ArticleJournal of racial and ethnic health disparities2026
Examining Barriers to Cancer Care: A Needs Assessment of African American and Black African Immigrants in Iowa.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
introductionNon-Hispanic Black (NHB) Iowans experience significantly higher cancer incidence and mortality rates compared to their non-Hispanic White (NHW) counterparts. Yet, their unique barriers to cancer-related care remain understudied, particularly in the context of a geographically rural state with limited racial and ethnic diversity like Iowa. A deeper understanding of the nuanced challenges faced by this population is essential to the creation of equitable, community-based solutions to cancer care across the continuum.
methodsWe conducted key informant interviews with 20 Black Iowans: 14 African Americans and 6 Black African immigrants. Using descriptive thematic analysis, we organized themes according to the Health Equity Framework.
resultsSix dominant themes emerged: health literacy and cultural understanding; structural barriers to care; interpersonal dynamics and communication; trust; strengths and resiliencies; and, community identified solutions. These themes revealed distinct experiences across subpopulations, highlighting both similarities and differences in barriers to care. Differences between groups primarily occurred within health literacy, and trust. For example, African Americans often understood the health system but reported distrust shaped by historical and cultural trauma, whereas Black African immigrants' mistrust frequently co-occurred with limited health literacy and unfamiliarity with the local health system.
conclusionBlack Iowans face multifaceted barriers to accessing cancer care, underscored by heterogeneity in cultural and social norms, resource limitations, and variations in cancer-related health literacy. Given differences between African Americans and Black African immigrants, our findings highlight the necessity for tailored interventions for specific subpopulations to effectively address inequities and improve cancer-related care outcomes.
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