Upstream and Downstream Factors for Breast Cancer in Latina Women: Understanding the Continuums and Closing the Gaps

Authors:

Swapna Reddy (Presenter)
Arizona State University

Nirali Patel, University of California, Los Angeles
Asha Devineni, Arizona State University
Matthew Speer, Arizona State University

Public Health Statement: Identifying and addressing perceived and actual barriers to care is crucial in reducing health disparities in breast cancer among high-need Latino populations. By better understanding the upstream and downstream factors that influence medical decisions for women in this population, health care providers are better equipped to provide patient-centered care and improve health outcomes.

Purpose: Despite incidence rates for breast cancer that are 26% less than non-Hispanic whites, Hispanic women are more likely to die from breast cancers of comparable age, stage, and tumor characteristics. At 30.7%, Latinos are a significant population within Arizona and while mammography rates are similar to non-Hispanic whites, Latina women have less favorable treatment plans, delayed follow-up rates, diagnosis at more advanced stages and highly disparate survivorship.

Simultaneously, this population experiences a parallel continuum of social determinants of health that exacerbate factors contributing to disparities in breast cancer outcomes, including lack of trust in health care/power systems, language barriers, cultural differences, health literacy, and/or immigration status. While many are shared among Latina women nationally, specific systemic and legislative practices in Arizona may exacerbate these challenges.

Methods/Approach: Utilizing a case study approach, qualitative data collection measures will be used to gain further insight into the interaction between the social determinant and access and utilization of care continuums for a small group of Latino women in downtown Phoenix. Researchers from Arizona State University’s School for the Science of Health Care Delivery (ASU-SHCD) are partnering with the University of Arizona Cancer Center/Dignity Health to conduct focus groups and semi-structured interviews for patient perspectives of social, economic and systemic barriers that influence breast cancer health decisions.

Results: The resulting gap and qualitative data analysis will ideally inform organizational, local and state policy recommendations that meet our nation’s public health goals and respond to the target community’s needs.

Conclusions/Implications: The Latina community in Arizona faces a complex set of barriers to accessing and maximizing health care services. A deeper understanding of upstream and downstream factors can foster a more robust healthcare conversation that drives better health outcomes by actively responding to these intersectional social determinants.