Abstract PO-043: Perceived everyday discrimination, socioeconomic status, and mammography screening behavior
Authors: Vinegar Jessica , Ericson Marissa , McDowell Kommah , Fairley Tonya , Kittles Rick , Treviño Lindsey , Teteh Dede 
Published: January 2022

Abstract
Black women (BW) experience age-adjusted breast cancer mortality rates that are 40-70% higher than White women. Although BW are more likely to report having had a mammogram compared to other racial/ethnic minority groups, differences in mammography utilization exist among women with lower socioeconomic status (SES). Moreover, perceived everyday discrimination (PED) has been shown to have an inverse relationship on health screening behavior among BW. However, mammography screening behaviors of BW with low SES, who also report higher levels of PED, is not well known. This study aims to explore the relationship between perceived discrimination, SES (income, education, health insurance), and mammography screening behavior. Methods: Participants completed a 40-item survey and were recruited between 2020-2021 through a community-based participatory research initiative—Bench to Community. Logistic regression was used to test the associations of mammography utilization with PED—short version of Everyday Discrimination Scale, SES, and race/ethnicity. Results: Most participants (n=159) identified as BW (55%)—African American, African, and Caribbean, followed by White (34%), and other groups (9.3%). Twenty-five percent had some high school (HS) or a HS diploma, 25% had some college education with 15% reporting an income below $25,000. Many respondents had health insurance (96%), and 74% reported having had a mammogram. Discrimination alone significantly impacted whether an individual had a mammogram, such that those who reported higher levels of PED were 38% less likely to have a mammogram, χ2(12) = 36.924, p&lt;.001. Additionally, while education significantly contributed to the model, income demonstrated a trending influence overall, with less than $25,000 income reaching significance (B=-3.331, SE=1.210, Wald = 7.576, p=.006). As race and insurance did not significantly contribute to the overall model, subsequent model fitting excluded these variables. In a model that included only discrimination, education, and income, all three predictors significantly contributed to the model χ2(9)= 33.571, p&lt;.001. Discrimination (B= -.536, SE=.178, Wald = 9.106, p=.003), education overall (B=-1.177, SE=.604, Wald = 3.797, p=.051), and income (B=-2.674, SE=.956, Wald = 7.815, p=.005) were significant predictors. More specifically, those with some college education or less were 3.245 times less likely to have a mammogram. In this final model, those who reported making less than $25,000 household income were .069 times less likely to have a mammogram. Lastly, race alone was significantly (p=.006) predictive of mammogram screening behavior. Discussion/Conclusion: PED, education, and income were associated with mammography screening behavior. The excess mortality faced by BW, is a probable reflection of their position within our hierarchal society. Addressing these social determinants of health factors may improve our understanding of ways discrimination leaves BW vulnerable to disparate health outcomes, including breast cancer.
Citation Format: Jessica Vinegar, Marissa Ericson, Kommah McDowell, Tonya Fairley, Rick Kittles, Lindsey Treviño, Dede Teteh. Perceived everyday discrimination, socioeconomic status, and mammography screening behavior [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-043.