IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i21p11267-d665665.html
   My bibliography  Save this article

Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers

Author

Listed:
  • Lynn N. Ibekwe

    (Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
    Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
    Kraft Center for Community Health, Massachusetts General Hospital, Boston, MA 02114, USA)

  • Maria Eugenia Fernández-Esquer

    (Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA)

  • Sandi L. Pruitt

    (Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
    Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA)

  • Nalini Ranjit

    (Michael and Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston–Austin Regional Campus, Austin, TX 78701, USA)

  • Maria E. Fernández

    (Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA)

Abstract

Although racism is increasingly being studied as an important contributor to racial health disparities, its relation to cancer-related outcomes among African Americans remains unclear. The purpose of this study was to help clarify the relation between two indicators of racism—perceived racial discrimination and racial residential segregation—and cancer screening. We conducted a multilevel, longitudinal study among a medically underserved population of African Americans in Texas. We assessed discrimination using the Experiences of Discrimination Scale and segregation using the Location Quotient for Racial Residential Segregation. The outcome examined was “any cancer screening completion” (Pap test, mammography, and/or colorectal cancer screening) at follow-up (3–10 months post-baseline). We tested hypothesized relations using multilevel logistic regression. We also conducted interaction and stratified analyses to explore whether discrimination modified the relation between segregation and screening completion. We found a significant positive relation between discrimination and screening and a non-significant negative relation between segregation and screening. Preliminary evidence suggests that discrimination modifies the relation between segregation and screening. Racism has a nuanced association with cancer screening among African Americans. Perceived racial discrimination and racial residential segregation should be considered jointly, rather than independently, to better understand their influence on cancer screening behavior.

