Research shows that Blacks from the diaspora and African Americans have the highest death and shortest survival rate among ethnic groups diagnosed with cancer, i.e., they have the highest mortality of any racial/ethnic group for all cancers combined while African American men have the highest overall cancer rates.
There are many reasons for this phenomenon - time of diagnosis (usually late stage diagnosis); lack of access to adequate health care; less knowledge (or even denial) about cancer symptoms; lack of awareness or limited access to cancer screening services, and no health insurance, period.

Other important reasons for late diagnosis and early deaths are the cultural beliefs that surround a diagnosis of cancer within this diverse community. Many blacks immigrate with their health belief systems intact and are at times very loathe to change. These beliefs can be that once you get cancer no turning back, you die; to the idea that cancer is karma - something bad that you did comes back as cancer. The machismo factor among some male members of this community might be among the reasons for high tolerance/high threshold for pain. For them, engaging in preventive health behavior might not be macho, hence they delay going to the doctor until it is too late.

Language plays an important part in the understanding of the diagnostic process. Many from the diaspora have different accents, intonations, and speak other languages and dialects, which are at times incomprehensive to the untrained ear.

In addition, the shortage of black medical personal specializing in the different "ologies" of the disease also introduce a communication and relational barrier to the doctor-patient relationship. Though poverty is directly linked to poor health care, however, it could be stressed that having more black doctors would help end a legacy of suspicion in the black community.

For example, people have knowledge about a study that intentionally left black men untreated for syphilis (the Tuskegee study where 400 black men were left untreated so that the disease could be studied for 40 years, even though penicillin was used as a cure during the time); and the rumor that a famous blues singer (Bessie Smith) bled to death from an accident because she was turned away from a white hospital have contributed to that legacy.

The non-participation or reduced participation of these communities in the screening process might also play a large role in the high incidence/prevalence of cancer among them. Emotions might affect frequency of visits to health care services, as anxiety of the results produces more fear than the possibility of having the dreaded disease.

And to top it off, lack of health insurance. Many people in these communities do not want to know that there is anything wrong with them, as their fear is not only about knowing but also about what to do with the knowledge that they have cancer, how to access treatment modalities without adequate insurance. Their focus might be on disease care (wait until...) and not on health and preventive care(check-ups and screenings), which might just correlate with the overall focus of the health system. Prevention is not seen as necessary for maintaining good health, but treating a disease is.

Thus, at times there is complete denial among many Blacks and African Americans as they are afraid to know. Moreover, the daily battle to survive in a country that can be insensitive to the needs of immigrants, the poor, the sick, and distressed is so overwhelming that many Blacks and African Americans ignore the warning signs. Until it is too late.

There is a preponderance of Black/African American men in jails - we might not agree with how they happen to land in jail, but we might have some understanding as to why they are incarcerated.

There is a preponderance of Black/African American men dying of cancer - we know and agree on the why - however, what can we do about it?

More light needs to be thrown on this subject.

Medical schools need to orient more Blacks/African Americans to specialize more in the "ologies" like histology, radiology, oncology, urology, immunology, etc..., since we do have quite a few black sociologists, psychologists...

Political pundits need to take this on as an issue in their campaigns.

The Black/African American community needs to develop a combined strategy for addressing this issue of targeted health care and examine what each of us can do at the individual level to support ourselves, our families, each other.

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Sources: http://jmh.sagepub.com/cgi/reprint/1/1/29 http://orig.jacksonsun.com/fe/cod/index.shtml http://www.blackcancernetwork.org/Blog.php

Author's Bio: 

Former United Nations employee for over thirty years living and working around the world (Haiti, Togo, Madagascar, to name a few countries) drilling wells and building latrines to help provide safe drinking water and adequate sanitation to poor communities. Very interested in health, nutrition and environmental issues. Muriella's Corner, the online newsletter she edits was created as a result of health challenges she overcame.