Biomedical racial profiling : a disease more deadly than the perceived barrier to breast cancer screening and treatment for African American women-late stage diagnosis PDF
Preview Biomedical racial profiling : a disease more deadly than the perceived barrier to breast cancer screening and treatment for African American women-late stage diagnosis
BIOMEDICALRACIALPROFILING:ADISEASEMOREDEADLYTHANTHE PERCEIVEDBARRIERTOBREASTCANCERSCREENINGANDTREATMENT FORAFRICANAMERICANWOMEN-LATESTAGEDIAGNOSIS. By SHEILABELINDAJEFFERS ADISSERTATIONPRESENTEDTOTHEGRADUATESCHOOL OFTHEUNIVERSITYOFFLORIDAINPARTIALFULFILLMENT OFTHEREQUIREMENTSFORTHEDEGREEOF DOCTOROFPHILOSOPHY UNIVERSITYOFFLORIDA 2003 Copyright2003 by SheilaBelindaJeffers ThisdocumentisdedicatedtomylovingmotherMattieB.Jeffers. ACKNOWLEDGMENTS Therearemanywhocontributedtothisproject.Itisdifficulttoshowfull appreciationtoeveryone.Firsttothecommittee,theirencouragementwaslikea blanketofsunshineinthemidstofastorm,theirenergykeptmegoingwhenI wasweary.JamesP.Stansburywasencouragingtothefinish.Hisnotesof encouragementandwordsofwisdomwillneverbeforgotten.JoeFeaginletme feeltheracisminsideteachingmetoturnitintopositiveexpressions. John Moore,neverlostfaithinme. Ithankhimfornotcarryingmebutwalkingbeside me.LeilaniDotyheldamostimportantpositionthroughsomeverytoughtimes.I amthankfultoherforteachingmetogiveandtakecriticalfeedback.Sheistobe admiredforherknowledgeandstyle.Sheisamongaspecialgroupofacademic women.Totheotherwomenwhohelpedmedefinemyroleintheacademe,I appreciateyourguidance.LeslieS.Liebermancontributedendlesshoursof expertiseduringeachphase.OtherstowhomIamgratefulincludeWynetta Devore,alifelongmentor.NancyS.Hardt,SueV.Rosser,DonnaH.Berardo, andKarenA.HolbrookrepresenttherealDreamTeamofAmerica.These womenencouragedmetoholdontothevisionforequalityandtruth.KarenA. Holbrook,deservesaspecialthanksforsharingsurvivaltechniques,onhowto hangintheretheend. IamalsogratefultoDr.LaFrancisRodgers-Roseandallofthesistersin theInternationalBlackWomen’sCongress,whowatchedmyback,Ihopeto IV makethemproud.Mycolleagueswhoplayedabigpartinmysuccessinclude, Dr.RosalynHoward,ShannelGrimes,KathyGrant,FatmaSoudandYolanda Goode.Theywereallverysupportive. TheSusanG.KomenBreastCancerFoundation,Inc,fundedtheresearch andthestaffwasmosthelpful.ThestaffandvolunteersoftheAmericanCancer SocietythroughoutthestateofFloridawereveryaccommodatinginproviding assistance.WomeninNorthernandNorthCentral,Florida,aswellasUpstate, NewYork,whoparticipated,approachedthesubjectwithsincerity,honestyand trust. Icannotexpressenoughgratitudetothetwosurvivorswhoprovided copiousamountsofenergy,emotionsandexpertisetothestudy,PaulineJones andDr.SaundraBarnett-Reyes.WithouttheinitialsupportofDr.Barnett-Reyes, Icouldneverhaveachievedthisgoal. Herwords,“Ihavebreastcancer,” catapultedmeintothisstudy.Anotherwomandeservingspecialmentionis DeniseJames,whobeganasasurvivorbuttransitionedbeforethestudyended. Sheputalotofloveintothegroup.Surely,herwordswillhelpsomeone. Iespeciallyappreciatemytworesearchassistants,DavidFazzinoand KathrynJemmott.Theirsensitivitytotheneedsofthewomenanddedicationto theprojectwasfundamentalinthesuccessfulnessofthestudy.Katie,Ihopeyou receivedasmuchasyoucontributed. Ourfightonlyjustbegan.Thestaffof anthropology,KarenJones,PatriciaKingandLeeAnnMartin,deservesthanks fortheirsupport. v