In 2008, South Shore resident Cheryl King found a lump in her right breast.
When she told a health professional at a South Side Chicago facility, he dismissed it, saying many black women have lumps in their breasts. In the three months it took to get appointments and tests with other professionals, it had grown into a stage 2 tumor.
“I feel like if I lived on the North Side or closer to Northwestern or Rush, and I would have gone in for a diagnosis, I think they would have taken my concerns more seriously,” King said.
King, 59, is not alone. Racial disparities in breast cancer diagnosis and survival rates may have more to do with neighborhood than race, said a new University of Illinois at Urbana-Champaign analysis.
The study looked at patients ages 19 to 91 from breast cancer registries in six states. More than 93,600 black women living in big cities from 1980 to 2010 were included in the data set, which looked at neighborhood racial composition and segregation, poverty rates and access to mammography.
The study found that residential segregation, defined as living in a neighborhood with a predominantly black population, significantly increased black women’s rates of late-stage diagnosis and doubled their odds of dying from breast cancer. White women living in predominantly black neighborhoods had comparable mortality rates.
Dr. Zeynep Madak-Erdogan, study co-author and assistant professor of nutrition at the University of Illinois at Urbana-Champaign, agrees. “Residential segregation, coupled with its high correlation to low-socioeconomic status, is keeping certain communities from having access to essential resources which are pertinent for optimal health,” she said.
But not all cities are created equal. Dr. Anne Marie Murphy, executive director of the Metropolitan Chicago Breast Cancer Task Force, points to New York City, which has relatively low breast cancer disparities and lower death rates for black women with breast cancer.
“You can’t really tell me that African-American women in New York are somehow biologically different from African-American women living in Chicago,” she said. “We know that these things are not mainly biological. … There is a segregation of resources (here) in addition to overall segregation.”
The Task Force is a nonprofit that brings together community leaders, advocates and health care providers to address the racial disparity. More than 50 health care institutions throughout the city have either joined or expressed an intent to join.
Breast cancer oncologist Dr. April Swoboda, an assistant professor of medicine at Rush University Medical Center, a Task Force partner, agrees with Murphy, saying biological factors play a role in breast cancer diagnoses despite race or ethnicity, and that environmental factors like access to health care, stress and racism should not be underestimated in the mortality rate disparity between black and white women.
“It’s very much a multifactorial thing. There is so much work that needs to be done. We need to tackle this problem from every angle,” she said.