Introduction: Racial breast cancer survival disparities persist, indicating that not all populations are benefitting equally from advances in cancer control. Individual and health care factors do not fully explain these disparities, and contributing factors may include institutional racism and racial segregation. Our study explores the ways in which women in a highly segregated metropolitan area navigate cancer survivorship. Methods: The study utilizes novel qualitative methods and is guided by a community advisory board. Participants were recruited from Milwaukee, Wisconsin. We use a stratified, purposive sampling approach to include survivors who vary by neighborhood racial and ethnic composition. Eligible participants have been diagnosed with breast cancer, identify as Black or Hispanic, and have completed their initial treatment regimen. Instruments and processes were guided by a conceptual framework relating racism and racial segregation to breast cancer survival. We use narrative inquiry as a reflexive tool in which participants’ lived experiences are captured as textual representations. Semi-structured interviews include a demographic questionnaire, a life narrative account, and completion of a timeline detailing residential history since diagnosis. Interviews were transcribed and analyzed utilizing a hybrid approach of both a data-driven inductive process and a deductive, a priori coding template consistent with the conceptual framework. We present current findings from this ongoing study. Results: To date, 34 interviews have been completed with self-identified Black women (n=22) and Hispanic women (n=12). Black participants lived in neighborhoods that were predominantly Black (41%), diverse (32%), and predominantly white (28%), while Hispanic women lived in neighborhoods that were predominantly Hispanic (58%), diverse (8%), and predominantly white (33%). Ages of women ranged from 37 to 81, with a median of 61. Most women had an early stage cancer diagnosis. Narrative responses included: 1) determinants of health such as biology and family history; 2) social status, including socioeconomic status, race, and neighborhood of residence; 3) individual and family stressors such as discrimination, access to health information, and care quality; and 4) social support, resilience, and physiological responses to treatment. Participants discussed living in different geographic locations in the city, personal safety, and exposure to racism in their communities and workplaces. All were hopeful that sharing their experiences would benefit other cancer survivors. Conclusions: This study demonstrates the importance of examining race, racism, and residential segregation as contributors to breast cancer survivorship. Utilizing narrative inquiry and residential history analysis allows for a deeper examination of women’s experiences situated in place. Study findings can inform community-based conversations, advocacy and policy change to reduce disparities. Citation Format: Staci Young, Sara Beltran- Ponce, Madeline Berendt, Carolina Cuevas, Jasmin Griggs, Courtney Jankowski, Natalie Jones, Kirsten Beyer. A qualitative examination of race, racism, residential segregation and cancer survivorship among Black and Hispanic women [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-083.
Staci A. Young, S. B. Ponce, Madeline Berendt
Cancer Epidemiology and Prevention Biomarkers