ArticlePsycho-oncology2021
Beyond Black and White: race and sexual identity as contributors to healthcare system distrust after breast cancer screening among US women.
Article in Psycho-oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Why do people trust (or mistrust) health organizations? A systematic review.International journal for equity in health · 2026Pooled it
- The Impact of Self-Reported Healthcare Stereotype Threat on Advance Care Planning Among Older, Sexual Minority Adults: A Black and White Difference.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- "Pink is my least favorite color": experiences of sexual minority women and partners navigating breast cancer.Journal of psychosocial oncology · 2026Article
- Intersectional discrimination, mental health, and health care access among transgender women in Brazil.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Article
- Disparities in Breast Cancer Care-How Factors Related to Prevention, Diagnosis, and Treatment Drive Inequity.Healthcare (Basel, Switzerland) · 2024Review
- Public willingness to receive chlamydia, gonorrhea, syphilis, and trichomoniasis vaccines: a scoping review.BMC health services research · 2023Article
- Engaging Black sexual minority women in breast cancer research: Lessons in community partnerships.Cancer · 2023Article
- Role of neighborhood context in ovarian cancer survival disparities: current research and future directions.American journal of obstetrics and gynecology · 2023Review
- Racial and Ethnic Demographic Reporting in Phase 2 Proton Therapy Clinical Trials: A Review.International journal of particle therapy · 2023Review
- Sexual minority-specific experiences of colorectal cancer survivors.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2022Article
- Ballroom Icons and the Power to Promote COVID-19 Vaccination Among Black and Brown LGBTQAmerican journal of public health · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveHealthcare system distrust (HCSD) has been linked to poor breast cancer outcomes. Previous HSCD analyses have focused on Black-White disparities; however, focusing only on race ignores the complex set of factors that form identity. We quantified the contributions of race and sexual minority (SM) identity to HCSD among US women who had received breast cancer screening.
methodsThis cross-sectional study used intersectionality decomposition methods to assess the degree to which racial and SM identity contributed to disparate responses to the validated 9-item HCSD Scale. The sample included online survey participants identifying as a Black or White woman living in the US, with a self-reported abnormal breast cancer screening result in the past 24 months and/or breast cancer diagnosis since 2011.
resultsOf 649 participants, 49.4% of Black SM women (n = 85) were in the highest HCSD tertile, followed by 37.4% of White SM women (n = 123), 24.4% of Black heterosexual women (n = 156), and 19% of White heterosexual women. Controlling for age, 72% of the disparity in HCSD between Black SM women and White heterosexual women was due to SM status, 23% was due to racial identity, and 3% was due to both racial and SM identity.
conclusionsSM identity emerged as the largest driver of HCSD disparities; however, the combined racial and SM disparity persisted. Excluding sexual identity in HCSD studies may miss an important contributor. Interventions designed to increase the HCS's trustworthiness at the provider and system levels should address both racism and homophobia.
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