An Evaluation of Psychosocial and Religious Belief Differences in a Diverse Racial and Socioeconomic Urban Cancer Population
- 535 Downloads
Despite years of research aimed at decreasing the cancer mortality rates, the disparity between African-Americans and whites continues to grow. The fundamental psychosocial and belief differences that may mediate these disparities are poorly studied and rarely disentangle race versus specific socioeconomic status (SES) effects. In this study, breast, colon, and lung cancer patients presenting for their first oncology appointment completed a self-administered survey utilizing previously validated instruments regarding psychosocial and belief factors. Results were analyzed by self-identified race, income, and education. In total, 161 African-American (37 %) and 269 white (63 %) new oncology patients with breast (47 %), colon (16 %), or lung (37 %) cancer enrolled. African-Americans were more likely to be in the US$<20,000 income group (45 vs. 9 %) but 21 % had incomes US$>60,000. Apparent racial differences in health literacy and cancer knowledge were primarily mediated by income and education. Significant racial differences in God’s perceived role in their cancer remained after adjustments for income and education with African-Americans more likely to feel that God was in control of their cancer (67 vs. 30 %). These findings suggest the need for a more nuanced understanding of how race and socioeconomic status exert both independent and interrelated effects in the health care setting. Only then can effective interventions that reduce disparities in survival be designed. This study adds further substantive evidence to the crucial importance of God’s perceived role in the cancer experience for African-Americans. An important area for future research is to examine whether these racial differences in religious belief are also associated with differences in health-related behavior and medical decision-making.
KeywordsCancer Race Health disparities Religious beliefs Trust Social support
Compliance with Ethical Standards
This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Oral informed consent was obtained from all individual participants included in the study.
This study was funded by the Conquer Cancer Foundation CDA (BNP).
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.NNA Howlader, M Krapcho, J Garshell, N Neyman, SF Altekruse, CL Kosary, M Yu, J Ruhl, Z Tatalovich, H Cho, A Mariotto, DR Lewis, HS Chen, EJ Feuer, KA Cronin (eds). SEER cancer statistics review, 1975-2010, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2010/, based on November 2012 SEER data submission, posted to the SEER web site, 2013.
- 8.Airhihenbuwa CO. Health and culture: beyond the western paradigm. Thousand Oaks, CA: Sage Publications; 1995.Google Scholar
- 19.Smedley BDSA, Nelson AR, editors. Unequal treatment: confronting racial and ethnic disparities in health care. Washington, D.C.: The National Academies Press; 2003.Google Scholar
- 20.Kinney AY, Bloor LE, Martin C, Sandler RS. Social ties and colorectal cancer screening among Blacks and Whites in North Carolina. Cancer Epidemiol Biomarkers Prev Publ Am Assoc Cancer Res Am Soc Prev Oncol. 2005;14(1):182–9.Google Scholar
- 26.Singh JA, Sloan JA, Atherton PJ, Smith T, Hack TF, Huschka MM, et al. Preferred roles in treatment decision making among patients with cancer: a pooled analysis of studies using the Control Preferences Scale. Am J Manage Care. 2010;16(9):688–96.Google Scholar
- 33.Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psycho-Oncology. 2004;13(6):408–28. doi: 10.1002/pon.750.CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Pargament KI, Koenig HG, Perez LM. The many methods of religious coping: development and initial validation of the RCOPE. J Clin Psychol. 2000;56(4):519–43. doi: 10.1002/(sici)1097-4679(200004)56:4 < 519::aid-jclp6 > 3.0.co;2-1.
- 40.Smith AK, McCarthy EP, Paulk E, Balboni TA, Maciejewski PK, Block SD, et al. Racial and ethnic differences in advance care planning among patients with cancer: impact of terminal illness acknowledgment, religiousness, and treatment preferences. J Clin Oncol Off J Am Soc Clin Oncol. 2008;26(25):4131–7. doi: 10.1200/JCO.2007.14.8452.CrossRefGoogle Scholar