Date of Conferral
3-13-2025
Degree
Ph.D.
School
Public Health
Advisor
Leah Miller
Abstract
Black/African American women face significant health disparities in hereditary breast and ovarian cancer syndrome (HBOC) due to systemic barriers to genetic counseling and testing, leading to poorer survival outcomes. Guided by the Social Determinants of Health (SDH) framework and Intersectionality Theory, this quantitative descriptive study examined disparities in access to genetic services, socioeconomic barriers, and healthcare biases. Data from the 2023 National Health Interview Survey (NHIS) included 1,357 Black/African American and White women aged 25–65 with a family history of HBOC. The Surveillance, Epidemiology, and End Results (SEER) dataset analyzed 15,684 Black/African American and 105,547 White women with breast cancer, and 773 Black/African American and 6,304 White women with ovarian cancer diagnosed between 2012 and 2021. The study assessed how health disparities impact mortality rates, the association between insurance coverage and genetic service utilization, and barriers to accessing genetic testing. Kaplan-Meier survival analysis revealed lower 5-year survival rates for Black/African American women. While insurance significantly improved genetic testing utilization for White women, no significant effect was found for Black/African American women. Significant barriers included healthcare access issues and underrepresentation in research, highlighting the need for culturally sensitive interventions to reduce cancer mortality and promote equity in genetic service access for Black/African American women at high risk for HBOC.
Recommended Citation
Fletcher, Alexandria E., "Understanding Hereditary Breast and Ovarian Cancer Syndrome in Black/African American Women: Implications for Equitable Outcomes and Interventions" (2025). Walden Dissertations and Doctoral Studies. 17476.
https://scholarworks.waldenu.edu/dissertations/17476
