Young Black Women Research Articles

Abstract A070: Association between socioeconomic and clinical factors on timely access to care among young Black women with breast cancer

Abstract Background: Young-onset breast cancer is associated with higher mortality due to multiple factors including tumor biology and delayed presentation. Young women with breast cancer with longer treatment delays have decreased survival time, with the impact on survival being more prominent in Black women. The factors contributing to the racial survival disparity are complex and are likely an interplay between tumor biology, genomics, patterns of care and socioeconomic factors. This study looked at socioeconomic and clinical factors that may affect timely access to care for breast cancer in young Black women, and thus impact survival. Methods: Data from the Black Women Etiology and Survival of Triple-negative Breast Cancers (BEST) Study, a population-based cohort of Black women diagnosed with breast cancer ≤ 50 years old between 2009 and 2015 from the Florida and Tennessee State Cancer Registries was used. The time to treatment (in days) was used as the exposure variable and defined as the time from breast cancer diagnosis to the date of first treatment. The primary outcome was determined by distant or local recurrence or death. Pearson chi-square test was conducted to assess the association between clinical and socioeconomic factors with time to treatment. The socioeconomic variables studied were insurance, income and education. Clinical factors evaluated were the stage of breast cancer at diagnosis, hormone subtype, neoadjuvant chemotherapy and type of surgery. Survival analysis and Cox proportional hazard model were performed to analyze the 10-year overall survival and recurrence rate while adjusting for income, breast cancer stage and hormone subtype. Results: There was a statistically significant association between time to treatment and hormone receptor subtype (p=0.04). More than 60% of women with triple-negative breast cancer (TNBC), and 57% of women with HER2+ breast cancer received treatment within a month of their breast cancer diagnosis. There was also a significant association between the time to treatment and type of surgery received (p=0.03). 64% of patients who had lumpectomies received treatment in ≤30 days, compared to 54% of patients who had a mastectomy. Survival analysis showed the highest mortality in patients with time to treatment >90 days, followed by patients who received treatment in ≤30 days. The study did not find a statistically significant association between insurance, income, or education on the timeliness of treatment for breast cancer. Conclusion: In our study of young Black women, delayed breast cancer treatment resulted in lower survival. While those with TNBC and HER2+ disease were more likely to receive treatment ≤30 days, i.e. neoadjuvant chemotherapy to assess response to chemotherapy and the amount of residual disease at the time of the surgery, the enrichment for aggressive disease is likely the reason for the low survival observed in this group. Timely access to treatment for breast cancer impacts survival and strategies to decrease treatment delays are crucial to reducing breast cancer mortality. Citation Format: Kikelola Oyeleye, Rebecca Lee, Sonya Reid, Tuya Pal, Anne Weidner, Lindsay Venton. Association between socioeconomic and clinical factors on timely access to care among young Black women with breast cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A070.

Abstract C007: Reasons for pursuing genetic testing among young Black women with breast cancer

Abstract Introduction Genetic testing is an increasingly important part of cancer treatment for women with breast cancer diagnosed under age 45. There has been evidence about low testing uptake and barriers to genetic testing for eligible Black women but less is known about motivations for testing. The objective of this study was to assess reasons for pursuing genetic testing among young Black women with breast cancer. Methods Study participants were a population-based sample of self-identified Black women diagnosed with invasive breast cancer at or below age 50, recruited through the Florida and Tennessee state cancer registries. Participants were categorized into tested and not tested groups. Among the tested, participants were asked why they pursued testing and response options included to guide surgical decisions, chemotherapeutic decisions, radiation decisions, or to benefit family. Respondents were categorized into 4 groups: no motivation specified; treatment motivation only; family benefit motivation only; both treatment and family motivation. Logistic regression was used to estimate factors associated with type of motivation. Results In total, 175 women were eligible for inclusion, 135 women had received genetic testing, and 40 had not. Median age of breast cancer diagnosis was 43. Among tested women, 30 (22%) endorsed treatment motivation only, 69 (51%) endorsed family motivation only, and 31 (23%) endorsed both treatment and family motivation. Women who had daughters had higher odds of endorsing being motivated by family benefit (OR 3.87, 95% CI 1.98, 7.57). This relationship was not seen for having sons (OR 0.84, 0.49, 1.83), sisters (OR 0.78, 95% CI 0.34, 1.77) or brothers (0.87, 0.43, 1.73). Among the 40 women who did not receive genetic testing, 24 (60%) indicated a lack of testing recommendation. Conclusions In our investigation, we found that a greater number of Black women were motivated to pursue genetic testing because of the potential benefit to family members rather than to guide treatment decisions. This finding was especially pronounced among women who had daughters. The null relationship between having sons or either gender sibling and motivation driven by family benefit may reflect greater awareness of BRCA associations with female breast cancer and low awareness of male breast and other BRCA associated cancers. Our findings suggest that conversations around the importance of genetic testing may need to go beyond the importance of guiding treatment decisions and include discussions around the potential benefit for family members. Citation Format: Mya L. Roberson, Sonya Reid, Tuya Pal. Reasons for pursuing genetic testing among young Black women with breast cancer [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C007.

