Asian American Women Research Articles

A qualitative study on biracial Black East Asian American women and their experiences of hypersexualization.

A qualitative study on biracial Black East Asian American women and their experiences of hypersexualization.

Shattering monolithic myths: gender gaps in STEM major selection across Asian American ethnic subgroups

Investigations into fostering gender parity in STEM have proliferated, yet the specific situation of Asian American women has been largely overlooked. Harnessing data from the High School Longitudinal Study of 2009 (HSLS:09), the analysis scrutinizes gender disparities in STEM major selections within distinct Asian American ethnic cohorts, accentuating the pivotal role of math self-efficacy. Pronounced gender disparities were discerned among Vietnamese/Thai and Filipino constituencies, as contrasting with their Chinese, Indian/Sri Lankan, and Japanese/Korean counterparts. For Vietnamese/Thai females, the disparity is partly attributable to diminished math self-efficacy, a dynamic not seen in Filipino disparities. These findings necessitate targeted interventions that foster female interest in STEM, while underscoring the imperative of ethnic specificity. It is paramount that strategies bolster the math confidence of Vietnamese/Thai females, thereby mitigating the deleterious effects of stereotypical expectations and ensuring equitable participation and outcomes.

Biryani with the Golden Girls: Muslim South Asian-American women’s food voices

ABSTRACT Muslim women communicate through food to express family and community belonging. This paper applies Hauck’s concept of the “food voice” (1992) as a tool to unpack multiple aspects of identity for Muslim Indian American women. Cooking together, eating together, and preserving these recipes and dishes is an important part of resistance work for women of color, and the history of racialized women in the United States (Williams-Forson 2006, Abarca 2006). For the Muslim Indian women in Florida with whom I spoke, halal food reveals ethnic, religious, political, and gendered identities. Using charlas culinarias or kitchen chats with a small group of Muslim Indian women, I learned about Muslim women’s contribution to maintaining their ethnic and religious identities in Tampa, Florida, through their food voices.

Risk factors for second primary breast cancer by laterality, age, and race and ethnicity.

Epidemiologic studies of risk factors for second primary breast cancer (SBC) have been conducted primarily in non-Hispanic White (NHW) women. A racially- and ethnically-diverse population-based pooled cohort of 9,639 women with first primary stage I-III invasive breast cancer (FBC) was linked with the California Cancer Registry; 618 contralateral SBC (CSBC) and 278 ipsilateral SBC (ISBC), diagnosed >6 months after FBC, were identified. Using Fine and Gray models accounting for competing risks, we assessed associations of CSBC and ISBC risk with FBC clinical characteristics and epidemiologic factors. In younger women (FBC at age <50 years), higher CSBC risk was associated with ER/PR-negative FBC [hazard ratio (HR)=1.68], breast cancer family history (HR = 2.20), and nulliparity (HR = 1.37). In older women (FBC at age ≥50 years), higher risk was associated with breast cancer family history (HR = 1.32), premenopausal status (HR = 1.49), overweight (HR = 1.39), and higher alcohol consumption (HR = 1.34). For ISBC, higher risk was associated with married status (HR = 1.94) in younger women, and overweight (HR = 1.60) among older women. For CSBC, HR estimates were generally similar across racial and ethnic groups. Even after adjustment for these risk factors, compared with NHW women, risk remained elevated for CSBC in younger African American, Asian American, and Hispanic women, and for ISBC in older African American and Hispanic women with ER/PR-positive FBC. Our findings support genetic risk evaluation, enhanced screening, and lifestyle changes in women at higher risk of SBC. Additional risk factors must contribute to the unequal burden of SBC across racial and ethnic groups.

