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Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions

1
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA
2
Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
3
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
4
Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA
*
Author to whom correspondence should be addressed.
Healthcare 2019, 7(1), 17; https://doi.org/10.3390/healthcare7010017
Received: 26 November 2018 / Revised: 19 January 2019 / Accepted: 21 January 2019 / Published: 24 January 2019
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Abstract

Aim: To determine whether socioeconomic status (SES; educational attainment and income) explains the racial gap in cancer beliefs, cognitions, and emotions in a national sample of American adults. Methods: For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a nationally representative sample of American adults. The study enrolled 2277 adults who were either non-Hispanic Black (n = 409) or non-Hispanic White (n = 1868). Race, demographic factors (age and gender), SES (i.e., educational attainment and income), health access (insurance status, usual source of care), family history of cancer, fatalistic cancer beliefs, perceived risk of cancer, and cancer worries were measured. We ran structural equation models (SEMs) for data analysis. Results: Race and SES were associated with perceived risk of cancer, cancer worries, and fatalistic cancer beliefs, suggesting that non-Hispanic Blacks, low educational attainment and low income were associated with higher fatalistic cancer beliefs, lower perceived risk of cancer, and less cancer worries. Educational attainment and income only partially mediated the effects of race on cancer beliefs, emotions, and cognitions. Race was directly associated with fatalistic cancer beliefs, perceived risk of cancer, and cancer worries, net of SES. Conclusions: Racial gap in SES is not the only reason behind racial gap in cancer beliefs, cognitions, and emotions. Racial gap in cancer related beliefs, emotions, and cognitions is the result of race and SES rather than race or SES. Elimination of racial gap in socioeconomic status will not be enough for elimination of racial disparities in cancer beliefs, cognitions, and emotions in the United States. View Full-Text
Keywords: perceived risk; worries; cancer beliefs; cancer screening; Health Information National Trends Survey (HINTS); race; class; socioeconomic status perceived risk; worries; cancer beliefs; cancer screening; Health Information National Trends Survey (HINTS); race; class; socioeconomic status
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Assari, S.; Khoshpouri, P.; Chalian, H. Combined Effects of Race and Socioeconomic Status on Cancer Beliefs, Cognitions, and Emotions. Healthcare 2019, 7, 17.

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