Brown Women Research Articles

Hospital-based registries of women with breast cancer from the oncology network of Espírito Santo, Brazil

Objective: To describe the cases of women with breast cancer (BC) and identify the epidemiological profile of the cases reported in the Hospital-based Cancer Registries (HCR) of the Oncological Care Network of Espírito Santo (OCN/ES). Methods: This is a hospital-based descriptive observational study, based on secondary data retrieved via the HCR Tumor Registration Form of the eight hospitals that comprising the OCN/ES, between 2000-2020. Results: There were 16,844 case records of women with breast cancer in this historical series. The median age of the women was 52 years. The age group with the highest number of cases (54.0%) was 41-60 years, 57.42% were brown, 51.70% married, and 30.80% had incomplete elementary school, residents of the Metropolitan region of the state (81.70%). Most cases were analytical (75.42%), referred from SUS (59.70%), had no occurrence of more than one primary tumor (94.21%), the most common histological type was infiltrating duct carcinoma (76.03%), and stage II (6.75%), with multimodal treatments (60.09%). Conclusion: The findings point to an increasing trend in the occurrence of breast cancer over the years in OCN/ES, occurring mainly in older, brown women and women with low education, in stage II of the disease.

The power of sisterhood: graduate students’ dialogic exploration at the margins of a Midwest university

In this duoethnography we, a Latina and Filipina, write letters to each other reflecting on a video discussing our graduate student lives and shared journal entries during COVID-19. After revisiting the reflections, we share what makes the marginal space of a Midwest university unique and transformative. By analyzing our experiences, as Women of Color graduate students in a predominately white institution, common themes of spirit injury and healing emerged. We learned to make space for authentic relationships. We shared examples of our teaching experiences as Brown women in white spaces. We integrated voices and wisdom of Women of Color Scholars when talking to one another. We shared cautionary tales and stories of resilience to combat the taxing space of higher education on our Brown bodies. Consistent with this dialogic method, our writing and formatting choices invite the reader to be the third partner in our conversation.

Strandlooping as a relational enquiry to reimagine higher education and gender studies along the Camissa coastline

ABSTRACT Thirty years after democracy in South Africa, the legacy of apartheid continues to affect Black and Brown 1 bodies by excluding them from the ocean and other spaces through the legacies of racist laws which continue to bleed into the present. In this paper, I argue that strandlooping as a method of enquiry is key to understanding care for our hydrocommons. This methodology can also be considered to be a generative way of re-imagining and practicing higher education research and gender studies differently. Strandlooping as a lone, Brown woman along certain stretches of the coastline is unsafe, and this influences the way I work and whom I choose to walk with. I make use of African feminism, Indigenous knowledge and research-creation frameworks in the paper to enact theory-practice-praxis in creative and relational ways. The paper concludes with three suggested watermarks or propositions for strandlooping to encourage knowledge-making with humans and more-than-human entities.

A Study on Economic Stressors During the COVID-19 Pandemic Among Intimate Partner and Sexual Violence Survivors in the United States.

Systemic racism and racialized poverty are socially produced structural determinants that shape health outcomes during infectious disease outbreaks. Public health emergencies compound vulnerabilities for survivors of intimate partner violence (IPV) and sexual violence (SV) and those who self-identify as people from racial and ethnic minority groups. We describe findings from an online survey designed to collect data on financial conditions faced by survivors of IPV and SV to understand these conditions during the COVID-19 pandemic. Our analyses were limited to a sample of women in the United States (91.4%, n = 523) who reported IPV or SV to whom we refer as survivors. We characterize the differences of economic stressors across White and aggregated categories of self-identified race, i.e., Black and Brown Latinx women and non-Black or non-Brown Latinx women of color, to highlight disparities between White and non-White populations in our sample. Logistic regressions were used to examine the relationships among racial categories, food insecurity, housing insecurity, and economic insecurity during the COVID-19 pandemic. Black and Brown Latinx women survivors were twice as likely as White women to report housing, financial, and economic insecurity during the COVID-19 pandemic. Approximately one-third of all survivors anticipated taking on more debt than they would want to cover their expenses due to COVID-19. The results of this study have implications for public health responses that involve coordinating economic relief measures among populations disparately affected by public health crises and disasters to ensure that the economic needs of the most impacted are addressed.

Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study.

To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause. This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis. A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253). The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.

