Evaluation of disparities in perceived healthcare discrimination among BRCA1/2-positive women from medically underserved populations

ABSTRACT

The current study evaluated associations between disparities relating to race/ethnicity, poverty status, educational status, and odds of experiencing healthcare discrimination among women with BRCA1/2 mutations. We conducted a cross-sectional study of United States (US)-based women (18+ years) who have tested positive for BRCA1/2 mutations within the past 5 years and who identify with one or more medically underserved populations. 211 women were recruited from BRCA1/2-oriented support groups and completed an online survey. Adjusted odds ratios (aORs) and 95 percent confidence intervals (CIs) were estimated using multivariable logistic regression models for associations between race/ethnicity, poverty status, education, and perceived healthcare discrimination adjusting for covariates. 182 women were included (31.3 percent were cancer survivors). Most were NHW (67.2 percent) and younger than 50 years (83.2 percent). Racial/ethnic minorities were 2.6 times more likely to report receiving poorer service than NHW women (95 percent CI, 1.26–5.33, p = .01). Associations with poverty status, education, and healthcare discrimination outcomes were not statistically significant. Improving patient-provider interactions that can contribute to medical mistrust should become a priority for the care of high-risk US minority women with BRCA1/2 mutations.

KEYWORDS:

• BRCA1
• BRCA2
• breast cancer
• gynecologic cancer
• health disparities
• healthcare discrimination

Acknowledgments

We would like to acknowledge all of the BRCA1/2-positive women who shared their experiences with us.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, KED, upon reasonable request.

Additional information

Funding

This work was supported by the Johns Hopkins Ho-Ching Yang Memorial Faculty Award. KED received research support from the National Cancer Institute [T32CA009314] Cancer Epidemiology, Prevention, and Control training program.