Neighborhood, Discrimination and Screening Mammography

Yale University, New Haven CT

Investigators

Linked publications & trials

Abstract

DESCRIPTION (PROVIDED BY APPLICANT): The persistent racial/ethnic difference in stage at diagnosis of breast cancer leads to disproportionate breast cancer mortality burden for African American women compared with White women. The primary mechanism by which the Healthy People 2010 Objective to reduce breast cancer mortality is to be achieved is by early detection via regular screening mammograms, in accordance with recommended guidelines. This proposed research will elucidate the relationship between neighborhood characteristics, perceived discrimination, and a cancer prevention behavior-adherence to mammography screening guidelines. Although many investigators have described health consequences associated with neighborhood characteristics, as well as with perceived discrimination, this proposal will take these relatively understudied concepts (in epidemiology) to the realm of health behaviors and health services by examining their impact on a critical tool used in the early detection of breast cancer. The specific aims of the proposed study are to determine the relationship between neighborhood characteristics, perceived discrimination, race and adherence to mammography screening guidelines. Residential information (via geocoding) collected on a cohort of 1,451 African American (44%) and White (55%) women who participated in a prospective study "Race Differences in the Screening Mammography Process" (B. Jones, principal investigator) will be linked to existing data bases (e.g., census data) to identify neighborhood factors that may influence health. Univariate, bivariate and multilevel, multivariate regression techniques will be used to analyze the following variables: neighborhood factors and existing individual-level SES measures as well as a broad range of potentially confounding variables; a perceived discrimination scale; and adherence to screening mammography guidelines. This proposal represents a unique opportunity to understand a potentially important role for neighborhood characteristics and perceived discrimination to influence health prevention behavior; specifically, mammography screening.