Human/Nature Dualism in Khan’s The Geometry of God: An Eco-feminist Study

This research proposes a comparative eco-feminist approach to challenge corporate narratives regarding women's associations with nature. The analysis is centred on Uzma Aslam Khan's (2008) novel, The Geometry of God, aiming to gain insights into Val Plumwood's (2002) contemporary critique of the ‘human/ nature dualism’. This research argues social constructivism and socialist eco-feminism to explore the differences in how language is employed to understand the eco-feminist assumptions concerning women and their relationship with nature. Eco-feminism, a movement that emerged in the 1990s, posits that the domination and degradation of women and the environment are the results of patriarchal and capitalist systems (Molyneux et al., 1995). This research argues the compelling issues concerning corporate representations and misrepresentations of women and their connections to their surrounding environment. The portrayals of the relationship between brown women and nature highlight the discursive reconfiguration of brown women's identity, examining how female novelists in Pakistani patriarchal societies redefine the narratives that deconstruct the eternal images of women imposed by the patriarchal academia (Mehmood, 2019).

Abstract 5207: Hypermethylation of SOX17 is an important epigenetic mark in Afro-Brazilian breast cancers

Abstract Afro-Brazilian women suffer from higher excess breast cancer mortality after adjusting for age, level of education and stage at diagnosis. Limited studies have researched disease characteristics in this population, which can benefit from the identification of molecular markers that can provide an insight into who is at greater risk of mortality. Epigenetic biomarkers represent the combined effect of environmental and genetic factors. Particularly DNA methylation biomarkers can be valuable as biomarkers of breast cancer risk and prognosis. While studies in other populations have identified DNA methylation biomarkers associated with breast cancer and its clinicopathological outcomes, research on Brazilian cohorts has been limited in scope and focused on women of European descent. The goal of this work was to determine the epigenetic makeup of breast cancer in Brazilian women of African descent. To identify epigenetic biomarkers in Brazilian women who self-identified as Black or Brown, we conducted a case-series analysis investigating DNA methylation patterns in tumor (T) and adjacent non-tumor (NT) tissue. For this, we used the Illumina EPIC (850k) arrays to carry out DNA methylation profiling in 48 frozen tissue paired T and NT samples of breast cancer patients treated at the National Cancer Institute Breast Cancer Hospital in Rio de Janeiro, Brazil. We identified a total of 7,749 probes with Benjamini-Hochberg adjusted p-value < 0.0001 and differences between T and NT tissue above |0.3|. Of these, 5,976 or 77.12% had lower DNA methylation in T when compared to NT tissue; while 1,773 (22.88%) had higher DNA methylation. These were used to identify 21 differentially methylated regions (DMRs) that contained a minimum of seven cg sites, a mean difference larger than |0.2| and a maximum difference above |0.4|. DMRs were mostly (12) hypermethylated in T, and included PCDHGA, NKAPL, ZKSCAN4, SPAG6, CA3, DPP6, RGS22, NXPH1, ANK3, OTX2, SOX17, and CDO1. We used pyrosequencing to validate the levels of SOX17 in eighty-eight tumor and non-adjacent tumor tissue DNAs. We found SOX17 to be hypermethylated in T (44.5±19.1% vs 10.2±10.6, p<0.0001). Differences in DNA methylation in T and NT tissue we still observed by race/ethnicity categories, 43.9±18.6% vs 11.0.±13.2% (p<0.0001) for Brown, and 45.1±20.7% vs 8.8±3.0% for Black women (p<0.0001), respectively. Similarly to previously reported, SOX17 hypermethylation was found to be associated with Luminal A and B molecular subtypes (p<0.0001). To our knowledge, this is the first study to use a discovery approach to identify epigenetic biomarkers in Black and Brown Brazilian women. Our findings confirming previously reported data on SOX17 hypermethylation in breast cancer are encouraging. We expect to validate other epigenetic markers unique to this population that can ultimately aid in the molecular characterization of Brazilian breast cancers. Citation Format: Lissette Delgado-Cruzata, Diego J. Gomes de Paula, Jennifer G. Vieira, André L. Christianes, Tatiana Simao, Leonor B. Gusmao, Luis Felipe Ribeiro Pinto, Sheila Coelho Soares Lima. Hypermethylation of SOX17 is an important epigenetic mark in Afro-Brazilian breast cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5207.

OBSTETRIC VIOLENCE AGAINST WOMEN FROM AN INTERSECTIONAL THEORETICAL PERSPECTIVE: A narrative review

This study aims to reflect obstetric violence against women from the theoretical perspective of intersectionality. This is a narrative review that was proposed to analyze from the national literature, available in the databases: SciELO, ARCA and VHL, research that addressed the central theme of the present study and in each database the health descriptors were used: "intersectional theory", "obstetric violence" and "gender and ethnic racism" organized by the Boolean operator “AND”. From the extensive literature we can infer that obstetric violence against women occurs mainly against black, brown, indigenous and poor women, that is, women who most accumulate intersections/social determinants of health. Finally, obstetric violence does not choose a profile, all people who are pregnant are subject to being violated just because of their ability to conceive and undergo obstetric procedures. However, it can worsen depending on your environment, class, race, gender, sexual orientation, religion, ethnicity and other intersections.