Exploring the intersectionality of race and gender on the incidence of and response to microaggression experienced by Asian American women medical students

BackgroundDiscrimination faced by Asian American trainees in medical school include those reported by female trainees. This study aims to characterize the microaggressions faced by Asian American woman medical students. MethodsWe use a mixed methods approach to characterize the experiences of Asian Americans in United States (US) medical schools through an anonymous online survey and participation in focus groups. ResultsAmong our 305 participants, 65.9 ​% were women. More women experienced microaggressions than men (p ​< ​0.001). Compared to men, women reported significantly higher rates of supervisors having higher expectations of them, implying they were submissive, and describing them as too quiet. Women felt that their experiences with microaggressions were entangled with being Asian and a woman, but could not distinguish which identity was being targeted. ConclusionThe intersectionality of being Asian American and a woman in medical training has not been explored. We found that this duality intensified experiences of microaggressions.

Facilitators, motivations, and barriers to physical activity among Chinese American women

Physical inactivity poses a significant risk to morbidity and mortality. Chinese American women, as part of the larger group of Asian American women, exhibit low adherence to recommended physical activity guidelines. To date, few physical activity interventions have been tailored to address specific sociocultural considerations in this population, and the heterogeneity among Asian Americans is often not considered. The purpose of this qualitative descriptive study was to understand facilitators, motivations, and barriers to physical activity perceived by Chinese American women to help inform tailored physical activity interventions for this population. Virtual, semi-structured individual interviews with 21 Chinese American women were completed. Data were analyzed using Clarke and Braun’s thematic analysis approach. Six main themes emerged: (1) desires to stay healthy; (2) achievement and satisfaction; (3) facilitators and motivations from social networks; (4) COVID-19 pandemic; (5) prioritizing family needs; and (6) weight status satisfaction. Participants expressed motivations rooted in their desire for improved health, personal experience of improvement and accomplishment gained from physical activity, and the influence of social networks, both online and in-person. The COVID-19 pandemic acted as both a facilitator and a barrier to physical activity. Identified barriers include prioritizing family needs over personal engagement in physical activity and lacking motivation due to perceiving a normal weight that does not necessitate participation in physical activity. The findings facilitate the development of culturally appropriate interventions to improve physical activity and enhance overall well-being in this population.

Gendered Racial Microaggressions and Depressive Symptoms Among Emerging Adult Asian American Women: Racial/Ethnic Differences Among Asian and White Romantic Partners.

Discrimination can contribute to adverse mental health outcomes among individuals in romantic partnerships. However, research has yet to examine how differences in partner race/ethnicity can shape the link between gendered racial microaggressions, an intersectional form of discrimination, and depressive symptoms among Asian American women. Accordingly, we assessed the link between gendered racial microaggressions and depressive symptoms, and whether partner race/ethnicity (White vs. Asian) moderated the link. Using a sample of 156 Asian American women (Mage = 26.5, SD = 5.33), we conducted multiple regressions to assess the main effects between four gendered racial microaggression stress subscale factors and depressive symptoms. We then examined partner race/ethnicity as a moderator in these associations. All four gendered racial microaggression stress subscale factors of ascribed submissiveness, assumptions of universal appearance, Asian fetishism, and media invalidation significantly predicted greater depressive symptoms. However, only Asian fetishism experiences maintained a significant and positive association with depressive symptoms for Asian American women with White male partners. The association between Asian fetishism and depressive symptoms was no longer significant for Asian American women with Asian male partners. Results indicate that Asian fetishization may be a uniquely oppressive experience for Asian American women with White partners that can contribute to greater depressive symptoms. These findings demonstrate an increased need for the development of critical consciousness in individual and couples counseling sessions to help Asian American women and their romantic partners identify and mitigate the negative effects of gendered racial microaggressions.

