Black women and breast cancer: A public policy analysis

Currently there is not policy literature that addresses the complex issues and concerns around Black women and breast cancer. My dissertation examines the extent to which Black women's questions and concerns about breast cancer are reflected in how breast cancer is defined and resonates as a national policy issue. This dissertation is organized around two primary research questions: What are the most pressing issues and concerns that Black women in Harlem, New York have about breast cancer; and are they reflected in how the policy problem is defined with regard to various breast cancer and health care proposals?; The findings in this research are based on four types of data that I collected in order to address my research questions through (1) a focus group, (2) interviews, (3) a newspaper content analysis and (4) document collection. From this data base the following conclusions can be drawn. Black women's interests and concerns are demonstrated in the following three oppositional frames: (1) distrust of the medical establishment, (2) resistance to pharmaceutical and chemical treatment options, and (3) free health care for all. Black women with breast cancer present an unresolved challenge to the scientific community and political community alike.; From the standpoint of Black women, the gaps in scientific research and public policies on breast cancer become glaringly evident because of the institutional and economic barriers they face in the policymaking process. While some of the most important questions and concerns of the Black women interviewed have been reflected in policy proposals, they have not been translated into law. The national breast cancer advocacy network continues to strive for increased federal appropriations directed towards finding a cure for breast cancer. However, special interest groups for Black people and Black women have pushed for more social justice policy solutions rather than increased federal research funds to existing bureaucratic agencies and departments. Such solutions are not politically or economically feasible because, at the very least, they would require significant changes to existing institutions. Deborah Stone (1989) aptly argues that “one major causal story—that the capitalist economic and political system is the cause of innumerable social ills—is consistently shut out” (293, 294).; Articulating the value of cultural difference has been a source of political empowerment, and a basis for the strategic redefinition of breast cancer by and for Black women. This thesis lays the foundation for framing breast cancer as a broader policy problem in the legislative arena whereby Black women and other women of color are considered.