RACISM AND CANCER PREVENTION: THE ROLE OF PERCEIVED RACISM AND RACE-BASED RESIDENTIAL SEGRETATION ON BEHAVIORAL CANCER RISK PROFILES
MetadataShow full item record
Problem statement: Cancer is a significant public health problem in the United States; since 1999 cancer has been the leading cause of death among those 85 years and younger. Racial/ethnic disparities in cancer exist. Some groups have experienced decreases or a leveling off with respect to their cancer burden while others have experienced increases. Though there is evidence that lifestyle and screening behaviors may contribute to a reduction in the cancer burden, they are not being fully utilized by all adults with prevalence rates varying by racial/ethnic groups. Racism has been hypothesized as a potential contributor to these disparities with limited research evaluating the relationship between racism and cancer risk behaviors. Methods: The purpose of this study is to evaluate the relationship between racism and cancer risk profiles with data obtained primarily from the 2003 California Health Interview Survey and the 2000 US Census. Racism measures included perceived racism at the individual-level and race-based residential segregation at the county-level. Cancer risk profiles were measured as a set of primary (e.g., tobacco use, physical inactivity) and secondary (e.g., lack of participation in early detection) cancer risk behaviors. Analyses included individual level and multilevel linear regression modeling. Results: The prevalence of perceived racism varied by racial/ethnic groups with minority groups having reported perceived racism experiences between 57% and 85%. In individual-level analyses, perceived racism and cancer risk profiles were associated with fixed effects that were moderated by gender, age, and education. Race/ethnicity-stratified analyses showed that these relationships were not maintained across all groups. Multilevel analyses demonstrated evidence of unexplained variance at the county-level iii for most racial/ethnic groups; after accounting for segregation and area correlates, for secondary risk profiles no more unexplained variation remained by county. Conclusion: This research underscores the importance of considering social determinants of health behaviors and understanding not just individual characteristics that shape these behaviors but also contextual effects. Further research into the association of racism and cancer risk profiles is needed to establish causality, identify additional pathways, and to begin to address some public health policy and practice solutions to prevent racism and its negative consequences on health.