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Potential
Barriers to the Prevention and Early Detection of Cancer
Among Minority Immigrants in New York City
CARIBBEAN and HAITIAN
COMMUNITIES
- Cultural, linguistic, structural and financial barrier to care.
- Lack
of knowledge and awareness of symptoms of cancer.
- Inability to pay and/or lack of insurance. Haitian participants
in CANIMP focus groups had the highest rate of uninsured at 63.2%,
compared to Latino, English-speaking Caribbean, Chinese, and Korean
participants in the focus groups.
- Transportation and child-care problems.
- Inconvenience and lack of time related to work and family priorities.
- Lack
of physician recommendation. It has been noted that Blacks are recommended
less often for screening.
- Psycho-cultural factors, such as fear and fatalism. CANIMP focus
groups demonstrated that Caribbean and Haitian communities of NYC
equated the word cancer with death.
- Cultural norms such as not discussing sex openly, made it difficult
for Haitians to discuss limited open discussions on cervical cancer
screening, according to some CANIMP focus group participants.
- Distrust in the medical care system. This stems in part from the
unjust treatment in experiments as with the Tuskegee study.
- Haitians in CANIMP focus groups expressed the lack of information
in Haitian Creole was a major limitation. In fact, there was much
misinformation regarding cancer in this community.
- There
was a large tendency for Caribbean and Haitians participating in
CANIMP focus groups to self-medicate and use home remedies prior
to seeking medical care.
LATINO
COMMUNITIES
- Cultural, linguistic, structural and financial barrier to care.
- Absence of symptoms leading to the belief that there is no need
for screening.
- Lack
of physician referrals (particularly for older women).
- Inability to pay and/or lack of health insurance. Latinos have
the highest rate of uninsured at 35.5%, compared to 11.9% for non-Hispanic
whites.
- Language barriers. The Latino community has been estimated to
have the highest rates of monolingual non-English speakers nationally.
Latino participants in CANIMP focus groups also had another language
as their primary language spoken at home.
- Embarrassment and discomfort concerning digital rectal exams (DRE's).
- Tendency to self-medicate and use home remedies prior to seeking
medical care.
KOREAN
AND CHINESE COMMUNITIES
- Cultural, linguistic, structural and financial barriers to care.
- Koreans have a high rate of uninsured.
- Korean
and Chinese focus group participants express great concern about
language barriers, stating that this is one of the greatest deterrents
of seeking medical care.
- Cultural values regarding health care, disease, social obligation,
and family honor that place psychological constraints on Asian American/Pacific
Islander from utilizing screening services.
- Fear
of difficulties in communicating - compounded by shame, guilt, anger,
depression, and other responses to stigmatized condition.
- Several Chinese women in CANIMP focus groups falsely believe that
the pushing and pulling during a mammogram could cause breast cancer.
- Chinese and Korean women participating in CANIMP focus groups
express a difficulty in participating in breast and cervical cancer
because of embarrassment.
- AAPIs
suffer from society's belief that they are the 'model minority',
which suggests that they are economically and academically successful,
and in good mental and physical health. This stereotype presents
a false picture of their health and socioeconomic needs.
- Tendency to self-medicate and use home remedies prior to seeking
medical care.
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