The stigma regarding health concerns in the Black community stems from the "old-school mentality" of don't tell people your business and leads to lack of health awareness, a panelist said at an event on Black's women's health.
Breast cancer affected her differently as a Black woman, said Francine Holness at the virtual event “Best health for Black women 2024,” hosted by the Peter Gilgan Centre for Women’s Cancer at Women’s College Hospital (WCH) on June 13. Holness said she was grateful Black nurses were among those who took care of her as they were able to help her understand some of her symptoms, particularly with her skin, that were different from the symptoms of white women.
The event aimed to provide patients and medical staff with health education and resources tailored specifically to Black women, according to the event information.
Elaine Goldburn, clinical director at the Peter Gilgan Centre, said Black women’s experiences of the health-care system and health care differ significantly from non-Black women.
Dr. Aisha Lofters, family physician at Women’s College Hospital, said breast cancer is the most common cancer among Canadian women. “And Black women face unique challenges, including having to navigate a health-care system that has not been designed for us.”
“We note from (US) research that African American women are 40 per cent more likely to die from breast cancer compared to their white counterparts. And we know that we are way behind in studying racial disparities here in Canada,” she said.
Dr. Nazik Hammad, a medical oncologist at St. Michael's Hospital, said among the factors influencing the long-term outlook of cancer patients are age, overall health, organ function and response to side effects of cancer drugs.
“Other factors are also related to the environment, social support, ability to access care and trust in the care, especially for us in the Black community. And these factors can in turn be influenced by other factors, such as chronic life stresses, racism, poverty and unemployment,” she said.
Dr. Crystal Clark, a scientist and associate head of research at WCH, said it was important to urge Black women to participate in clinical trials. Clark said the trials are safe and well-designed to answer important clinical questions.
“That being said, I am a physician, and I've written clinical trials, and I participate in clinical trials. And it's one of our best ways to offer new, you know, cutting edge treatment.
“I want my people to have access to these trials, to have access to these drugs,” she said.
Dr. Hammad concurred and said there is a need to research Black women's experiences to make informed policies and educate the workforce.
McInnes used the example of Black women's experience with lung cancer treatment to illustrate.
Tobacco use remains the leading preventable cause of death in the U.S., accounting for about one in five deaths each year, according to the American Cancer Society.
Historically, similar numbers of Black women and white women smoked. But since the 1990s, smoking among Black women has decreased. “And so, Black women are at a reduced rate of lung cancer compared to white women,” said McInnes.
But when Black women do develop lung cancer, it's at an earlier age than white women, yet it is diagnosed at a later stage. “I suspect that a lot of this relates to access to health care,” he said.
Dr. Aisha Lofters said health-care providers can be better engaged with the Black community to provide lung cancer awareness and prevention by talking to their patients.
“We need to be asking patients about smoking history. We know that there's a lot of stigma around cigarette smoking. Or they might feel that there's shame or that there's judgement involved,” she said.
She said it is the job of health-care providers to create a safe and open environment where people can talk about these things.
Elaine Goulbourne said cancer awareness is essential in Black communities. It starts with knowing one’s family history and having conversations around lung cancer and other forms of cancer with family members.
Dianne Bissessar, another breast cancer survivor, who is also Black, said she wished she could have shared her struggles in the hospital with another Black woman and a Black doctor who understood the unique challenges she faced of being a Black woman with cancer.
Other examples were presented. for instance,a hair relaxer is a type of lotion or cream generally used by Black women to chemically straighten their hair.
Dr. Clark mentioned hair relaxers are dangerous in regards to increasing the risk of cancer.
“I think a lot of us have relaxed our hair for a long time,” she said. But hair relaxers can be dangerous. “They're associated with an increased risk of uterine cancers and fibroids." Only recently have researchers started studying them.
Hair relaxers "are not safe. I would strongly recommend against the use of hair relaxers,” Clark said.
Dr. Cynthia Maxwell, vice-president and lead medical executive at WCH, said Black women in need of mental health care often hesitate to ask for it.
According to the CDC, mental health includes one's emotional, psychological, and social well-being.
“Data reports tell us that members of the Black community are less likely to access mental health services compared to other racial groups, Maxwell said.”
Dr. Clark said one of the main barriers Black women face in accessing mental health care are location of mental health services, time, cost of quality care, shortage of mental health workers and religion.
She also said that having to see someone, who may not understand one’s culture can be discouraging when seeking a therapist.
“Some of these issues are around stigma and cultural misconceptions around mental health within Black communities, communities affecting Black women's willingness to seek help,” said Clark.