Violence against brown and black women during the pandemic: a scoping review

Objective: To map and summarize the main available evidence on intimate partner violence against brown and black women during the COVID-19 pandemic. Methods: This is a scoping review carried out in the National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Excerpa Medica DataBASE, PsycINFO – APA PsycNET and Latin American and Caribbean Literature in Health Sciences databases. Studies on interpersonal violence against brown and black women after the COVID-19 pandemic decree, perpetrated by an intimate partner, published from 2020 onwards in Portuguese, Spanish or English, were included. Editorials, response letters, retractions and studies focused on self-inflicted violence were excluded. Descriptive analysis was carried out. Results: A total of 26 studies were obtained, and after selection, a sample of eight articles was obtained, published between 2020 and 2022. The results showed mostly North American studies, however, they pointed to intimate partner violence against brown and black women as a global phenomenon during the pandemic. The victims presented multiple conditions of vulnerability and encountered several barriers to accessing health and public safety services, including racism. Prevention and control measures were scarce and had consequences for women’s overall health. Conclusion: The phenomenon was characterized as a global problem during the COVID-19 pandemic. Individual, collective and political coping strategies were created by the victims. Public policies to prevent and control intimate partner violence were not adequately implemented in many countries during the pandemic.

Violence against women during the COVID-19 pandemic: types of occurrences from an ethnic perspective

This study arose from an interest in finding out the profile of women who experienced violence during the Covid-19 pandemic. Given that black and brown women are more vulnerable to these occurrences, the aim was to comparatively describe the occurrence of types of violence in women in the state of Rio de Janeiro, considering their ethnicity and the period before, during and after the Covid-19 pandemic. This is a documentary, descriptive, retrospective study with a quantitative approach. Government documents obtained from the virtual platform of the Public Security Institute of Rio de Janeiro - ISP on the occurrence of violence against women from 2019 to 2022 in the state of Rio de Janeiro were analyzed. Among the main results, it was identified that women with a low level of schooling experience more violence than women with a higher level, as well as black and brown women experiencing more violence than white women. The low level of schooling (directly related to economic conditions) and skin color (being black or brown) showed an increase in women's vulnerability to experiencing violence. It was also possible to identify that the majority of employed women suffered more violence than unemployed women, as well as the fact that the main place of aggression was in the victim's home. Considering the results, there is an urgent need for socio-political actions to combat violence, valuing ethnicity, as well as other indicators of groups of women who are more vulnerable to violence.

Risk assessments and ethnicity in maternity care: looking through the wrong end of the telescope?

Many Black and brown women are classified as ‘high risk’ and follow obstetric-led pathways. This may be the result of social determinants of health, or over pathologisation as a result of racial bias by healthcare providers and systems. There may be times when social determinants are mistaken for innate physiological differences, leading to iatrogenic harm. There is both over and underdiagnosis resulting from racial bias in midwifery care. Women with intermediate risk factors may benefit from midwifery-led care, especially Black and brown women. Community-based, relational, women-centred midwifery models of care can reduce the problems of pathologisation and redress some social inequalities.

Factors associated with the length of breastfeeding during the COVID-19 pandemic: a survival study.

To investigate the repercussions of COVID-19 on the length of breastfeeding and analyze the associated factors in Belo Horizonte, Minas Gerais, Brazil. This is an epidemiological, prospective cohort study. Data were collected from medical records and through telephone interviews. Women who weaned were estimated using Kaplan-Meier survival analysis. The log-rank test was used to verify differences between groups, analyzing weaning time, according to sociodemographic and clinical characteristics. The values of hazard ratio and 95% confidence intervals were estimated using Cox regression analysis. A total of 1,729 women participated in the study. During the COVID-19 pandemic, brown women and women undergoing cesarean section were more likely to stop breastfeeding. The birth route and mothers' ethnic characteristics were associated with early weaning during the COVID-19 pandemic. Such findings are important to guide the assistance of the multidisciplinary team, especially nursing, during the post-pandemic period and in future epidemiological scenarios.

Psychological stress and cardiovascular risk among women in Brazilian communities: a cross-sectional study.