Abstract A103: Feasibility of using data from the All of Us Research Program to better understand Asian American breast cancer risk

Abstract Asian Americans (AAs) are the only racial/ethnic group in the United States for whom cancer is the leading cause of death. In AA women, the rate of breast cancer (BC) has significantly increased in the past two decades. However, the reasons behind the observed increase in risk are not well understood. The All of Us (AoU) Research Program aims to enroll one million participants nationwide, focusing on including individuals from diverse backgrounds, to advance precision health research. The goal of this pilot study was to evaluate the feasibility of using AoU data to analyze factors potentially associated with breast cancer risk in AAs and to develop enhanced breast cancer prediction models. There were 3,433 self-reported AA women with available genomic data. In addition to the genomic data, data was available from surveys, participants’ electronic health records (EHRs), and physical measurements taken at the time of their study visit. BC cases were identified by self-report on surveys (n=38), EHR diagnosis data (n=104), or both survey and EHR (n=59), totaling 201 cases identified. Of these, only 17 were incident cases. Of the 163 cases detected in the EHR, 96.3% were invasive BCs, and the median age at diagnosis was 54.2 (±12.6) years. Among the 38 survey-only-identified cases, age at diagnosis was unclear due to the large age ranges (e.g.18-64 years) in the categories presented in the survey. For purposes of the case-control analysis, five AA women with no BC diagnosis were matched to each BC case by age group and geographic region. Body mass index, annual household income, marital status, history of alcohol consumption, and history of cigarette smoking and vaping were not statistically significantly different between cases and controls (a=0.05). One third (34.3%) of cases were born in the U.S. and 65.2% were born in another country vs. 25.0% and 74.0% of controls, respectively (p= 0.01). Employment status was also different, with 50.8% of cases being unemployed vs. 42.0% of controls (p=0.02). There appeared to be a difference in first-degree family history of BC (reported in 8% of cases vs. 5% of controls) although the results were not statistically significant (p=0.08). However, family history of BC data was not available for 43.3% and 51.0% of the cases and controls, respectively. Gynecologic factors, such as ages at menarche and menopause, and hormone use, were not asked in the surveys and were not widely captured in the EHR data. In our analysis of nine BC- associated genes (BRCA1, BRCA2, ATM, TP53, PTEN, CHEK2, CDH1, PALB2, STK11), pathogenic variants were identified in 1.0% of cases and 0.7% of controls. In summary, the AoU data set enables the study of a diverse national cohort with rich genomic data. However, the low representation of AAs, small numbers of incident cases, limited data on personal gynecologic history, cancer family history and social determinants of health, and broad categorization of age at diagnosis present challenges to using this data to build accurate and effective risk prediction models for BC risk in AAs. Citation Format: Catalina Haas Garcia, Wen-Pin Chen, Danni Liu, Alice W Lee, Min Zhang, Argyrios Ziogas, Sora Tanjasiri, Hannah Lui Park. Feasibility of using data from the All of Us Research Program to better understand Asian American breast cancer risk [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A103.

