Neighborhood Racial/Ethnic Composition and Medical Discrimination’s Relation to Mammograms: A Philadelphia Case Study

Abstract

Late-stage breast cancer diagnosis is common for women of color even though cancer screening rates in this group have increased over time. Perceived medical discrimination from health care providers is a key culprit of this inconsistency, discouraging women of color from seeking out timely preventative care. Non-white neighborhoods offer social support structures that mitigate discrimination. However, it is not clear whether this mitigation applies to the chance women of color get timely mammograms. This study addresses that question, applying Hierarchical Linear Modeling methods onto the Public Health Management Corporation’s 2006 and 2008 survey, as well as the 2005–2009 American Community Survey. Findings indicate that while neighborhood racial/ethnic composition does not directly reduce medical discrimination’s association to screening, factors closely connected to place, like health care access, do have a mitigating influence on this association. Also, neighborhood racial/ethnic composition and social support have a positive direct relation with screening.