Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Cynthia Newell


African American women are more likely than White women to be diagnosed with breast cancer after the disease has progressed to advanced stages. Further, African American women experience higher breast cancer mortality rates than White women at all stages of cancer diagnosis. The purpose of this quantitative comparative study was to examine differences between implementation of the Affordable Care Act (ACA) and 5-year breast cancer survival rates among African American and White women. The independent variable was African American women and White women who were survivors of breast cancer after the ACA implementation; the dependent variables were breast cancer survival rates after ACA implementation. Data were gathered from the Surveillance, Epidemiology, and End Results (SEER) program for the time period between 2010 and 2015. The theoretical foundation for this study was Penchansky and Thomas’s concept of healthcare access. This quantitative study followed a retrospective design using cohort data from the SEER program. Data were analyzed via independent samples t-test and chi-square test of association. Results indicated that White women had a higher 5-year survival rate than African American women; the association between race and survival was significant. White women survived also survived breast cancer for more months, on average, than African American women. Findings indicate that racial disparities in breast cancer survival have endured, post ACA. The primary social change implication is that more research is needed to improve the breast cancer survival rates of African American women. The ACA may be working to help reduce the racial disparities in breast cancer survival, but providing access to healthcare is not necessarily enough.