Abstract A069: Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020

Abstract Background: Asian American and Pacific Islander races are two distinct groups that continue to be aggregated in many large, national mortality statistics in the United States (US), which leads to structural biases encoded into databases and inaccurate health implications that may deprive Pacific Islander individuals from opportunities for interventions aimed at reducing health disparities. Examining mortality rates for disaggregated Asian American and Pacific Islander populations across all 50 states was not possible until 2018. We compared the leading causes of death between Asian American and Pacific Islander individuals in the US during 2018-2020, stratified by sex and age. Methods: Cause of death among non-Hispanic Asian American and Pacific Islander individuals aged ≥20 years who died during 2018-2020 were obtained from the US National Center for Health Statistics. Age-standardized all-cause mortality rates (MRs) and the 5 leading causes of death were reported per 100,000 person-years separately for Asian American and Pacific Islander individuals, by sex (female/male) and age (20-54/55-64/65-74/75- 84 years). MR ratios (MRRs) were calculated by comparing MRs among Pacific Islander with Asian American individuals (reference group), by sex and age. Results: During 2018-2020, 63,338 female and 85,601 male deaths occurred among Asian American adults, and 4,116 female and 5,512 male deaths occurred among Pacific Islander adults. Compared to Asian American individuals, all-cause mortality was higher for Pacific Islander females (MRR=2.50,95%CI=2.43-2.59) and males (MRR=2.10,95%CI=2.04-2.16). Cancer was the leading cause of death for Asian American (MR=93.8) and Pacific Islander females (MR=181.6) and second for Asian American (MR=100.4) and Pacific Islander males (MR=185.2) after heart disease. Death rates for leading causes were substantially higher for Pacific Islander compared to Asian American females: cancer (MRR=1.93,95%CI=1.82-2.06), heart disease (MRR=3.18,95%CI=2.95-3.42), stroke (MRR=2.41,95%CI=2.13-2.73), diabetes (MRR=4.03,95%CI=3.55-4.56), and COVID-19 (MRR=2.60,95%CI=2.25-3.01) and for Pacific Islander compared to Asian American males: heart disease (MRR=2.56,95%CI=2.42-2.71), cancer (MRR=1.52,95%CI=1.42-1.62, diabetes (MRR=3.14,95%CI=2.81-3.50), accidental death (MRR=2.60,95%CI=2.33-2.88), and COVID-19 (MRR=2.04,95%CI=1.82-2.27). The largest relative cancer mortality rate disparity occurred in those aged 20-54 years and declined with older age among women (MRR range=1.37-2.67) and men (MRR range=1.16-2.26). Conclusion: Cancer was among the leading cause of death for both Asian American and Pacific Islander individuals, but cancer mortality rates were twice as high among Pacific Islander women and men compared to Asian American women and men. These disparities persisted among Pacific Islander individuals for nearly all leading causes of death, regardless of sex and age, underscoring the need to disaggregate Pacific Islander from Asian American race data to improve tailored health equity-focused interventions. Citation Format: Jacqueline B. Vo, Jazmyn L Bess, Kekoa Taparra, Paloma R. Mitra, Amy Berrington de Gonzalez, Neal D. Freedman, Meredith S. Shiels, Jaimie Z. Shing. Leading causes of death among Asian American individuals compared with Pacific Islander individuals in the United States, 2018-2020 [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A069.

Beyond the Filter: Tiktok's Role in Shaping Body Image and Self-esteem in Asian and Asian American Girls and Women

This study examines the relationship between TikTok content consumption and body image concerns among Asian and Asian American females, focusing on the influence of cultural beauty standards. The research explores how exposure to TikTok videos featuring attractive influencers affects body image and self-esteem of participants. Participants included 26 Asian and Asian American women, aged 15-43, who completed surveys incorporating the Body Shape Questionnaire and Rosenberg's Self-Esteem Scale. The data were analyzed using correlation and regression analyses. Results indicated a significant negative relationship between the frequency of TikTok consumption and self-esteem, with increased exposure to influencer content correlating with lower levels of body satisfaction. Qualitative findings also revealed cultural tensions between Western and traditional Asian beauty ideals as key factors in shaping participants' body image concerns. The study results suggest that TikTok may exacerbate body image issues in this demographic, highlighting the need for targeted media literacy programs.

Contraceptive Use Disparities in Asian American Women in 2015–2016: California Health and Interview Survey

Contraceptive Use Disparities in Asian American Women in 2015–2016: California Health and Interview Survey

A Community-Based Cervical Cancer Education and Navigation Program for Korean American Women.

In the United States (US), rates of cervical cancer screening among Asian American women (notably Korean American women) lag far behind other populations. Thus, guided by the Health Belief Model, we developed a multi-component intervention to enhance Korean American women's knowledge and beliefs about screening and to increase screening uptake. The intervention group (N=341) received a culturally-relevant cancer education program and navigation services. The control group (N=335) received a similar program on cervical cancer risk and screening, along with information about free/low-cost screening sites. Women's knowledge and beliefs were measured at baseline and post-program, and screening behavior was assessed at 12-months post-program. It was hypothesized that the intervention would lead to positive changes in health beliefs and knowledge about cervical cancer and screening, which were then evaluated as potential mediators of the intervention on screening behavior. From pre- to post-program, the intervention group reported significantly greater increases in knowledge (p<0.01) and perceived risk (p=0.02) and significantly greater decreases in perceived barriers (p<0.001) compared to the control group. However, changes in knowledge and health beliefs did not mediate intervention effects on screening behavior. Use of navigation services was associated with greater odds of obtaining screening (OR=3.15, 95% CI=2.28-4.01, p<0.001) and attenuated the significant effect of group assignment (intervention vs. control) on screening behavior to non-significance. In conclusion, although our intervention program was effective in improving women's knowledge and beliefs about screening, delivery of navigation services was the critical component in increasing cervical cancer screening rates in this underserved population.

