Breast Cancer in America: Social Determinants, Epidemiology, and Role of Primary Health Care Nurse

Running head: BREAST CANCER IN AMERICA
BREAST CANCER IN AMERICA
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Breast cancer in America is one of the significant health issues suffered by the women
and potent reason for high mortality rate since 1990 (Horwitz, 2016). Incidence of breast cancer
is high due to late detection, inappropriate use of mammography and racial discrimination. There
is the requirement for improvement of survival rate of the breast cancer patients in America,
hence needs critical analysis on the identified health issue. Therefore, the main goal of the paper
is to discuss the high prevalence of breast cancer in America population. Firstly, the paper
addresses the social determinant of health, counting social justice and equity by analyzing the
methods through which it has contributed to causing breast cancer. Secondly, the paper
highlights the epidemiological studies that have shown the prevalence of health issue. Thirdly,
the papers have discussed the role and responsibility of primary health care nurse in solving the
health issue, and lastly, it reflects on the use of cultural competency in Primary health care nurse
role in supporting breast cancer.
The social determinant of health studied by the researcher in relation to the incidence of
breast cancer, its diagnosis and survivals which includes unemployment, racial discrimination,
equity and social justice, socioeconomic status and social support (Horwitz, 2016). These social
health determinants have contributed to breast cancer in America. The socio-economic factors
like poor education and low income have led to increasing in the risk of breast cancer. It is
obvious from the recent studies that these factors are positively linked with the high rate of breast
cancer among the racial and ethnic groups (De Maio et al., 2019). Moreover, low socioeconomic
status people do not have access to adequate health service that has contributed to a high rate of
breast cancer in America.
Among the social health determinant, equity and social justice are the primary cause of
breast cancer in America. The survival rate of breast cancer women in America is low due to

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social injustice and health inequity. Data from the study of De Maio et al. (2019) indicate that
there is enormous inequity among the white and high-income women and racial minorities
women in terms of breast cancer care and treatment. Women who belong to the racial and ethnic
minorities groups live in rural areas, and due to inadequate knowledge, they are diagnosed with a
later stage of breast cancer. There is no timely detection and follow up care available to poor
women than the white and high-income groups. It is evident from the study of Otis et al. (2019)
that breast cancer can be treated if it is detected at an early stage and given adequate care.
However, due to health inequity, many racial women are unable to receive timely treatment and
diagnosis as medical resources are mostly available to the white community peoples.
The disparity in breast cancer stems from the interplay of power, racism, economic and
discrimination that has led to social injustice. Research suggests that social injustice among the
American population has led to health disparity, and breast cancer has become a social justice
issue (Momin et al., 2018). Breast cancer is predominant women health issues in the society and
its ending needs amendments at each level of society. Social justice reflects on the fairness and
equal access to health care which is shaped by age, gender, race and colonial relation. However,
in the study of Polite, Gluck and Brawley (2019) it is inferred that in America, there is social
injustice among breast cancer women related to fairness in medical care. As the impact of social
injustice, there is low quality treatment and poor access to health care which has led to
subsequent cancer disparities. The women are not timely diagnosed, and unequal medical
resource allocation in the society has caused breast cancer issue. In America, racism has directed
to social injustice which has led to cause high prevalence of breast cancer and even death.
Researching on the issue of poorer access to breast cancer screening for the American women,
Rust (2017) has focused on women's awareness and language barrier that typically used to

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describe the basis of breast cancer. The unfair social arrangement linked with class and race
intersects with society in everyday life of minorities. It has put them in disadvantage situation
where breast cancer screening is challenging; hence, leading to breast cancer. Therefore,
epidemiology studies have worked to identify breast cancer as a vital health issue.
There are several studies undertaken that infer the epidemiology of breast cancer in
America. In the study of Tao et al. (2015), pervasiveness of breast cancer has been highlighted
by conducting a literature review of different finding. The author highlighted that breast cancer
in America had been estimated with 1,384,155 new cases with death of 459,000 in the year 2014.
The current statistic and prediction suggest that there are nearly 1.7 million women reported with
breast cancer. According to the American cancer society, it is suggested that out of eight women,
one woman in United States will advance breast cancer in her lifetime. Epidemiological studies
by Tao et al. (2015) also suggest that importance must be paid to socio-economic issue so that all
the women can get equal access to health and medical care from the stage of screening to
treatment.
Lambertini et al. (2016) have conducted meta-analysis and systematic review of the
epidemiological studies related to breast cancer in America. The research has included 15 studies
which include 21,941 breast cancer patient and 864,177 controls. The author has highlighted that
there is a close association between the age at first birth, parity, breastfeeding and risk of
developing breast cancer. These factors have led to a high rate of up to 67% of breast cancer in
America. The reproductive behaviour has shown negative impact on breast cancer. However,
parity has linked with reduced risk of forming luminal subtype of breast cancer.
Winters et al. (2017) have conducted descriptive studies and data suggested that in
America, medical resources are declining, which has caused change in the pattern of early