So, Susan Gubar had to get cancer to start caring about women of colour. I lost my own mother to cancer and I developed a tumour myself already at the age of 18, but I do not feel at all sorry for you Susan. The one I truly feel for is Jean Rhys. What month was the madwoman in the attic first published in 1979? Was it after Jean's death, or did she have to live to witness the cold dismissal of her work by your whitewashed, so-called feminism?
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Maternal mortality studies and stories show that Black women's post-partum concerns are often disregarded by health care providers, with life-threatening and life stealing consequences--Serena Williams being the most famous recent example. While this article focuses on economic and environmental factors, I have to wonder how personal racism (conscious or unconscious) might lead to the subtle symptoms of diseases like ovarian cancer being dismissed too. Disparities in how people are treated within the system are harder to measure but just as important.
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I had to look up what happened to Serena Williams - all I knew was that she had a baby not too long ago.
It's hard to know if the medical staff ignored what she told them because she is Black or because she is a woman. They said that they thought she was confused because she was on pain medication, so there is that, as well.
Regardless, it's clear that communities of People of Color and poor people in general have fewer resources, such as the number of doctors available. And then there's the issue of cost.
For many years, I have argued that in addition to food, shelter and clothing, that everyone needs affordable medical care. And if people don't have the money to pay, affordable should mean free.
This is unspeakably
tragic. Not just
the article but
the muted response.
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Thanks for this. There needs to be a major effort on the part of doctors to recruit more folks for clinical cancer trials, and more people of various demographics. The parameters of the trials may also need to specifically include people of various backgrounds.
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There is no question that race and socioeconomics play a major role
in these healthcare disparities. In Baltimore city where the obesity rates for black men and women are 46 and 38% respectively, most families rely on a steady diet of McDonalds,Burger King and Taco Bell. Poor nutrition lack of access to affordable health care are major issues.
And responsibilty for diet resides with whom?
This documentary film isn't just about race-- watch the trailer in which blacks and whites say the very same things about being poisoned by the Koch brothers' companies. This is a story about social justice and lack of sufficient government regulation of the enterprises owned by the "donor" class that owns most of our politicians. The most accurate predictor of people's life expectancy is their zip code [http://fortune.com/2017/05/08/us-life-expectancy-study/]. If you life in a polluted poisoned environment, you will suffer the consequences regardless of race.
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Mrs. Obama attempted to enlighten people about the lack of nutritional food in communities, she tried to educate the public at large and the white GOP claimed that the government was telling them what to eat etc. while they went home to supermarkets, hunted for there dinner and good medical care.
Black communities have been destroyed by government policies and always received the worst care in every life experience venue. Inexperienced teachers, falling down school buildings, polluted water, you name it minorities have had to deal with it. Minorities are not valued as people but as cattle, so why should cancer be any different. Knowing so many people with cancer, the doctors/nurses need to be carefully monitored because many of them don't have the interest of the patient so when we talk about medical care, we need to be informed because medical care is deliberately never administered the same to all ethnic groups. Health care is a business and those people who cant pay the top dollar do not get the services they deserve.
don't believe me look at the hospital ratings and the truth will bear me out
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My first response: How wonderful that Susan Gubar who came to our attention by writing so graphically about her individual experience of cancer has time and interest to pay attention to disparities in who gets cancer. And then I read, with dismay--I had imagined myself in a community in which readers would be on the same page--the comments pushing back. (Many commenters make the mistake of suggesting that race doesn't matter for health in the USA because it is not a sound genetically defined category.) Hmm. Much food for thought.
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Racializing disease implies that race is a natural phenomenon with firm roots in the genetic makeup of a person. This assumption runs against scientific evidence. See the American Anthropological Association’s position paper on this issue (1998). After all, how ‘black’ is a black person since African-Americans’ genetic make up varies greatly? There may be pockets of populations that share gene pools, but environmental (nurture as against nature) factors seem to be a much better explanation.
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How many people of European or Asian decent have the sickle cell mutation? There are many genetic diseases and traits that are common for what we call races making your point not exactly accurate.
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Sickle cell is found in Greece and Italy and other Mediterranean countries. It has more to do with genetics than race.
5
Race is indeed a social construct, but it is often based on heredity (genetics), so it's all of a piece oftentimes.
3
Race is a social construct, not a biological one. As humans, 99.99% of our genome is identical. But buried in the miniscule genetic variation between populations, you can find different responses to medical treatment.
In the past 30 years, researchers have started increasing efforts to include women & non-white people in medical studies and clinical trials. Those efforts have to be stepped up if we are to adequately assess how responses to treatment vary.
Of course, among black communities, the legacy of abusive and unethical studies casts a long, dark shadow over any current investigations. The medical community will have to rebuild that trust in order to move forward.
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The medical literature is clear. The main cause of a higher incidence of cancer in African Americans and all people with a dark skin is most probably because they don`t make enough vitamin D. Vitamin D is important for the immune system. One should aim at 80 ng/ml (blood test). And don`t forget the cofactors of vitamin D: Magnesium, Boron, Vitamin A and vitamin K2 (MK7).
5
Thank you for this very important article. You beautifully address so many of the problems that exacerbate the racial differences in cancer mortality.
I'll chime in one more - about the aggressive type of breast cancer, called triple negative, which is not ruled by estrogen or progesterone and has no HER2 receptors. Triple negative breast cancer is more common in the African American community than any other group. Is is coincidence that this type of cancer is also the only one without a targeted treatment? Triple negative breast cancer is still treated by old-fashioned chemotherapy, with its myriad side effects.
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It is a fact that 10 - 20% of breast cancers are triple-negative and that a high proportion of black women have this aggressive form of disease but I feel that the lack of an additional targeted treatment is a coincidence. Science has been researching treatments for triple-negative so this should not be racialized. Bear in mind that immunotherapy treatment for HER2 was approved recently in 2006 and that research is for the most part done on HeLa cells named after the African American donor Henrietta Lack - what works on her cells works for everyone.
1
Patient-centered care is supposed to be more sensitive to the different constraints that different people face in their lives. Your sense of “autonomy” may vary.
1
It is most unfortunate that wherever we look at medical issues and problems, racial issues come to the fore. It should not be.
14
But in order for this to be so we have to find out why there are racial disparities and try hard to fix them.
2
I grew up in an industrial area. Everything from paper to machine coolants and so on. The odd thing is that while there was a large black population mostly white people got cancer. It wasn't addressed for almost half a century and it still is being fought by some large companies in court. Does race have to play a part in every aspect of life or are we, as a nation, ever going to grow up and represent the people who are in need of representing. Rich, middle class or poor money does you no good if you are dying from something incurable.
16
I understand your point, but please try for a minute understand the role that race plays in the health and sickness of people of color. I for one can speak of the stress of constant racism, and I am an educated Black woman. White people cannot understand the stress of being Black in the U.S. I don't expect them to either. What I do expect is for whites to use basic empathy to try to understand what we go through everyday. Poverty as a whole plays a role in health status. But ask yourself what it would be like to stack race onto poverty. The article talks about race and cancer. It does not mean that we are to ignore the plight of whites. Maybe it is just me, but money makes a difference.
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Very well stated. I’m with you 100%. The constant stress and anguish systemic racism and poverty create must contribute to health problems in the populations that live within them. Studying these sectors can only benefit the rest of us.
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Only a matter of time before this was turned into a racist issue....
It's hard to be anything in this country, life is hard.
Failure and sickness cannot always be tracked back to being a minority, that excuse is getting old.
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