Mysiblings,VeronicaBrownandCarlJeffersJr,werealwaysencouraging. Myfather,CarlJeffers,Sr.,plantedthisseedtoreachforthestars.Mymother, MattieB.Jeffers,wasthenativeanthropologistteachingmeasayounggirlto learnandrespectthe“others.” ShelikeRonniaHughes,myniecewenttoa higherjourneybeforethisworkwascompleted. AteachstagethisachievementcontinuedtobepossiblebecauseIwas blessedwithtwowonderfulchildren,CliffandAnikaPrudhomme,whose understandingandsacrificesaregreatlytreasured.Thingsthathappenedduring thisdissertationwouldhavebeenunbearableifIdidnothavetheirlove,patience andsupport.Thanksforbeinggreatpeople.Iadmireyouall. VI TABLEOFCONTENTS page ACKNOWLEDGMENTS iv ABSTRACT xi CHAPTER 1 SHH!LISTENTOTHEWHISPERS 1 Introduction 1 AimofStudy 2 InterpretingFears 6 OverviewofBreastCancer 7 TheoreticalFramework 8 RacialProfiling 13 BiomedicalRacialProfiling 14 BreakdownoftheChapters 15 2 HEALTHDISPARTIESBEYONDBREASTCANCER 17 Introduction 17 PrinciplesofHealthCareSystem 19 HealthDisparities 23 EpidemiologicalFactors 24 SocioeconomicFactors 27 PoliticalFactors 30 PerceptionsofHealth-TrustandSatisfaction 32 RacialDisparitiesandEducation 34 PhysiologicalDisparitiesAmongTheRaces 38 CardiovascularDisease 40 HIV/AIDS 41 Diabetes 42 Cancer 43 BreastCancer 45 ThreatofBreastCancer 46 PoliticalEconomicFactors 50 StandardsforScreening 51 Conclusion 54 vii 571 3 CREATINGTHEPROFILE 56 Introduction 56 HowDidWeGetHere 57 EstablishmentofSlaveRoles 59 IdentifyingNewGroups 61 TheDenialofPresence 62 SocialConstructionofGenderRoles 63 CreatingGenderDifferences 64 SymbolicConstructionofGender 65 CultureandGender 69 SocialRelationsandGender 73 SocialConstructionofSickness 75 LookingBeyondtheObvious 78 BeingProfiled 80 AnthropologicalApproachestoRacialStudies 83 Race,PowerandCancer 83 TheRealThreat 85 TheNeedForSilence 86 Conclusion 88 4 SCULPTINGAPROFILE 89 Introduction 89 MassagingtheMaterials 90 SettingtheGoals 91 ChoosingtoWorkFromInsideorOutside 91 WorkingThroughtheSilence 93 Incentives 94 Instruments 95 Conclusion 97 5 WOMANINTHEMIRROR 98 Introduction 98 Setting 99 LocatingthePopulation 101 WhenandWhereIEntered 105 LearningtoSpeaktheLanguage 106 BusinessoftheMeetings 107 MIeHeotpiengThtihseIIsBMWyCMWirormoren 111008 AcknowledgedFamilyMembership 11 AfricanAmericanWomen’sSummit 11 CulturalFeaturesofSummit 11 MeetingtheWomenattheSummit 117 Conclusion 123 viii 6 UNDERSTANDINGHOWRACEMATTERS 129 Introduction 129 IBWCWomen 131 TheFirstResponse 134 FactorsInfluencingResponses 135 AwarenessofMammograms 136 PurposeoftheSummit 138 FocusGroups 140 DifferencesinPerceptionsaboutIllness 143 IdentifyingtheProblem 145 FocusontheMessage 155 Conclusion 159 7 ELEMENTSOFBIOMEDICALRACIALPROFILING 160 Introduction 160 FailuretoIdentifytheProblem 161 Mammy 162 Jezebel 163 WorkhorseorFieldHand 164 StrongBlackWoman 164 WelfareMother 164 TheTrueAmericanWoman 165 ConnectingRace,StatusandTreatment 167 IgnoringTraditionalValues 168 Superstitions 169 IsRaceTheRealIssue 170 ProfiledToSuffer 171 Isolation,SuspicionandFear 171 TuskegeeStudy 172 DisregardforLife’sExperience 172 Conclusion 174 APPENDIX A AFRICANAMERICANSUMMITONBREASTCANCERPRE CONFERENCESURVEY 176 B AFRICANAMERICANSUMMITONBREASTCANCERPOST- CONFERENCESURVEY 178 C PRESENTINGSITUATIONandINSTRUCTIONSTOTHESTUDENT 180 D FOCUSGROUPQUESTIONS: 182 IX LISTOFREFERENCES 184 BIOGRAPHICALSKETCH 213 x
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