Acculturating to multiculturalism: a new dimension of dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander women in the San Francisco Bay Area, USA

BackgroundDietary acculturation is the process by which diet and dietary practises from the environment of origin are retained or changed and/or those prevalent in a new environment are adopted. Despite rapid population growth the U.S., knowledge gaps exist on characterising dietary acculturation among Asian American, Native Hawaiian, and Pacific Islander communities (AANHPI). This study characterise dietary patterns in a sample representative of AANHPI on key demographic characteristics.MethodsData were from a 2013–2014 population-based case-control study in the San Francisco Bay Area, U.S. Survey items were adapted from dietary acculturation scales developed for AANHPI populations. Validated measures assessed social capital, social standing, discrimination and immigration experiences. A principal components factor analysis was conducted to characterise dietary patterns of acculturation.ResultsThree dietary patterns were identified: “Asian,” “Western,” and a distinct “Multicultural” factor. Respondents reporting a high-Asian diet tended to also report smaller social networks, higher levels of stress, and, among those born outside of the U.S., an educational standing that was better before immigration. Respondents reporting a high-Western diet tended to also report the highest level of discrimination. Those reporting a high-Multicultural diet tended to report higher neighbourhood collective efficacy.ConclusionsThe finding of a distinct “Multicultural” factor beyond the typical “Asian” and “Western” factors may reflect the multidirectional relationships between culture, diet, and dietary behavior, in which origin and destination cultures interact in complex ways and where foods from multiple ethnicities intermix.

Disparities in timely surgery among Asian American women with breast cancer

BackgroundWe investigated the likelihood of timely surgery for breast cancer patients among diverse Asian subgroups. MethodsWe analyzed the National Cancer Database from 2010 to 2019 and included White and Asian women diagnosed with stage I-III breast cancer. Patients with multiple cancers, patients who received chemotherapy, and those diagnosed and treated at different hospitals were excluded. The primary outcome was timely surgery within 8 weeks of diagnosis. Race was the primary independent variable. Asian Americans were stratified by geography. ResultsA total of 716,701 women were analyzed, with 3.5% Asians. Delayed surgery was experienced by 13.2% of women. Adjusted analysis indicated no difference in receiving timely surgery between all Asians and Whites. However, Southeast Asians were less likely to undergo timely surgery compared to Whites (OR 0.75, 95% CI 0.67–0.84). ConclusionsVariations among Asian ethnicities emphasize the need to explore treatment patterns to address disparities in breast cancer care.

Doing Gender, Undoing Race: Token Processes For Women With Multiple Subordinate Identities

Through interviews with 29 Asian American women tech workers, this article demonstrates how cultural frameworks around race and gender shape identity salience and construct a token process for workers with multiple subordinate identities. This approach to tokenism better accounts for multiple systems of inequality affecting workers and demonstrate how certain identities are prioritized—and others neglected—through institutional interventions and cultural ideologies. It also provides an additional lens through which to interpret the emphasis on gender inequality within the high-tech industry: Whereas gender inequality is generally considered a critical step in achieving an equitable work environment, I consider how it is intentionally leveraged within organizations to divert from interventions toward establishing racial equality. Results suggest serious barriers preventing the high-tech industry from reckoning with racial inequality for Asian American women workers; more broadly, they hint at how other racial groups with white-adjacent privileges are similarly exploited to uphold the high-tech industry’s white racial project.