P403: Reasons for pursuing germline genetic testing and family sharing of results among young Black women with breast cancer

P403: Reasons for pursuing germline genetic testing and family sharing of results among young Black women with breast cancer

Abstract C114: Racial and ethnic differences in breast cancer incidence, clinicopathological features and survival by age and breast cancer subtypes

Abstract Background: Age and ethnicity are important factors in breast cancer (BC) disparities and outcome. However, studies examining both racial and age-related disparities are scarce. We sought to determine differences in epidemiological and clinicopathological characteristics of breast cancer between races in age-specific cohorts. Methods: Gulf Centre for Cancer Registration database and King Faisal Specialist Hospital and Research Center BC registry database for Saudi/Arab women (n=4,206) and Cancer Incidence in Five Continents Volume XI reports, and Surveillance, Epidemiology, and End Results for African-American and non-Hispanic White women with BC were used. Results: Early onset BC (age < 50 years) was more prevalent among Arab women (63%) compared with African-American women (29%) and White-American women (21%). Young Arab and African-American women had more estrogen/progesterone receptor negativity than young White-American women. The triple negative and (HER2)+/(HR)– BC subtypes were more prevalent among young Arab women compared to African-American and White women. The Arab women had the worst prognosis, especially among young women cohort. The differences persisted even after stratification to aggressive BC subtypes. The age-standardized incidence rate was significantly higher in developed countries than in Arab countries within the elderly-women cohort, but was comparable in the young women cohort. Conclusions: While young Arab and Black women had significantly higher frequency of hormonal negativity than White women, Arab women showed significantly higher prevalence of HER2+/HR- and TNBC subtypes than Black and White women. The racial/ethnic differences were more pronounced in the young women cohort. Citation Format: Dilek Colak, Olfat Al-Harazi, Hala Khalil, Maha M. Aleid, Amal N. Almadouj, Sukina Qanbar, Dahish S. Ajarim, Ibrahim H. Kaya, Ali S. Al-Zahrani. Racial and ethnic differences in breast cancer incidence, clinicopathological features and survival by age and breast cancer subtypes [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C114.

PhDing while panicking in a Pandemic

The Covid-19 pandemic resulted in a global panic and the destabilisation of economic, and education systems resulting in a sense of anxiety and helplessness at a societal and individual level. We offer a reflection of the end of our PhD journey, that occurred concurrently with the beginning of the Covid-19 lockdown in South Africa. Thinking through an intersectional lens we draw parallels between our precarity as black women in higher education nearing the end of our PhD journey (s) and the unpredictability of life during the pandemic. While we recognise the incompatibility of life during a pandemic and PhDing (completing a PhD), we use this moment to map out how the precariousness in academia lends itself to a sense of anxiety and helplessness often to the death of scholarship. We attribute our panic while PhDing to the process of completing the thesis as well as the sense of insecurity we have observed and experienced within academia. We argue that the casualisation of young black women academics, lends itself to the reproduction of exclusionary practices in higher education.

