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Perceived discrimination does not appear to affect black women's adherence to screening mammography guidelines

Black women are more likely to have their breast cancer diagnosed later and to die from the disease than white women.

Perceived racial discrimination has been shown to play a role in lack of compliance with medical recommendations. However, a new study found that while 42 percent of black women reported experiencing racial discrimination in their lifetime, there was no link between perceived racial discrimination and black women's adherence to screening mammography guidelines.

These findings indicate that women who recognize and report racial discrimination may develop compensatory behavior that enables them to engage in health prevention behavior in spite of their past experiences.

Researchers examined receipt of index mammograms at 1 of 5 Connecticut urban hospitals between 1996 and 1998 among 484 black women and 745 white women. The women completed telephone interviews at the time of the initial mammogram and an average of 29 months later.

The interviews addressed perceived racial discrimination as lifetime experience in seven possible situations: at school, getting a job, at work, at home, getting medical care, in a public setting, and interactions with the police or in the courts. About 42 percent of black women and 10 percent of white women reported discrimination at some point in their life. Perceived racial discrimination was not associated with nonadherence to age-specific mammography screening guidelines, even after adjusting for other factors.

However, the researchers caution that if black women in the study underreported racial discrimination, then the researchers may have underestimated its prevalence and subsequently diluted its effect on regular mammography screening. They note that black women may underreport perceived racial discrimination due to the sensitive nature of the topic, social desirability, discomfort in reporting discrimination to the white telephone interviewers, or other reasons.

The study was supported in part by the Agency for Healthcare Research and Quality (HS15686).

See "Perceived racial discrimination and nonadherence to screening mammography guidelines: Results from the race differences in the screening mammography process study," by Amy B. Dailey, Ph.D., Stanislav V. Kasl, Ph.D., Theodore R. Holford, Ph.D., and Beth A. Jones, Ph.D., M.D., in the June 2007 American Journal of Epidemiology 165, pp. 1287-1295.

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