It’s probably because my mom was born in a little mountain village outside the Honduran capital of Tegucigalpa, or that she was a single mom who drove a forklift during the graveyard shift in a warehouse, but when I was growing up I never heard of preventative healthcare.
I didn’t know of any Latino adults who went in for a yearly check-up, much less a mammogram or colonoscopy—Latinas didn’t talk about such things openly, especially in front of boys, and there weren’t many men around to teach the importance of health. You only went to the doctor when something was hurting; if you were merely sick, then you toughed it out with Vick’s VapoRub and steady shots of Robitussin.
Health insurance or not, trips to the doctor’s office cost money, so you had to be knocking on death’s door if Mom was going to spend part of the money for rent, bills, and groceries on a doctor’s appointment. If you found a tiny lump or felt persistent discomfort in your abdomen, you just assumed it was cancer and waited for the inevitable, which never came, of course.
My mom was dying of stage 4 cancer from the time that I was in fourth grade till about my sophomore year in college, though it was strictly a self-diagnosis.
Us kids only got yearly physicals because they were school-mandated. And when we did go see a doc, we were so intimidated, so afraid of being given a grim diagnosis, that we just answered her questions with a short yes or no, never alerting her to the pain in our side or the suspicious mole on our inner thigh.
According to Dr. Carmen E. Guerra, who serves as board scientific officer at the American Cancer Society and is associate director of diversity and outreach at the Abramson Cancer Center at the University of Pennsylvania, a lot of my childhood experiences with health and health care are sadly quite common among Latinos.
“Cultural barriers [to cancer screening among Latinos] include fatalism, the belief that health events are predetermined and therefore inevitable,” Dr. Guerra tells Latino Rebels. “Respect for the physician’s authority is highly prevalent in the Hispanic community and it results in Hispanic individuals not feeling comfortable with more American medicine models of shared decision making often employed during cancer screening decision or simply asking questions about screenings and cancer.”
December 6 to 10 is Cancer Screen Week, an initiative sponsored by the American Cancer Society and Stand Up to Cancer along with biotech company Genentech and health services company Optum, with the goal of saving lives by sharing information about the importance and accessibility of cancer screenings.
The group released a survey this year showing that “Latino adults aged 40-60 were more likely than others to express concerns about cancer screening costs, not knowing where to go for a screening, and that getting screened feels intimidating or overwhelming. They were also slightly less likely than others to report having undergone recommended cancer screenings.”
Does cancer screening help people live longer? Finding some cancers at an early stage (before symptoms appear) may help decrease the chance of dying from those cancers. https://t.co/C1VCr5GUSi #CancerScreenWeek #CancerScreening pic.twitter.com/oOZt8IMOMp
— National Cancer Institute (@theNCI) December 8, 2021
Cancer is the leading cause of death among Latino, comprising 20 percent of all deaths. Close to 176,600 Latinos will be diagnosed with cancer in 2021. Yet three in four Latino adults surveyed expressed concerns about the cost of cancer screenings compared to 69 percent of non-Latino adults, and 57 percent were unaware of free or low-cost screenings compared to 31 percent of non-Latinos.
Add to that the COVID-19 pandemic, which forced many Latinos to miss their scheduled screenings.
“As a two-time breast cancer survivor and melanoma stage 0 survivor, I have personally faced these diseases and I know how important it is for the Latino community to be self-advocates in learning more about these diseases and the cancer screening options available,” Ivis Sampayo, chief diversity officer for SHARE, a support group for women affected by breast and ovarian cancer, tells Latino Rebels. “We need to become a community empowered, knowledgeable and powerful. With so many Latino adults expressing concerns about cancer screening costs, this demonstrates the need there is to make free cancer screenings available and accessible to all.”
While the cancer death rate among Latinos is not as high as it is among Blacks —barring the fact that “Latino” and “Black” are not mutually exclusive categories— and though Latinos have a slightly lower chance of getting cancer than non-Latino white people, Latinos are much less likely to be diagnosed with early-stage cancer, as they regularly fail to receive screenings. The highest disparities in early detection between Latinos and non-Latino whites are in melanoma and female breast cancer.
Fifty-one percent of the Latinas surveyed by Cancer Screen Week said they have had a Pap test or HPV test, compared with 70 percent of non-Latino white women. Twenty-nine percent of the Latinos asked said they have had a colonoscopy, compared with 39 percent of non-Latino whites.
It’s important to get back on track with regular cancer screenings. Take control of your future this #CancerScreenWeek. Explore available screenings and learn how to get screened at https://t.co/6MUeOw0ydv. #StandUpToCancer pic.twitter.com/U6v3Emt910
— Stand Up To Cancer (@SU2C) December 6, 2021
Besides the cultural barriers, socioeconomic, or class, also plays a major role in health and health care disparities. “Lower [socioeconomic status] has been shown to be correlated with lower access to and completion of cancer screenings,” explains Dr. Guerra. “In the U.S., compared to non-Hispanic whites, Hispanic individuals have lower levels of educational attainment and are more likely to live in poverty. In 2019, 16 percent of Hispanic individuals lived in poverty compared to seven percent of non-Hispanic whites.”
Dr. Guerra also points to bias among healthcare workers and how it affects Latino patients. “Many Hispanic individuals face colorism … unconscious bias, and racism,” she says, “which may lead to lower recommendation rates for cancer screenings to these individuals by health care providers and poorer outcomes.”
Among the major racial and ethnic groups, Latino adults are the least likely have health insurance. “Among those 18 to 64 years of age, 26 percent of Hispanic individuals were uninsured during 2017-2018 compared to nine percent of non-Hispanic whites.”
“Given the higher rates of uninsured Hispanic individuals, policies such as Medicaid expansion are critical for providing health insurance coverage for the members of the Hispanic community, and allowing them to access cancer screenings which diagnose cancer at earlier stages, when it is most treatable,” says Dr. Guerra.
“At SHARE, we have a toll-free helpline where women interested in receiving information about mammograms can call to find out about local resources,” Sampayo adds. “It is extremely important that we educate Latino communities about which cancer screenings are recommended for them, as well as the availability of free and low-cost options for cancer screenings including colonoscopies and FIT tests, Pap tests, HPV tests and mammograms, among others.”
During Cancer Screen Week, Latinos should not only schedule their own screenings but also discuss the importance of preventative healthcare with their fellow Latinos. Because when it comes to maintaining good health, knowing is half the battle.
Hector Luis Alamo is the Senior Editor at Latino Rebels and hosts the Latin[ish] podcast. Twitter: @HectorLuisAlamo
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