Wayward lives and beautiful experiments

Saidiya Hartman’s 2021 Wayward Lives, Beautiful Experiments literally re-imagines the experience of young black women in 1910s New York, employing a method Hartman calls ‘critical fabulation’, in which—rather in the form of retconned speculative fiction—she teases out gaps in the archival record. Employing Hartman’s own call-and-response technique of rhetorical questions which spotlight the uncertain answers to questions about minoritized human experience, I ask: ‘How did the “light-skinned chorines” in multi-racial 1930s nightclub and theater culture create spaces of “beautiful experiment” within their day-to-day? How did the “noisy” dance of jazz reinscribe—or subtly subvert—the white racist gaze? What did the chorines think about all this?’ This creative non-fiction essay imagines responses.

Incidence and epidemiology of conjunctival squamous cell carcinoma in relation to the HIV epidemic in South Africa: a 25-year analysis of the National Cancer Registry (1994–2018)

AimsTo describe the incidence and epidemiology of conjunctival squamous cell carcinoma (CSCC) in South Africa over a 25-year period (1994–2018), with particular reference to the HIV epidemic.MethodsIncident cases of histologically...

Obstetric experiences of young black mothers: An intersectional perspective

BackgroundIn Chicago, maternal morbidity and mortality is six times more likely among Black birthing people than white, despite policy initiatives to promote maternal health equity. Disparities in maternal morbidity and mortality reflect experiences of structural inequities – including limited quality obstetric care, implicit bias, and racism resulting patient mistrust in the health care system, inadequate social support, and financial insecurity. Although there is published literature on Black women's experiences with obstetric care, including experiences with individual and structural racism, little is known about the intersection of age and race and experiences with health care. The purpose of this study was to explore the maternal health and pregnancy experiences of young Black women utilizing an intersectional theoretical lens. MethodsIn this study, we conducted two focus groups in a sample of 11 young Black pregnant people. We conducted a thematic analysis to identify codes, themes, and subthemes of the data. ResultsWe developed two overarching themes: obstetric racism and obstetric resistance. To elucidate how obstetric racism framed our participants’ healthcare experiences, we identified sub-themes: intersectional identities as young Black women, medical mistrust, and pregnancy trauma. The second major theme describes ways in which participants protected themselves against obstetric racism to engender positive health experiences. These methods of resistance included identifying advocates and relying on trusted providers. ConclusionsThe current standard of obstetric care in the US is suboptimal due to individual and structural racism. This study provides unique data on the experiences with health care for young, Black pregnant individuals and delivers valuable insight into how individual and structural racism impacts obstetric care for young Black women.

South Africa - the African-PREDICT Study.

The high prevalence of hypertension (one of the main risk factors for cardiovascular disease) in the sub-Saharan African region has been reported, and its management remains a challenge. Although the challenge in controlling hypertension has been attributed to noncompliance with existing guidelines and best practices, lack of evidence-based guidelines, resources and poor access to healthcare; the full understanding of pathophysiology in the development of hypertension may be necessary for effective prevention and treatment strategies in the region. Due to lack of pathophysiologic understanding, the African Prospective study on the Early Detection and Identification of Cardiovascular disease and Hypertension (African-PREDICT) was then initiated to fulfill this need. African-PREDICT is an ongoing longitudinal study which started in 2013, and is expected to continue for the next 10-20 years. A total of 1,202 young black (n=606) and white (n=596) South African men and women (aged 20-30 years) who were screened to be healthy and clinically normotensive are included in this study. At each data collection phase (baseline and each 5-year follow-up) of the study, detailed measures of health behaviours, cardiovascular profile and organ damage will be taken. In addition, biological sampling for determining novel early markers or predictors will be performed. The research results reported from the African-PREDICT study will contribute to a clear understanding of early cardiovascular disease development in young and healthy black and white individuals.

