This research was supported by a number of awards received by Dr. Gonzales including: National Institute of Diabetes and Digestive and Kidney Diseases Award Number F31DK082279; National Cancer Institute (NCI) grant no. UO1-CA 86098; Northwest Health Foundation (NWHF) grant no. F03890; and Northwest Native American Research Center for Health (NW NARCH) grant no. U26IHS300003.
Womens Health Issues
Cervix uteri -- Cancer -- Diagnosis, Discrimination in medical care, Diabetes -- United States, Indian women -- North America -- Social conditions
Purpose - Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes.
Methods - Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors.
Findings - Substantial proportions of AI women in our sample were behind the recommended schedules of screening for breast and cervical cancer. Adjusted estimates revealed that perceived discrimination was significantly associated with not being current for clinical breast examination and Pap test, and was close to statistical significance with not being current for mammography. The number of suboptimal health care-seeking behaviors increased with higher mean levels of perceived discrimination.
Conclusions - Among AI women, perceived discrimination in health care may negatively influence use of breast and cancer screening services, and health care-seeking behaviors. More research is needed among AIs to examine features of health care systems related to the phenomenon patients perceived experience of discrimination.
Gonzales, Kelly; Harding, Anna K.; Lambert, William E.; Fu, Rongwei; and Henderson, William G., "Perceived Experiences of Discrimination in Health Care: A Barrier for Cancer Screening Among American Indian Women with Type 2 Diabetes" (2013). OHSU-PSU School of Public Health Faculty Publications and Presentations. 198.