Monday, November 7, 2011

Rural women at higher risk for breast cancer

A new study from the University of Missouri found women living in rural areas are more likely to be diagnosed with late-stage breast cancer. Faustine Williams, a Ph.D. student with the Office of Social and Economic Data Analysis (OSEDA), conducted the study in conjunction with the Department of Rural Sociology. Williams found that women who travel between 50 to 75 miles to obtain health care are 10% more likely to be diagnosed with late-stage breast cancer than those who live closer to health care.

Due to the time and money required for travel to reach a health care facility, rural women are less likely to seek preventative treatment and testing. This means rural women aren't getting annual mammograms, which help detect breast cancer at earlier stages. Williams pointed out the importance of diagnosing breast cancer at the earliest stage.
The stage at which the cancer is diagnosed has tremendous impact on the type of treatment, recovery and survivability. In most cases, the earlier cancer is detected and treated the higher the survival rate for the patient.
Research, like Williams' recent study, that suggests rural women have a high risk for late-stage breast cancer diagnoses lead to subsequent studies that investigate the best strategies for breast health awareness in rural populations. Researchers ask questions such as, "What messages will motivate rural women to attend to breast health issues and become actively involved in their own breast health?" and "Why don't rural women seek preventative health care?".

A study from March 2011 published in the Journal of Consumer Affairs studied women's motivation for seeking breast cancer prevention screenings. The study, entitled Developing Breast Health Messages for Women in Rural Populations, found that women in rural populations seek screenings primarily out of concern for their families. Women who participated said they sought breast cancer screenings because they "need to be around for those [they] love." Dr. Eric Haley, who conducted the study, stated:
Our research shows that facts and figures don't motivate [rural women]. Speaking to rural women in a way that recognizes their vital role in family and community motivates women to take control of their health. Regardless of how they are commentated, PSAs, brochures, video, web sites or person-to-person, breast health promotional messages must break through the clutter of all messages in the market.
This study, unlike previous studies on the issue, shows that women are strong and willing to take control of their health if motivated to do so. It found, specifically, that messages acknowledging women's role as "caretaker" in the household resonated well with the Appalachian women who participated in the study. Interestingly, these women responded negatively to messages about the empowerment of women. Hopefully future women's health programs will look to Haley's research when developing programs in rural areas. Haley's research can help these programs understand how to create messages that incentivize rural women to seek preventative breast health care.

Missouri, like many other states, has a free breast health-screening program called Show Me Healthy Women (SMHW). The program's motto is, "I deserve to live the longest, healthiest life possible." According to Haley's research, this message may not resonate with rural women who could see the motto as selfish and not reflective of the women's perceived social role as caretaker.

Unfortunately, the fact that SMHW's message does not incentivize rural women to seek preventative care may not matter. Williams points out that the SMHW clinics are not evenly distributed geographically and many rural areas in Missouri still do not have a local clinic. This leaves rural women still less likely to seek medical care due to the travel and expense required to do so.


KevinN said...

I wonder if some sort of roving clinic might be able to better serve rural women and provide the types of screenings that can detect breast cancer in its early stages. Perhaps rather than trying to convince rural women to head to clinics in more metropolitan areas, those clinics could be brought to them. Perhaps hospitals or other organizations could organize some sort of mobile clinic that can be easily transported to provide greater healthcare access to rural people. It wouldn't even have to have all the trappings of a full hospital. Instead, simply providing screening tests and providing information about how to obtain treatment if something shows up might be sufficient to ensure that rural people get access to better healthcare.

JT said...

It's interesting that the facts and figures don't motivate women to seek breast cancer screenings. I happened to work on an econometrics research paper focusing on behavioral economics using anti-tobacco advertising to determine its effectiveness on targeted adolescents. The results are strikingly similar. But as Kevin points out, what if the screening clinics came to areas where they are missing? Or what if there was a bus-line (like the Justice Bus) that transported women to metropolitan areas for health screenings in general? Beyond breast screenings? If it was a group effort, maybe it could lower travel expenses.

oceguera said...

I agree that it is necessary for the public health and medical industry to try to be more understanding of the tremendous spectrum of cultural values and ethics that diverse communities hold. Specifically, when trying to generate awareness about a health issue. Framing things in ways that are in line with the population's cultural values and recognizing their knowledge or value system as just as legitimate as that of institutional one. Marginalized communities are not ignorant of the problems they face, there are just a plethora of reasons that prevent them from doing things in a certain way--in this case spending time taking care of yourself to prevent deadly diseases.