The “Strong Black Girl” Dilemma

This article explores the mental health of a group of young Black undergraduate women during the dual pandemics of COVID-19 and gendered anti-Black racism in the U.S. Drawing on intersectionality as a theoretical framework, the research participants reflect on how race and gender interact to shape their struggles and coping strategies during a period of racial unrest and a global health crisis. With support from the African American Policy Forum (AAPF) and using youth participatory action research, the student researchers undertook a qualitative study utilizing focus group discussions to answer the question, How did the dual pandemics impact the mental health practices of young Black women student researchers? The article analyzes their written reflections on their mental health and self-care practices, including barriers and bridges to community and professional mental health support. The research holds implications for scholars and practitioners interested in intersectional research and ethics of care in higher education, as well as mental health advocates committed to protecting Black girls and young women.

Archiving Black Diasporas

Archiving Black Diasporas

Young Black women's resistance to the Canadian settler colonial state apparatus: Negotiating the complexities of “being part of the system that oppresses”

AbstractYoung Black peoples encounter racism and discriminatory practices and policies through formal education and in the larger society (Creese, 2013; Dei & James, 1998; Kelly, 1998). As the experiences of the research participants—young Black women between the ages of 18 and 30—highlight, a formal education system that is structured to benefit and perpetuate the settler colonial state apparatus marginalizes Black youth, including those who are deemed “successful” through their acceptance into higher education as formal education and the labour market are structured according to the logic of settler colonialism. As such, these systems operate by imposing Euro‐Western systems of knowledge, justice, and community on racialized peoples, and in particular, Black peoples. Yet, the research also shows that while injustice is the reality for young Black people, so too is resistance through a small yet powerful contingent who are refusing to remain complicit in perpetuating settler colonialism.

Burden of lymphedema in long-term breast cancer survivors by race and age.

Risk assessment for breast cancer-related lymphedema has emphasized upper-limb symptoms and treatment-related risk factors. This article examined breast cancer-related lymphedema after surgery, overall and in association with broader demographic and clinical features. The Carolina Breast Cancer Study phase 3 followed participants for breast cancer-related lymphedema from baseline (on average, 5months after breast cancer diagnosis) to 7years after diagnosis. Among 2645 participants, 552 self-reported lymphedema cases were identified. Time-to-lymphedema curves and inverse probability weighted conditional Cox proportional hazards model were used to evaluate whether demographics and clinical features were associated with breast cancer-related lymphedema. Point prevalence of breast cancer-related lymphedema was 6.8% at baseline, and 19.9% and 23.8% at 2 and 7 years after diagnosis, respectively. Most cases had lymphedema in the arm (88%-93%), whereas 14% to 27% presented in the trunk and/or breast. Beginning approximately 10months after diagnosis, younger Black women had the highest risk of breast cancer-related lymphedema and older non-Black women had the lowest risk. Positive lymph node status, larger tumor size (>5cm), and estrogen receptor-negative breast cancer, as well as established risk factors such as higher body mass index, removal of more than five lymph nodes, mastectomy, chemotherapy, and radiation therapy, were significantly associated with increased hazard (1.5- to 3.5-fold) of lymphedema. Findings highlight that hazard of breast cancer-related lymphedema differs by demographic characteristics and clinical features. These factors could be used to identify those at greatest need of lymphedema prevention and early intervention. In this study, the aim was to investigate breast cancer-related lymphedema (BCRL) burden. This study found that risk of BCRL differs by race, age, and other characteristics.

“Unmanageable”: Exploring Black Girlhood, Storytelling, and Ideas of Beauty

AbstractThis article explores how Black women use storytelling to construct their Black girlhood on the axes of Black hair and beauty politics. The study includes a discourse analysis of a series of focus groups with a student organization dedicated to Black women’s natural hair at a midwestern predominantly white institution. I ask: How do young Black women use storytelling as a tool to construct, recall, and (re)negotiate their childhood experiences of hair and beauty politics? I explore the ways these women use storytelling to articulate how their Black girlhood was in part shaped by encounters with hair politics and constructions of beauty. These “hair moments” that they recall reveal complex negotiations of standards of beauty. I analyze three themes that emerge from these conversations: (1) shared experiences around play, imagination, and relationship to images of mainstream beauty; (2) family as a social unit that socializes Black girls around beauty; and (3) adolescence, prom, and contested notions of appropriate “formal” adornment. These themes among these young women illustrate shared experiences, negotiation/critique, and meaning making around concepts of beauty. This study contributes to conversations around beauty culture, Black hair politics, and the bourgeoning field of Black girlhood studies. Through understanding how Black women reflect on their girlhood experiences of the politics of hair and beauty, we can better understand the inner experiences of Black girls, and the complexities of how they come to know and understand their bodies.

