Institutionalized racism and classism: A meta analysis of Canadian and American studies of breast cancer care.

摘要

There are many diverse factors that can affect the health of a population. Competing theorists tend to focus on the biological view that health problems are genetically determined and influenced by personal factors versus the structural notion that social and economic forces primarily determine population health. Numerous American studies reflect the prevalence of health care disparities affecting minority Americans. These disparities are similar to the experiences of Canadian immigrants and aboriginals as both are rooted in historical and contemporary inequities that can be traced back to legalized segregation and oppression. Much of American social and economic life remains ordered by race and ethnicity. Within the context of American health outcomes, cancer survival studies have demonstrated that people of colour experience poorer prognosis. Breast cancer, a sentinel health outcome, is a disease known to result in successful prognosis when prevention/education, adequate screening, treatment and follow up are provided. A comparison of retrospective and prospective Canadian and American breast cancer studies reveal great variability in health delivery and outcomes. In particular, American studies show differences of female breast cancer based on race, and socioeconomic variables. Much is yet to be learned with respect to minority breast cancer survival outcomes in Canada. Research has shown that Canada's universal single payer health care system may explain survival advantages when compared to the American managed care system, where cost containment and welfare reform has had a tremendous impact on the accessibility of medical care and treatment for minorities. Social policies could solve racial inequities in health outcomes on both sides of the border.