Abstract 975: A comparison of Black and White women with breast cancer living in the Seep South and their experiences with health care providers and access to environments that promote wellbeing
Authors: Lauren K. Evans, Layja J. Grant, Ne'Kiya D. Jackson, KiTani Parker Lemieux
Journal: Cancer Research (2025)

Abstract Background: Although black women have a lower incidence of breast cancer, their mortality rate is 40% higher than in white women. Black women are also disproportionately affected by more aggressive subtypes of breast cancer, which are often linked to a poorer prognosis. Subtypes alone, however, do not fully account for this significant difference in mortality. This research project aims to use the All of Us Research Program (AoURP) dataset to evaluate and compare the experiences of black and white women living in the Deep South. These experiences include how they were treated by their healthcare providers and their access to safe environments that promote wellness. Methods: Survey data from the AoURP Database was used, with inclusion criteria of black and white women aged 18+ up diagnosed with breast cancer and living in Alabama, Georgia, Mississippi, and Louisiana. Selected questions from the SDoH survey assessed infrastructure, experiences with healthcare providers, and perceptions of community dynamics. Black and white participants were identified via the cohort selection tool and further subdivided based on 3-digit zip code values. Using Python in Jupyter Notebook, participant responses were extracted and quantified to allow comparison. Results: Three hundred and twenty black women and four hundred and twenty-seven white women met the inclusion criteria. The number of respondents per survey question varied. Infrastructure was the area where feedback indicated a consistent socioeconomic deficit. When community dynamics were surveyed, however, more than 2x the number of black women reported feeling that their neighborhood is not safe. Responses related to healthcare experiences indicate that more black women feel their providers are less courteous and treat them as if they are unintelligent. Conclusion: Based on these preliminary results, there is evidence that aspects of the SDoH impact black women with breast cancer more than their white counterparts. Specifically, black women experienced less respect, felt less safe, and reported less access to infrastructure that promotes well-being. A lack of respect in healthcare settings can negatively impact disease progression and burden. As such, cultural competence education for healthcare providers is essential to improving health outcomes for black women in the Deep South. Differences in feelings of safety could also influence poorer outcomes. Perceived unsafety can contribute to chronic stress, a response that can exacerbate disease progression. Additionally, both cohorts' responses indicated a disparity in infrastructure, which aligns with the predominantly rural composition of the Deep South. This indicates a systemic, structural issue that must be addressed by local and state governments. Citation Format: Lauren K. Evans, Layja J. Grant, Ne'Kiya D. Jackson, KiTani Parker Lemieux. A comparison of Black and White women with breast cancer living in the Seep South and their experiences with health care providers and access to environments that promote wellbeing [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 975.