Abstract A061: The Breast Cancer, Race and Place study: Exploring the influence of race, racism, and residential segregation on cancer survivorship among Black women in Milwaukee, Wisconsin
Authors: Young Staci , Jones Natalie , Fritzen-Pedicini Charissa , Namin Sima , Beyer Kirsten 
Published: September 2020

Abstract
Introduction: Racial breast cancer survival disparities persist, indicating that not all populations are benefitting equally from advances in cancer control. Individual and health care factors do not fully explain these disparities, and factors such as institutional racism and racial segregation may be contributors. Our study explores the ways in which Black women in a highly segregated metropolitan area navigate cancer survivorship. Methods: The study utilizes novel qualitative methods and is guided by a community advisory board. Participants were recruited from Milwaukee, Wisconsin, a hyper-segregated city. We use a stratified, purposive sampling approach to include survivors who vary by neighborhood racial and ethnic composition. Eligible participants have been diagnosed with breast cancer, identify as Black, and have completed their initial treatment regimen. The study population is diverse in age, tumor type and stage at diagnosis to ensure multiple perspectives. Instruments and processes were guided by a conceptual framework relating racism and racial segregation to breast cancer survival. We use narrative inquiry as a reflexive tool in which participants’ lived experiences are captured as textual representations. Semi-structured interviews include a demographic questionnaire, a life narrative account, and completion of a life history calendar detailing residential history since diagnosis. Interviews were transcribed and analyzed utilizing a hybrid approach of both a data-driven inductive process and a deductive, a priori coding template consistent with the conceptual framework. We present early findings from this ongoing study. Results: To date, 18 interviews have been completed with Black women. Participants lived in neighborhoods that were predominantly Black (50%), diverse (28%), and predominantly white (22%). Ages of women ranged from 41 to 79, with a median of 63. Most women had their cancer diagnosed in the early stage (83%). Narrative responses included: 1) determinants of health such as biology and family history; 2) social status, including socioeconomic status, race, and neighborhood of residence; 3) individual and family stressors such as discrimination, access to health information, and care quality; and 4) social support, resilience, and physiological responses to treatment. Participants discussed living in different geographic locations in the city, personal safety, and exposure to racism in their communities and workplaces. All were hopeful that sharing their experiences would benefit other cancer survivors. Conclusions: This study demonstrates the importance of examining race, racism, and residential segregation as contributors to breast cancer survivorship. Utilizing narrative analysis and a modified life history calendar, emphasizing residential histories, allows for a deeper examination of women’s experiences situated in place. Study findings can inform community-based conversations, advocacy and policy change to reduce disparities.
Citation Format: Staci Young, Natalie Jones, Charissa Fritzen-Pedicini, Sima Namin, Kirsten Beyer. The Breast Cancer, Race and Place study: Exploring the influence of race, racism, and residential segregation on cancer survivorship among Black women in Milwaukee, Wisconsin [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr A061.