Psychosocial evaluations are rarely conducted with community-dwelling individuals, especially those with higher risk of cardiovascular disease. This study aims to evaluate the perceptual stress and cardiovascular risk among women in a large cross-sectional study performed in Brazilian communities. Subjects aged over 18 years were included out of 500 public basic health units (BHU) in Brazil. All subjects were subjected to a clinical consultation and questionnaires application. Data were used to identify healthy lifestyle, smoking status, and self-perception of psychological stress. The National Health and Nutrition Examination Survey (NHANES) risk score (NRS) was used to estimate cardiovascular risk. Ethnicity information was self-reported, considering white versus non-white (black, brown, and mixed-race) women. A total of 93,605 patients were recruited from a primary care setting, of which 62,200 (66.4%) were women. Intense and severe auto-perception of stress was higher within non-white women at home (p < 0.001), at work (p = 0.008), socially (p < 0.001), and financially (p < 0.001) compared to white women. Therefore, the NRS indicates that non-white women had higher cardiovascular risk, lower physical activity, and lower daily vegetables/fruits consumption compared to white women (p < 0.001). Non-white women in Brazilian communities are susceptible to increased stress and cardiovascular disease risk, which adds up to disparities in access to the public health system.

Mulheres pretas e pardas: vulnerabilidades ocorridas de 2010 a 2018 no extremo sul baiano

Violence alters society in countless ways, being disproportionate in relation to women, especially blacks and browns in situations of vulnerability, which makes them prone to marks that influence their daily lives. The objective of this theme was to analyze the prevalence of domestic, sexual and / or other conditions in black and brown women in the period from 2010 to 2018, in the extreme south of Bahia. For the concreteness of this research, in the methodological field, an epidemiological, cross-sectional, descriptive approach was chosen secondary information provided by the Ministry of Health in the DATASUS database, evaluating the state and the macro-region of the Far South, correlating with the number of psychogical / moral violence in both. Upon entering the questions that guided this study, it was noticed that in view of the universe researched, the results show a growing number of cases, from 873 cases in 2010 to 25,872 in 2018 in the state, when the macro-region was analyzed, there were a total of 1,751 cases, as for psychological / moral violence, the maximum peak occurred in 2018, in both regions; the study shows an exorbitant increase in relation to black and brown women at risk in Bahia, especially in the macro-region. It is concluded that it is necessary to increase measures aimed at providing greater protection and care for the victims, since that the home is "the most dangerous place for these women", which culminates, often in long-term violence.

Aborto e raça no Brasil, Pesquisa Nacional de Aborto 2016 a 2021

Abstract We examine racial differentials in abortion among women in Brazil using data from three editions of the Brazilian National Abortion Survey (PNA), 2016, 2019 and 2021. We test the difference in means in data from separate surveys, combined surveys without reweighting, and combined and reweighted surveys. We also use logistic models for the chance of having an abortion. The results indicate that there is a consistent racial differential in the three editions of PNA, with the percentage of abortions among Black women being higher than among white women. In the combined and reweighted surveys, among Black women of all ages the probability of having had an abortion is 11.03% while among white women it is 7.55%. This means a difference of 3.5 percentage points, which translates into a 46% higher probability for Black women, statistically significant values for a 5% interval. Logistic regressions produce similar results, with an average predicted probability of 12.61% for Black women and 8.90% for white women, also significant. Racial differences remain statistically significant for various combinations of PNA editions. However, in the separate surveys, the difference in means tests are only statistically significant in 2016. Black refers to the group formed by Black and Brown women (pretas and pardas). Due to the small sample size, it is not possible to say much about the differences with Asian and Indigenous women.

Impacts of Sociodemographic Factors, Screening, and Organization of Health Services on Breast Cancer Mortality in Brazil: An Ecological Study of 20 Years.

Breast cancer mortality is increasing in Brazil. This study examines the impact of sociodemographic factors, screening procedures, and primary healthcare (PHC) on breast cancer mortality. An ecological study analyzed secondary data of women diagnosed with breast cancer who died between 2000 and 2019. Sociodemographic factors, screening procedures, and PHC were examined in relation to breast cancer mortality. Statistical analyses included normality tests, Kruskal-Wallis and one-way ANOVA tests with post hoc comparisons, Pearson and Spearman correlation tests, age-period-cohort analysis, Kaplan-Meier analysis, and Cox regression analysis. Significance was set at p < 0.05. Mortality rates were higher in the southeast (15.77) and south (15.97) regions compared to the north (5.07) (p < 0.0001). Survival rates were longer in the southeast (70.3 ± 0.05) and south (70.6 ± 0.09) than in the north (63.98 ± 0.053) (p ≤ 0.001). Mortality increased with age after 32 years (p ≤ 0.001). Brown and indigenous women had lower mortality and survival rates. Increased coverage of PHC, ultrasound, and biopsy did not reduce mortality. However, improved cytopathologic analysis led to a decrease in mortality. Sociodemographic factors, screening procedures, and PHC are specific predictors of breast cancer mortality in Brazil.