Risk factors for breast cancer subtypes by race and ethnicity: A scoping review.

Breast cancer is comprised of distinct molecular subtypes. Studies have reported differences in risk factor associations with breast cancer subtypes, especially by tumor estrogen receptor (ER) status, but their consistency across racial and ethnic populations has not been comprehensively evaluated. We conducted a qualitative, scoping literature review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews to investigate consistencies in associations between 18 breast cancer risk factors (reproductive, anthropometric, lifestyle, and medical history) and risk of ER-defined subtypes in women who self-identify as Asian, Black or African American, Hispanic or Latina, or White. We reviewed publications between January 1, 1990 and July 1, 2022. Etiologic heterogeneity evidence (convincing, suggestive, none, or inconclusive) was determined by expert consensus. Publications per risk factor ranged from 14 (benign breast disease history) to 66 (parity). Publications were most abundant for White women, followed by Asian, Black or African American, and Hispanic or Latina women. Etiologic heterogeneity evidence was strongest for parity, followed by age at first birth, post-menopausal BMI, oral contraceptive use, and estrogen-only and combined menopausal hormone therapy. Evidence was limited for other risk factors. Findings were consistent across racial and ethnic groups, although the strength of evidence varied. The literature supports etiologic heterogeneity by ER for some established risk factors that are consistent across race and ethnicity groups. However, in non-White populations evidence is limited. Larger, more comparable data in diverse populations is needed to better characterize breast cancer etiologic heterogeneity.

Recruitment and Retention Issues in a Technology-Based Intervention Among Korean American Midlife Women With Depressive Symptoms.

The number of health technology-based intervention studies has grown significantly. However, issues in the recruitment and retention for such studies, especially of Asian Americans, have rarely been discussed. The purpose of this paper was to discuss issues in the recruitment and retention of a specific group of Asian Americans-Korean American midlife women with depressive symptoms-into a technology-based intervention study using computers and mobile devices with a measurement device and to provide directions for future participant recruitment and retention in technology-based intervention studies. The written memos of research team members and the written records of research team meetings were analyzed using a content analysis. The issues in the recruitment and retention process included (1) low recruitment and retention rates; (2) the perceived long intervention period; (3) strict inclusion/exclusion criteria; (4) concerns related to the use of a measurement device; and (5) the perceived adequacy of monetary incentives. Based on the issues identified in the study, several suggestions are made for future recruitment and retention of racial/ethnic minorities in technology-based intervention studies (eg, appropriate intervention period, innovative and creative motivation strategies, acceptable measurement scales and devices, and adequate monetary reimbursement).

A 42-year-old woman with abnormal uterine bleeding—leiomyoma (AUB-L) reporting a hemoglobin of 1.6 g/dL: a case report

BackgroundAbnormal uterine bleeding, formerly known as menometrorrhagia, is estimated to occur in up to one-third of women, commonly at menarche or perimenopause. Among many other causes, abnormal uterine bleeding is known to be caused by leiomyomas, and is itself a leading cause of severe iron deficiency and iron deficiency anemia in women. Rarely, abnormal uterine bleeding can lead to critically low hemoglobin values of less than 2 g/dL. We report here a case of a woman with abnormal uterine bleeding caused by leiomyomas presenting with severely low hemoglobin.Case presentationWe report the case of a 42-year-old Asian American woman who presented to the emergency department with chronic abnormal uterine bleeding and symptoms of anemia, including multiple syncopal episodes and abnormally pale skin but otherwise alert and oriented. Laboratory tests found a record-low hemoglobin of 1.6 g/dL and hematocrit of 6%. Transabdominal pelvic ultrasound revealed a lower uterine segment/cervical fibroid measuring 7.5 × 5 × 7.8 cm (length × depth × width). Patient was diagnosed with abnormal uterine bleeding–leiomyoma and received five units of packed red blood cells, one unit of fresh frozen plasma, Venofer infusions, tranexamic acid, and medroxyprogesterone. She was discharged from the hospital after 4 days.ConclusionTo date, only a handful of cases have been reported of female patient survival following severely low hemoglobin caused by abnormal uterine bleeding. This case adds to this literature, highlighting the remarkable degree of compensation that can lead to an alert, ambulatory, and oriented patient with abnormal uterine bleeding caused by leiomyoma.