Eating to cope: Advancing our understanding of the effects of exposure to racial discrimination on maladaptive eating behaviors.

Racial discrimination is a stressor for young Black women that leads to poor health outcomes, including maladaptive eating. This study presents findings on racial discrimination and maladaptive eating behaviors (overeating, LOC eating) using ecological momentary assessment (EMA). Black emerging adult women (N=27) with overweight or obesity participated in a 14-day EMA study examining exposure to racial discrimination, eating behaviors, and racial identity. Frequencies and chi-square tests were used to characterize the type of racial discrimination experienced and frequency of overeating. Mixed effect ordinal logistic regression models were used to assess the relation between racial discrimination and maladaptive eating. Moderation analysis was conducted by creating interaction terms for discrimination and racial identity variables. 81.5% of participants reported experiencing racial discrimination. Young Black women reporting exposure to racial discrimination were more likely to endorse higher levels of both overeating and LOC eating compared to times when discrimination was not experienced (p < .0001). Racial identity moderated the link between racial discrimination and maladaptive eating (overeating, LOC) such that reporting greater levels of private regard buffered the deleterious effect of racial discrimination. Higher levels of public regard exacerbated the association between racial discrimination and both overeating, and LOC. Higher centrality worsened the relation between racial discrimination and LOC. Young Black women might use maladaptive eating to cope with exposure to racial discrimination, which underscores the importance of examining the link between racism and disordered eating, particularly among Black women submerged in a society that continuously exposes them to racial discrimination. Emerging adult Black women are exposed to racial discrimination daily. In theory, exposure to racial discrimination could contribute to overeating and loss of control eating in this population. Using ecological momentary assessment, to capture experiences and eating behaviors in the moment they occur, this project quantified the magnitude of racial discrimination and how it was associated with maladaptive eating behaviors. Further, it examined ways in which racial identity was linked to this association.

Perceptions and experiences of young Black South African women with obesity from a low socioeconomic community after following a 12-week structured exercise intervention.

BackgroundPrevious research has shown that Black South African (SA) women perceive a bigger body size to be acceptable and desirable, but nonetheless have shown interest in participating in community-based exercise programmes. This study aimed to investigate perceptions and experiences of participating in a 12-week exercise intervention designed to study the mechanisms of insulin sensitivity and secretion in young Black SA women with obesity.MethodsQualitative data was collected from young (23 ± 2.9 years) Black SA women (n = 17) residing in a low-income setting in Cape Town, who took part in a 12-week structured exercise intervention. Focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted 1–4 months after the completion of the intervention. These were all audio recorded and took between 45 and 60 min. The recordings were transcribed, translated and qualitative content analysis, entailing a systematic process of coding and identification of salient themes, was conducted using the ATLAS.ti software.ResultsSix broad themes were identified from participants' experiences and perceptions: motivational factors, acceptability of the programme, barriers, sustainability and influencing others, benefits of being physically active, definitions and perceptions of exercise. Anticipated weight loss and financial remuneration were identified as motivational factors for enrolment and retention in the exercise programme. Aspects of the training environment and feelings of wellness appeared in the acceptability, sustainability and benefits themes, whereas time scheduling and travel constraints were regarded as barriers. Exercise was perceived as the maintenance of a healthy body, and in some cases, only relevant for specific groups.ConclusionFinancial considerations played an important role in participants enrolling and staying in the 12-week exercise intervention. Participants liked many aspects of the intervention and identified physical and mental benefits that seemingly outweighed the barriers and disliked aspects of the programme. Optimizing the acceptability of exercise programmes and maximizing the opportunity for participants to experience improved mental well-being may contribute to attracting and retaining young Black SA women in exercise programmes.

