racial disparities

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Why do black women wait longer for breast cancer diagnosis and treatment than white women?

Wednesday, April 28th, 2010

Among pundits, there is a tendency to proclaim that we live in a post-racial society. We’ve had laws on the books banning racial discrimination for decades now. In 2008, we elected our first African-American president. Perhaps the most popular talk show host of our time is a black woman.

While all these signs of progress are encouraging, they are still only steps along the road to equality; we haven’t yet reached our destination. That reality becomes painfully evident in the results of a recent study about the disparities in diagnosis and treatment of breast cancer between white and black women.

In a five-year study, using initial screening data that reached back 12 years, researchers at The GW Cancer Institute examined the effect of race and health insurance status on the diagnosis and treatment of breast cancer. What they found was startling:

• insured black women and uninsured white women waited more than twice as long to reach their definitive diagnosis than insured white women;

• lack of health insurance decreased the speed of diagnosis in white women, but having insurance did not increase the speed of diagnosis in black women; and

• overall, black women waited twice as long as white women for treatment initiation following definitive diagnosis.

The researchers had, quite reasonably, expected to find that any insured woman, of any color, would get diagnosed and treated earlier than any woman of any color without insurance.

What do we make of the data that suggest that being black is as great a barrier to treatment as being uninsured?

It’s a question without an answer but it shows that we have a long way to go on this journey. For those quick to proclaim the “post-racial” era has arrived, this is a call, first for introspection but most urgently, for action. Neither insurance status nor race should get in the way of life-saving treatment.

– Yvonne S. Thornton, MD, MPH