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Addressing the Racial Disparities in Breast Cancer Screening

Each October, we are reminded just how important it is to support life-saving breast cancer research. It is a time of heightened awareness and reflection. This year, the team at Diversity Crew would not only like to aid in raising awareness, but we would like to propel conversations around how we, as a society, might be more actionable in working towards eradicating a disease that has profoundly impacted so many individuals and families.

Despite US healthcare spending and medical technology advancements, cancer is the second leading cause of death for both women and men. Although there have been improvements in cancer treatment and outcomes, including a decrease in mortality rates across all racial and ethnic groups, avoidable racialized disparities remain. These improvements in treatment and outcomes have been more significant for White women, while African-Americans still have the highest death rate for most types of cancer, including breast cancer (KFF, 2022). Statistics show African-American women are 40% more likely to die from breast cancer than White women (Women, 2016).

Several obstacles contribute to widening health and care gaps for African-American women and other women of color. Research conducted over many decades has demonstrated that such disparities result from structural, socioeconomic, and environmental factors rooted in discriminatory and racist practices. While evidence shows some differences in outcomes may stem from biology and genomics, they are also thought to be heavily influenced by an unhealthy environment (KFF, 2022).

In addition to social and economic factors, access to quality care and preventive services have also been identified as potential barriers. Evidence has shown mammograms and annual screenings are essential for detecting breast cancer before symptoms arise and when the chances for survival are greatest. Yet, while screening rates are similar amongst White and African-American women, mortality rates are not. Quality differences in mammograms have been reported as critical challenges in early detection. As African-American women are more like to receive care from underfunded health systems, the equipment within these facilities is often antiquated and inadequate, and because of staffing shortages and pay inequities, they may lack the qualified staff to read films. Delayed follow-up appointments after an abnormal screening are an additional challenge, resulting in delayed diagnoses and treatment (Komen, 2016).

The above are merely a few of the factors leading to longer diagnostic and follow-up times. For example, one study reported, “among women with the most suspicious mammographic findings, the median number of days for follow-up for African-American women was 26 days versus 14 days for White women.”  It has also been reported that once treatment begins, the recommended standards of care are not provided for African-American women (Komen, 2016).  

As a society, we often dismiss the many factors contributing to health. We may subscribe to the narrative that individuals should be more personally responsible or wonder why people don’t make better lifestyle choices and engage in healthier behaviors. While there is certainly an element of personal responsibility, we want to consider the entire picture. It is not uncommon for individuals to lack the work flexibility needed to attend annual visits, have screenings, or schedule follow-up visits. In addition, many individuals lack the transportation to attend doctors’ appointments or adequate insurance to cover services beyond their annual preventive visits.

The truth is, it takes an entire community to cultivate health. Creating a culture where well-being is a value means ensuring you are doing your part as a partner in health. Encouraging your employees to attend appointments, sharing health information, and providing them an opportunity to participate in healthy behaviors is vital to achieving positive health outcomes for your employees and controlling your healthcare spending.

What are some things you can do?

As an employer, you play a significant role in shaping the well-being of your employees. From your organizational culture and wellness resources to the benefits you provide, how you show up in support of annual screenings can make a world of difference. Here are a few things you can do to support your employees in their health journey.

  1. Allow your employees opportunities to attend visits without losing pay or using their personal time.
  2. Provide complete health coverage that encourages appropriate use
  3. Provide health and health insurance education trainings to promote health literacy and raise awareness of condition management
  4. Develop wellness programs that incentivize and enable all employees to engage in health-promoting behaviors and that will not unintentionally widen the disparities gap.

What are some unique ways your organization contributes to the health of your employees?

To learn more about contributing to health equity in your organization or have one of our Health Equity Advancement experts work with your organization, visit today! 

About The Author:

Dana Middleton (she/her/hers) is a strategic health and social impact designer whose holistic approach to equity advancement facilitates the alignment of human and commercial interests, effectively bridging the corporate, care, and community gap.


Michelle Tong, L. H. F. @hill_latoya on T. (2022, February 3). Racial disparities in cancer outcomes, screening, and treatment. KFF. Retrieved from

Susan G. Komen Foundation. (2016). A perfect storm – Susan G. Komen®. Retrieved from

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