate health insurance could positively impact stage of breast cancer diagnoses, ultimately reducing health disparities and premature death.

Keywords: Breast cancer; Early stage; Late stage; Social determinants.

MeSH terms

  • Black or African American / statistics & numerical data*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / ethnology*
  • Delayed Diagnosis / statistics & numerical data*
  • Female
  • Health Status Disparities*
  • Humans
  • Income / statistics & numerical data
  • Insurance, Health / statistics & numerical data*
  • Mississippi / epidemiology
  • Neoplasm Staging
  • Social Determinants of Health / ethnology*
  • White People / statistics & numerical data