title: An Evaluation of Psychosocial and Religious Belief Differences in a Diverse Racial and Socioeconomic Urban Cancer Population.
abstract: Despite years of research aimed at decreasing the cancer mortality rates, the disparity between African-Americans and whites continues to grow. The fundamental psychosocial and belief differences that may mediate these disparities are poorly studied and rarely disentangle race versus specific socioeconomic status (SES) effects. In this study, breast, colon, and lung cancer patients presenting for their first oncology appointment completed a self-administered survey utilizing previously validated instruments regarding psychosocial and belief factors. Results were analyzed by self-identified race, income, and education. In total, 161 African-American (37 %) and 269 white (63 %) new oncology patients with breast (47 %), colon (16 %), or lung (37 %) cancer enrolled. African-Americans were more likely to be in the US$<20,000 income group (45 vs. 9 %) but 21 % had incomes US$>60,000. Apparent racial differences in health literacy and cancer knowledge were primarily mediated by income and education. Significant racial differences in God's perceived role in their cancer remained after adjustments for income and education with African-Americans more likely to feel that God was in control of their cancer (67 vs. 30 %). These findings suggest the need for a more nuanced understanding of how race and socioeconomic status exert both independent and interrelated effects in the health care setting. Only then can effective interventions that reduce disparities in survival be designed. This study adds further substantive evidence to the crucial importance of God's perceived role in the cancer experience for African-Americans. An important area for future research is to examine whether these racial differences in religious belief are also associated with differences in health-related behavior and medical decision-making.
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA. bpolite@medicine.bsd.uchicago.edu.|Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2115, Chicago, IL, 60637, USA. bpolite@medicine.bsd.uchicago.edu.
authors.forename: Blase N
authors.initials: BN
authors.lastname: Polite
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.|Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2115, Chicago, IL, 60637, USA.
authors.forename: Toni
authors.initials: T
authors.lastname: Cipriano-Steffens
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.|Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2115, Chicago, IL, 60637, USA.
authors.forename: Fay
authors.initials: F
authors.lastname: Hlubocky
authors.affiliation: Department of Health Studies, University of Chicago, Chicago, IL, USA.
authors.forename: James
authors.initials: J
authors.lastname: Dignam
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Mandira
authors.initials: M
authors.lastname: Ray
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.affiliation: Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
authors.forename: Samir
authors.initials: S
authors.lastname: Undevia
authors.affiliation: Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
authors.forename: Evie
authors.initials: E
authors.lastname: Sprague
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.|Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2115, Chicago, IL, 60637, USA.
authors.forename: Olufunmilayo
authors.initials: O
authors.lastname: Olopade
authors.affiliation: Department of Medicine, University of Chicago, Chicago, IL, USA.|Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC 2115, Chicago, IL, 60637, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Daugherty
authors.affiliation: Department of Religion, Health and Human Values, Rush University Medical Center, Chicago, IL, USA.
authors.forename: George
authors.initials: G
authors.lastname: Fitchett
authors.affiliation: School and the Department of Surgery, Washington University, St. Louis, MO, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Gehlert
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms; D003110:Colonic Neoplasms; D003657:Decision Making; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy; D006801:Humans; D007182:Income; D007389:Internal-External Control; D008175:Lung Neoplasms; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D012067:Religion; D012923:Social Class; D012944:Social Support; D011795:Surveys and Questionnaires; D014505:Urban Population; D044465:White People
keywords: Cancer; Health disparities; Race; Religious beliefs; Social support; Trust