Black common sense

abstract This article explores ‘uhuru’ as a critical noun through a reading of the 2020 music video of Sun El-Musician (featuring Azana), ‘Not Yet Uhuru’. A form of rendition of Letta Mbulu’s (1993) ‘Not Yet Uhuru-Akhamandela’, various other echoes of this, conjured in Makhosazana Xaba’s (2019) poem of the same name, are double speak, elegy, repetition and onomatopoeic in action. One of its signifiers appears in the use of the biographical, with uses against a ‘knownness’ of iconographic Black figures, even while the music video appears in a space and time where a ‘new’ signifier of politics is conjured in the image of young black women. Turning to the figure of the Black femme as a belated figure of uhuru, Black common sense is an incursion on and against singular/linear time, os an ‘as is’ sensibility.

S1602 The Disproportionate Rise of Non-Cardia Primary Gastric Cancer Incidence Rates in Younger Women Is Driven by Black and White Race but Not Asian Race: A Population-Based Time-Trend Analysis Using the USCS Database

S1602 The Disproportionate Rise of Non-Cardia Primary Gastric Cancer Incidence Rates in Younger Women Is Driven by Black and White Race but Not Asian Race: A Population-Based Time-Trend Analysis Using the USCS Database

Knowledgeable, aware / interested: Young black women's perceptions of pre-exposure prophylaxis.

PurposeHIV in the United States disproportionately affects young Black women. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention option that has the potential to reduce HIV incidence among HIV-vulnerable populations. However, data regarding women's awareness, interest in starting, and feelings of acceptability or stigma about PrEP remains limited, particularly among adolescent and young Black women.Materials and methodsA cross-sectional survey was conducted with 100 sexually active young Black women ages 13–24 years attending women's health clinics in Chicago, IL. Descriptive statistics were used to characterize the sample and determine more about what the PrEP needs and barriers are in this community. Associations were modeled using logistic regression and 95% confidence intervals for both bivariate and multivariable models.ResultsIn our survey (N = 100), half of study participants (50%) expressed interest in starting PrEP in the next three months and a majority (80%) of young women were confident they could obtain PrEP. Pregnant young women were significantly more interested in starting PrEP than non-pregnant women [OR 2.3 95% CI (1.0, 5.4)], p = 0.05), however, this association did not remain significant in adjusted models.ConclusionsThis study provides a more complete understanding of awareness, interest in, and acceptability of PrEP among adolescent and young Black women attending women's health clinics. Findings indicate sustained interest in starting PrEP, reduced stigma, and increased awareness of PrEP among young Black women. These findings suggest that integrating PrEP into women's health clinics is a promising strategy to increase awareness and utilization of PrEP and decrease HIV transmission among youth at highest risk.

The Rise and Normalisation of Blessee/Blesser Relationships in South Africa: A Post-Colonial Feminist Analysis

Since 2015, young urban black women in South Africa have been posting images of luxury items on social media platforms such as Instagram. These women claim that their luxury items are gifts from their ‘blessers’/wealthy men in exchange for sex and companionship. This has led to the rise of the ‘blesser culture’ on social media and the prevalence of transactional sex for upward mobility and status. This article provides a post-colonial feminist evaluation of 10 young black women from northern Johannesburg. It examines their motivations for engaging in these relationships. It draws from Stoebenau et al.’s (2016) theoretical framework that describes the three paradigms of transactional sex, ‘sex for basic needs,’ ‘sex for upward mobility and status’ and ‘sex and material expressions of love’ as a continuum of deprivation, agency, and instrumentality. This analysis challenges research frameworks that limit transactional sex to matters of HIV/AIDS transmission, and the framing of women as powerless victims of men. The article reveals these women seek blessers based on relative deprivation, to access a more high-status lifestyle and upward social mobility and from a position of agency. They view blesser relationships as a mutually beneficial exchange that allows them to give sex to access the commodities of modernity.