When My Brown Got Colored

Abstract This essay is a testimonial of the author’s experiences, memories, and reflections about becoming a person/woman of color, discovering, and unearthing the meanings of racialization, white privilege, and white supremacy in the contemporary United States. The author gives voice to her new migrant experience as a Brown woman from India, positioning her reflections and learnings amidst the history and politics of colonialism and capitalist development, linking it to contemporary neoliberal academia in the United States. By sharing some events and encounters in her relatively short stint in Charlottesville, Virginia, between 2016 and 2019, the author reviews her attempts to critically analyze concepts like women of color, diversity, colorism, privilege, invisibility, and othering. The article further connects some of the author’s experiences of racialization in view of the growing politics of casteism and Brahmanical supremacy in India, locating and reassessing herself in the midst of Trump’s hardened propagation of white privilege in the United States and Modi’s Hindutva, both emanating a politics rooted in racialization, exploitation, and marginalization of the other.

Sisters in the “Hostile Environment”: A Womanist Theological Analysis of Brexit

ABSTRACT This article builds upon Anthony Reddie's Theologising Brexit by offering a womanist perspective in response to his postcolonial and liberationist critique. In keeping with the framing of Reddie's argument I begin with history, by drawing on feminist historians which demonstrate that British enslavement, colonialism and mission should be understood as gendered as well as racialised forms of oppression in Africa and the Caribbean. In the second section, I critique Britain's “hostile environment” policies and Brexit as continuations of Britain's White supremacist and masculinist colonial past by centring the experiences of the “Zambrano carers”: predominantly single Black mothers left destitute by the UK government, and Black and Brown Muslim women who have borne the brunt of Islamophobic violence. In the final section I look to Hagar in Delores Williams's Sisters in the Wilderness to theologise Brexit with these women who are marginalised and dehumanised in contemporary British society.

Racismo antinegro e morte materna por COVID-19: o que vimos na Pandemia?

Abstract Anti-Black Racism traverses the lives of Black and Brown women, compromising sexual and reproductive health. Obstetric racism during pregnancy, prenatal care, childbirth, abortion, and puerperium affects these women, exposing them to harmful and often lethal maternal outcomes. This study aims to present racism and its manifestations in maternal death by COVID-19. It included data from COVID-19 notifications among pregnant women and puerperae recorded in the severe acute respiratory syndrome database (2021 and 2022). Information on race/skin color, age, region, clinical signs and symptoms, ICU, and deaths were collected. The results indicate how racism affects Black and Brown pregnant women and puerperae, who have higher lethality due to COVID-19 compared to White women (a difference of 14.02%), particularly in the puerperium. Black and Brown pregnant women least accessed the ICU. After adjustments, maternal death in the puerperium for Black women was 62% more likely than for White women (OR=1.62; 95%CI: 1.01-2.63). Racism and its manifestations (dis)organize the reproductive trajectories of Black and Brown women, whose interaction with sexism contributes to harmful and lethal maternal outcomes by COVID-19.

Anti-Black racism and maternal death from COVID-19: what have we seen in the Pandemic?

Anti-Black Racism traverses the lives of Black and Brown women, compromising sexual and reproductive health. Obstetric racism during pregnancy, prenatal care, childbirth, abortion, and puerperium affects these women, exposing them to harmful and often lethal maternal outcomes. This study aims to present racism and its manifestations in maternal death by COVID-19. It included data from COVID-19 notifications among pregnant women and puerperae recorded in the severe acute respiratory syndrome database (2021 and 2022). Information on race/skin color, age, region, clinical signs and symptoms, ICU, and deaths were collected. The results indicate how racism affects Black and Brown pregnant women and puerperae, who have higher lethality due to COVID-19 compared to White women (a difference of 14.02%), particularly in the puerperium. Black and Brown pregnant women least accessed the ICU. After adjustments, maternal death in the puerperium for Black women was 62% more likely than for White women (OR=1.62; 95%CI: 1.01-2.63). Racism and its manifestations (dis)organize the reproductive trajectories of Black and Brown women, whose interaction with sexism contributes to harmful and lethal maternal outcomes by COVID-19.