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Article

Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers

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Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
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Kraft Center for Community Health, Massachusetts General Hospital, Boston, MA 02114, USA
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Department of Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Harold C. Simmons Comprehensive Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Michael and Susan Dell Center for Healthy Living, School of Public Health, The University of Texas Health Science Center at Houston–Austin Regional Campus, Austin, TX 78701, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Leo Wilton and Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(21), 11267; https://doi.org/10.3390/ijerph182111267
Received: 21 July 2021 / Revised: 21 October 2021 / Accepted: 22 October 2021 / Published: 27 October 2021
Although racism is increasingly being studied as an important contributor to racial health disparities, its relation to cancer-related outcomes among African Americans remains unclear. The purpose of this study was to help clarify the relation between two indicators of racism—perceived racial discrimination and racial residential segregation—and cancer screening. We conducted a multilevel, longitudinal study among a medically underserved population of African Americans in Texas. We assessed discrimination using the Experiences of Discrimination Scale and segregation using the Location Quotient for Racial Residential Segregation. The outcome examined was “any cancer screening completion” (Pap test, mammography, and/or colorectal cancer screening) at follow-up (3–10 months post-baseline). We tested hypothesized relations using multilevel logistic regression. We also conducted interaction and stratified analyses to explore whether discrimination modified the relation between segregation and screening completion. We found a significant positive relation between discrimination and screening and a non-significant negative relation between segregation and screening. Preliminary evidence suggests that discrimination modifies the relation between segregation and screening. Racism has a nuanced association with cancer screening among African Americans. Perceived racial discrimination and racial residential segregation should be considered jointly, rather than independently, to better understand their influence on cancer screening behavior. View Full-Text
Keywords: cancer screening; racial discrimination; racial residential segregation; racism; African Americans; critical race theory; breast cancer; cervical cancer; colorectal cancer; 2-1-1 cancer screening; racial discrimination; racial residential segregation; racism; African Americans; critical race theory; breast cancer; cervical cancer; colorectal cancer; 2-1-1
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MDPI and ACS Style

Ibekwe, L.N.; Fernández-Esquer, M.E.; Pruitt, S.L.; Ranjit, N.; Fernández, M.E. Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers. Int. J. Environ. Res. Public Health 2021, 18, 11267. https://doi.org/10.3390/ijerph182111267

AMA Style

Ibekwe LN, Fernández-Esquer ME, Pruitt SL, Ranjit N, Fernández ME. Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers. International Journal of Environmental Research and Public Health. 2021; 18(21):11267. https://doi.org/10.3390/ijerph182111267

Chicago/Turabian Style

Ibekwe, Lynn N., Maria Eugenia Fernández-Esquer, Sandi L. Pruitt, Nalini Ranjit, and Maria E. Fernández. 2021. "Racism and Cancer Screening among Low-Income, African American Women: A Multilevel, Longitudinal Analysis of 2-1-1 Texas Callers" International Journal of Environmental Research and Public Health 18, no. 21: 11267. https://doi.org/10.3390/ijerph182111267

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