title: Effects of social injustice on breast health-seeking behaviors of low-income women.
abstract: OBJECTIVE
  The study uses qualitative research to gain a better understanding of what occurs after low-income women receive an abnormal breast screening and the factors that influence their decisions and behavior. A heuristic model is presented for understanding this complexity.
  
  
  METHODS
  Qualitative research methods used to elicited social and cultural themes related to breast cancer screening follow-up.
  
  
  METHODS
  Individual telephone interviews were conducted with 16 women with confirmed breast anomaly.
  
  
  METHODS
  Low-income women screened through a national breast cancer early detection program.
  
  
  METHODS
  Grounded theory using selective coding was employed to elicit factors that influenced the understanding and follow-up of an abnormal breast screening result. Interviews were digitally recorded, transcribed, and uploaded into NVivo 8, a qualitative management and analysis software package.
  
  
  RESULTS
  For women (16, or 72% of case management referrals) below 250% of the poverty level, the impact of social and economic inequities creates a psychosocial context underlined by structural and cultural barriers to treatment that forecasts the mechanism that generates differences in health outcomes. The absence of insurance due to underemployment and unemployment and inadequate public infrastructure intensified emotional stress impacting participants' health decisions.
  
  
  CONCLUSIONS
  The findings that emerged offer explanations of how consistent patterns of social injustice impact treatment decisions in a high-risk vulnerable population that have implications for health promotion research and systems-level program improvement and development.
authors: Institute for Families in Society, University of South Carolina, 1600 Hampton Street, Suite 507, Columbia, SC 29208, USA. Bowensk2@mailbox.sc.edu
authors: Shelly-Ann
authors: SA
authors: Bowen
authors: Edith M
authors: EM
authors: Williams
authors: Chayah M
authors: CM
authors: Stoneberg-Cooper
authors: Saundra H
authors: SH
authors: Glover
authors: Michelle S
authors: MS
authors: Williams
authors: Michael D
authors: MD
authors: Byrd
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003657:Decision Making; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D010342:Patient Acceptance of Health Care; D011203:Poverty; D036301:Qualitative Research; D012935:Social Justice