Suggested Citation

  • Lynn N. Ibekwe & Maria Eugenia Fernández-Esquer & Sandi L. Pruitt & Nalini Ranjit & Maria E. Fernández, 2021. "Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers," IJERPH, MDPI, vol. 18(21), pages 1-19, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11267-:d:665665
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/21/11267/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/21/11267/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. David M. Cutler & Edward L. Glaeser & Jacob L. Vigdor, 1999. "The Rise and Decline of the American Ghetto," Journal of Political Economy, University of Chicago Press, vol. 107(3), pages 455-506, June.
    2. Ford, C.L. & Daniel, M. & Earp, J.A. & Kaufman, J.S. & Golin, C.E. & Miller, W.C., 2009. "Perceived everyday racism, residential segregation, and HIV testing among patients at a sexually transmitted disease clinic," American Journal of Public Health, American Public Health Association, vol. 99(S1), pages 137-143.
    3. Shariff-Marco, S. & Klassen, A.C. & Bowie, J.V., 2010. "Racial/ethnic differences in self-reported racism and Its association with cancer-related health behaviors," American Journal of Public Health, American Public Health Association, vol. 100(2), pages 364-374.
    4. Leah Platt Boustan, 2013. "Racial Residential Segregation in American Cities," NBER Working Papers 19045, National Bureau of Economic Research, Inc.
    5. Shavers, V.L. & Fagan, P. & Jones, D. & Klein, W.M.P. & Boyington, J. & Moten, C. & Rorie, E., 2012. "The state of research on racial/ethnic discrimination in the receipt of health care," American Journal of Public Health, American Public Health Association, vol. 102(5), pages 953-966.
    6. Krieger, Nancy & Smith, Kevin & Naishadham, Deepa & Hartman, Cathy & Barbeau, Elizabeth M., 2005. "Experiences of discrimination: Validity and reliability of a self-report measure for population health research on racism and health," Social Science & Medicine, Elsevier, vol. 61(7), pages 1576-1596, October.
    7. Ford, C.L. & Airhihenbuwa, C.O., 2010. "Critical race theory, race equity, and public health: Toward antiracism praxis," American Journal of Public Health, American Public Health Association, vol. 100(S1), pages 30-35.
    8. Ihlanfeldt, Keith R. & Scafidi, Benjamin, 2002. "Black Self-Segregation as a Cause of Housing Segregation: Evidence from the Multi-City Study of Urban Inequality," Journal of Urban Economics, Elsevier, vol. 51(2), pages 366-390, March.
    9. Yin Paradies & Jehonathan Ben & Nida Denson & Amanuel Elias & Naomi Priest & Alex Pieterse & Arpana Gupta & Margaret Kelaher & Gilbert Gee, 2015. "Racism as a Determinant of Health: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-48, September.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Came, H. & Doole, C. & McKenna, B. & McCreanor, T., 2018. "Institutional racism in public health contracting: Findings of a nationwide survey from New Zealand," Social Science & Medicine, Elsevier, vol. 199(C), pages 132-139.
    2. Stephen L. Ross, 2003. "Ségrégation and Racial Preferences: New Theoretical and Empirical Approaches," Annals of Economics and Statistics, GENES, issue 71-72, pages 97-139.
    3. Nijkamp, Peter & Poot, Jacques, 2015. "Cultural Diversity: A Matter of Measurement," IZA Discussion Papers 8782, Institute of Labor Economics (IZA).
    4. Bayer, Patrick & McMillan, Robert & Rueben, Kim S., 2004. "What drives racial segregation? New evidence using Census microdata," Journal of Urban Economics, Elsevier, vol. 56(3), pages 514-535, November.
    5. Harris Selod & Yves Zenou, 2006. "City Structure, Job Search and Labour Discrimination: Theory and Policy Implications," Economic Journal, Royal Economic Society, vol. 116(514), pages 1057-1087, October.
    6. Victoria Gregory & Julian Kozlowski & Hannah Rubinton, 2022. "The Impact of Racial Segregation on College Attainment in Spatial Equilibrium," Working Papers 2022-036, Federal Reserve Bank of St. Louis, revised 24 Jul 2023.
    7. David M. Brasington & Diane Hite & Andres Jauregui, 2015. "House Price Impacts Of Racial, Income, Education, And Age Neighborhood Segregation," Journal of Regional Science, Wiley Blackwell, vol. 55(3), pages 442-467, June.
    8. Boitier, Vincent & Auvray, Emmanuel, 2021. "Schelling paradox in a system of cities," Mathematical Social Sciences, Elsevier, vol. 113(C), pages 68-88.
    9. Nancy Krieger & Pamela D Waterman & Anna Kosheleva & Jarvis T Chen & Dana R Carney & Kevin W Smith & Gary G Bennett & David R Williams & Elmer Freeman & Beverley Russell & Gisele Thornhill & Kristin M, 2011. "Exposing Racial Discrimination: Implicit & Explicit Measures–The My Body, My Story Study of 1005 US-Born Black & White Community Health Center Members," PLOS ONE, Public Library of Science, vol. 6(11), pages 1-24, November.
    10. Jessie Bakens & Raymond J.G.M. Florax & Peter Mulder, 2018. "Ethnic drift and white flight: A gravity model of neighborhood formation," Journal of Regional Science, Wiley Blackwell, vol. 58(5), pages 921-948, November.
    11. Robert Bifulco & Helen F. Ladd & Stephen Ross, 2007. "Public School Choice and Integration: Evidence from Durham, North Carolina," Working papers 2007-41, University of Connecticut, Department of Economics, revised Jun 2008.
    12. Ana Isabel Maldonado & Carol B. Cunradi & Anna María Nápoles, 2020. "Racial/Ethnic Discrimination and Intimate Partner Violence Perpetration in Latino Men: The Mediating Effects of Mental Health," IJERPH, MDPI, vol. 17(21), pages 1-17, November.
    13. Bayer, Patrick & Fang, Hanming & McMillan, Robert, 2014. "Separate when equal? Racial inequality and residential segregation," Journal of Urban Economics, Elsevier, vol. 82(C), pages 32-48.
    14. Akinade, Temitope & Kheyfets, Anna & Piverger, Naissa & Layne, Tracy M. & Howell, Elizabeth A. & Janevic, Teresa, 2023. "The influence of racial-ethnic discrimination on women's health care outcomes: A mixed methods systematic review," Social Science & Medicine, Elsevier, vol. 316(C).
    15. Li Yin, 2009. "The Dynamics of Residential Segregation in Buffalo: An Agent-based Simulation," Urban Studies, Urban Studies Journal Limited, vol. 46(13), pages 2749-2770, December.
    16. Vigdor, Jacob L., 2003. "Residential segregation and preference misalignment," Journal of Urban Economics, Elsevier, vol. 54(3), pages 587-609, November.
    17. Patrick Bayer & Robert McMillan, 2005. "Racial Sorting and Neighborhood Quality," NBER Working Papers 11813, National Bureau of Economic Research, Inc.
    18. Gilbert, Paul A. & Zemore, Sarah E., 2016. "Discrimination and drinking: A systematic review of the evidence," Social Science & Medicine, Elsevier, vol. 161(C), pages 178-194.
    19. Laurent Gobillon & Harris Selod & Yves Zenou, 2002. "Spatial Mismatch : From the Hypothesis of the Theories," Working Papers 2002-57, Center for Research in Economics and Statistics.
    20. Pam Phojanakong & Emily Brown Weida & Gabriella Grimaldi & Félice Lê-Scherban & Mariana Chilton, 2019. "Experiences of Racial and Ethnic Discrimination Are Associated with Food Insecurity and Poor Health," IJERPH, MDPI, vol. 16(22), pages 1-13, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11267-:d:665665. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.