Deconstructing Desire: Criticism of Western Romantic Narratives in Mitski's "Your Best American Girl" Music Video

Mitski Miyawaki, a Japanese American indie-rock artist professionally known as Mitski, wrote her 2016 song, “Your Best American Girl,” from the perspective of a woman who is unable to have a relationship with her love interest due to their different racial and cultural backgrounds. The accompanying music video engages with the song’s social message while adding nuance and complexity to it. Many of the lyrics portray Mitski’s feelings of isolation as an Asian American woman, especially through their employment of Japanese cultural symbols, while the music video uses parody, camera angles, and Americana iconography to further illustrate Mitski’s experiences of isolation. This essay analyzes the subtle ways in which “Your Best American Girl” subverts Asian stereotypes and destabilizes white patriarchal structures that are perpetrated by popular media, particularly through white centrality in the indie-rock genre. Comparison of “Your Best American Girl” to Lana Del Rey’s “Born to Die” music video reveals how “Your Best American Girl” uses parody techniques to criticize this white centrality. Further, its references to PJ Harvey allows Mitski to occupy a similar position of musical authenticity and command respect. Through lyrical, musical, and visual storytelling, “Your Best American Girl” chronicles Mitski’s journey towards self-acceptance, while critiquing the pervasive whiteness in romantic narratives.

Reproductive characteristics, menopausal status, race and ethnicity, and risk of breast cancer subtypes defined by ER, PR and HER2 status: the Breast Cancer Etiology in Minorities study

BackgroundAssociations between reproductive factors and risk of breast cancer differ by subtype defined by joint estrogen receptor (ER), progesterone receptor (PR), and HER2 expression status. Racial and ethnic differences in the incidence of breast cancer subtypes suggest etiologic heterogeneity, yet data are limited because most studies have included non-Hispanic White women only.MethodsWe analyzed harmonized data for 2,794 breast cancer cases and 4,579 controls, of whom 90% self-identified as African American, Asian American or Hispanic. Questionnaire data were pooled from three population-based studies conducted in California and data on tumor characteristics were obtained from the California Cancer Registry. The study sample included 1,530 luminal A (ER-positive and/or PR-positive, HER2-negative), 442 luminal B (ER-positive and/or PR-positive, HER2-positive), 578 triple-negative (TN; ER-negative, PR-negative, HER2-negative), and 244 HER2-enriched (ER-negative, PR-negative, HER2-positive) cases. We used multivariable unconditional logistic regression models to estimate subtype-specific ORs and 95% confidence intervals associated with parity, breast-feeding, and other reproductive characteristics by menopausal status and race and ethnicity.ResultsSubtype-specific associations with reproductive factors revealed some notable differences by menopausal status and race and ethnicity. Specifically, higher parity without breast-feeding was associated with higher risk of luminal A and TN subtypes among premenopausal African American women. In contrast, among Asian American and Hispanic women, regardless of menopausal status, higher parity with a breast-feeding history was associated with lower risk of luminal A subtype. Among premenopausal women only, luminal A subtype was associated with older age at first full-term pregnancy (FTP), longer interval between menarche and first FTP, and shorter interval since last FTP, with similar OR estimates across the three racial and ethnic groups.ConclusionsSubtype-specific associations with reproductive factors overall and by menopausal status, and race and ethnicity, showed some differences, underscoring that understanding etiologic heterogeneity in racially and ethnically diverse study samples is essential. Breast-feeding is likely the only reproductive factor that is potentially modifiable. Targeted efforts to promote and facilitate breast-feeding could help mitigate the adverse effects of higher parity among premenopausal African American women.