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This study from the University of Southern California explores the effects of racial discrimination on the care received by Black cancer survivors. It aims to shed light on the challenges and disparities faced by this population during their cancer care journey.
At the beginning of the research project, the researchers didn’t intend to investigate racial discrimination specifically. Their main goal was to learn more about the experiences of Black cancer patients. This was part of a more significant effort to determine how to improve the quality of cancer care and reduce disparities in outcomes based on race and ethnicity.
However, during their conversations with the study participants, it became clear that many Black patients had experienced racial discrimination in their cancer care.
Corresponding author Albert Farias, Ph.D., MPH, assistant professor of population and public health sciences at the Keck School of Medicine and a USC Norris Cancer Control Research Program member said, “Getting the right treatment in a timely manner really sets patients up for a better prognosis. By learning about how exposure to racial discrimination hinders receipt of high-quality, evidence-based cancer treatment for Black patients, we can start looking at what we can do about it. As an exposure, it’s modifiable, which means there’s a chance for us to intervene.”
At the start of the project, the researchers didn’t plan to look at racial discrimination. They wanted to learn about the experiences of Black cancer patients in general. This was part of a more significant effort to figure out how to improve cancer care and reduce differences in outcomes based on race and ethnicity. As they talked to the people in the study, they found that many Black patients had experienced racial discrimination in their cancer care.
Farias said, “We realized we needed to ask, ‘Why do you continue to return to a specific provider if this is how you’re treated? The most shocking part is that our participants said it’s part of the Black experience. One participant noted, ‘It’s just something we deal with all the time.”
The researchers talked to 18 Black cancer survivors aged 29 to 88 in Los Angeles. They found two kinds of bias: overt discrimination when people are openly and intentionally prejudiced because of race, and microaggressions, which are subtler and unintentional but still hurtful.
Examples of overt discrimination included a doctor referring to the Black community as “you people” and someone saying that “most of you” couldn’t afford a specific treatment. Microaggressions were when patients felt they were treated differently because of their race, like ignoring their concerns or being left waiting while others arriving later were seen.
Patients felt degraded, frustrated, and disheartened when they experienced racial discrimination, to the point of dreading getting medical care. Some even went to emergency rooms or urgent care clinics instead of regular appointments, or they skipped meetings and left without seeing a specialist because they were ignored.
Others changed how they dressed when going to the clinic, hoping it would make them get better treatment. Worst of all, some said they weren’t screened for colon cancer even when they had symptoms and didn’t follow their oncologists’ recommendations because they didn’t trust the healthcare system.
Farias said, “I’m optimistic that this will be one of the first of many papers to explore this topic. We know that racial discrimination occurs. We must document and call attention to it to make the necessary changes.”
Co-author Chanita Hughes-Halbert, PhD, who holds Dr. Arthur and Priscilla Ulene Chair in Women’s Cancer at the Keck School and is the associate director for cancer equity at USC Norris Cancer Center, emphasized that discrimination is a widespread issue that needs solutions at multiple levels, from policy changes to individual patient care.
Some critical steps in addressing this issue involve oncologists asking patients about their risks, community education, awareness programs, efforts to make the healthcare workforce more diverse, and support programs where patients can get one-on-one help from advocates.
Hughes-Halbert stressed the importance of healthcare providers understanding their patients’ real-life experiences. By improving communication across different patient groups, providers can offer better-quality care.
Understanding the impact of racial discrimination on Black cancer survivors is crucial for healthcare providers to deliver equitable and high-quality care. Addressing this issue at multiple levels, from policy to patient care, is essential to eliminate disparities in cancer care outcomes for underserved populations.
Journal reference:
Elleyse Garrett, Cindy Ma, et al., Black Cancer Patients Navigating a Healthcare System of Racial Discrimination. Journal of the National Cancer Institute. DOI: 10.1093/jnci/djad208.
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