Understanding Breast Cancer Disparities Affecting Black Women: Obtaining Diverse Perspectives Through Focus Groups Comprised of Patients, Providers, and Others.

Black women have the highest death rate from breast cancer and a higher chance of developing breast cancer before the age of 40 than White women. Mammography screening is recommended for early detection which has led to decreased mortality and improved survival. Unfortunately, Black women are less likely to have breast cancer screenings. Environmental justice communities represent place-based structural disparity/racism leading to health inequality. Environmental justice specifically addresses situations where minority or low-income communities bear disproportionately poor human health outcomes and environmental risks. The purpose of this qualitative study was to gain a deep understanding of breast cancer screening disparity from multiple perspectives to enable collective solutions to barriers faced by Black women in an environmental justice community. Data were collected from 22 participants using a focus group approach from Black women with breast cancer (n = 5) and without it (n = 5), healthcare providers (n = 6), and community leaders (n = 6). An iterative and inductive thematic data analysis method was used to analyze data. The themes that emerged from the data included: (1) misconceptions and fear of mammograms; (2) breast cancer screening beyond mammograms; and (3) barriers beyond mammograms. These themes reflected personal, community, and policy barriers leading to breast cancer screening disparity. This study was an initial step to develop multi-level interventions targeting the personal, community, and policy barriers that are needed to advance breast cancer screening equity for Black women living in environmental justice communities.