An Evaluation of Psychosocial and Religious Belief Differences in a Diverse Racial and Socioeconomic Urban Cancer Population

  • Blase N. PoliteEmail author
  • Toni Cipriano-Steffens
  • Fay Hlubocky
  • James Dignam
  • Mandira Ray
  • David Smith
  • Samir Undevia
  • Evie Sprague
  • Olufunmilayo Olopade
  • Christopher Daugherty
  • George Fitchett
  • Sarah Gehlert


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.


Cancer 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.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2016

Authors and Affiliations

  • Blase N. Polite
    • 1
    • 2
    Email author
  • Toni Cipriano-Steffens
    • 1
    • 2
  • Fay Hlubocky
    • 1
    • 2
  • James Dignam
    • 3
  • Mandira Ray
    • 1
  • David Smith
    • 1
  • Samir Undevia
    • 4
  • Evie Sprague
    • 4
  • Olufunmilayo Olopade
    • 1
    • 2
  • Christopher Daugherty
    • 1
    • 2
  • George Fitchett
    • 5
  • Sarah Gehlert
    • 6
  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Department of Medicine, Section of Hematology/OncologyUniversity of Chicago Medical CenterChicagoUSA
  3. 3.Department of Health StudiesUniversity of ChicagoChicagoUSA
  4. 4.Advocate Illinois Masonic Medical CenterChicagoUSA
  5. 5.Department of Religion, Health and Human ValuesRush University Medical CenterChicagoUSA
  6. 6.School and the Department of SurgeryWashington UniversitySt. LouisUSA

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