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	<title>Comments on: Breast Cancer Death Rate Disparity</title>
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	<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/</link>
	<description>In defense of the sanctimonious women&#039;s studies set.</description>
	<lastBuildDate>Fri, 10 Feb 2012 13:58:43 +0000</lastBuildDate>
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		<title>By: zuzu</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37339</link>
		<dc:creator>zuzu</dc:creator>
		<pubDate>Thu, 23 Mar 2006 16:18:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37339</guid>
		<description>They could also be responding to *perceived* socioeconomic situations and assuming that minority = poor.

Remember, the first study, the one that found black women died of breast cancer 19% more than white women, controlled for socioeconomic factors.  I&#039;d love to know if the study that found wide disparity in recommended treatment did the same.</description>
		<content:encoded><![CDATA[<p>They could also be responding to *perceived* socioeconomic situations and assuming that minority = poor.</p>
<p>Remember, the first study, the one that found black women died of breast cancer 19% more than white women, controlled for socioeconomic factors.  I&#8217;d love to know if the study that found wide disparity in recommended treatment did the same.</p>
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		<title>By: Samantha Vimes</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37336</link>
		<dc:creator>Samantha Vimes</dc:creator>
		<pubDate>Thu, 23 Mar 2006 15:39:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37336</guid>
		<description>Doctors not recommending the same treatment *could* be responding to their patients&#039; economic situations knowingly. If the patient has already shown fears of economic devastation, if a treatment is only somewhat likely to be beneficial, the doctor may decide the patient will suffer less emotional stress, which might be more harmful. 
Another matter could be patient assertiveness. Most doctors rush patients, and do the &quot;I know better than you&quot; thing. Some people are going to be better at insisting on more options, more treatment, and fighting their insurance to make sure it&#039;s covered, too. </description>
		<content:encoded><![CDATA[<p>Doctors not recommending the same treatment *could* be responding to their patients&#8217; economic situations knowingly. If the patient has already shown fears of economic devastation, if a treatment is only somewhat likely to be beneficial, the doctor may decide the patient will suffer less emotional stress, which might be more harmful.<br />
Another matter could be patient assertiveness. Most doctors rush patients, and do the &#8220;I know better than you&#8221; thing. Some people are going to be better at insisting on more options, more treatment, and fighting their insurance to make sure it&#8217;s covered, too.</p>
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		<title>By: That Girl</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37333</link>
		<dc:creator>That Girl</dc:creator>
		<pubDate>Thu, 23 Mar 2006 14:13:13 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37333</guid>
		<description>I would really love to see what the statistics look like if they are based on economics also. I know that being poor also limits your options to follow up on medical treatment or your desire to do so - it&#039;s fine that you need certain treatment but it also (usually) puts you in lots of debt - debt that you cant afford.
Doctors who dont think they have racial bias also usually dont acknowledge economical bias when they two are very closely related.
And zenzicube is correct - reasearch depends on grant money and grant money is often tied to a cause.
Breast cancer has gazillions of dollars a year, as does prostate cancer and aids, yet basic biological studies which could effect ALL cancers go unfunded for two reasons:

1. Scientists have to become a lot smarter in framing their grant requests
2. Basic science is not sexy

#2 is the mantra of people like me, who have struggled for many years to get grants on important scientific studies and watched as the smarter researchers got funding for some ridiculous avenue of study because they framed it in terms of breast cancer.</description>
		<content:encoded><![CDATA[<p>I would really love to see what the statistics look like if they are based on economics also. I know that being poor also limits your options to follow up on medical treatment or your desire to do so &#8211; it&#8217;s fine that you need certain treatment but it also (usually) puts you in lots of debt &#8211; debt that you cant afford.<br />
Doctors who dont think they have racial bias also usually dont acknowledge economical bias when they two are very closely related.<br />
And zenzicube is correct &#8211; reasearch depends on grant money and grant money is often tied to a cause.<br />
Breast cancer has gazillions of dollars a year, as does prostate cancer and aids, yet basic biological studies which could effect ALL cancers go unfunded for two reasons:</p>
<p>1. Scientists have to become a lot smarter in framing their grant requests<br />
2. Basic science is not sexy</p>
<p>#2 is the mantra of people like me, who have struggled for many years to get grants on important scientific studies and watched as the smarter researchers got funding for some ridiculous avenue of study because they framed it in terms of breast cancer.</p>
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		<title>By: Margaret</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37327</link>
		<dc:creator>Margaret</dc:creator>
		<pubDate>Thu, 23 Mar 2006 11:57:35 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37327</guid>
		<description>Enough already. The problem is the still belief that white people are superior. White supremacy is alive and well and the doctor&#039;s office is no exception. Study after study shows that black people are under treated for a variety of ailments. Having a brown face puts a patient at risk of being dismissed and disregarded. If black people are considered inferior then they don&#039;t need chemo, or bypasses or any other procedure that can help them live. If we were treated equally there would be no need for white supremacy, and that would turn the nation on its head.</description>
		<content:encoded><![CDATA[<p>Enough already. The problem is the still belief that white people are superior. White supremacy is alive and well and the doctor&#8217;s office is no exception. Study after study shows that black people are under treated for a variety of ailments. Having a brown face puts a patient at risk of being dismissed and disregarded. If black people are considered inferior then they don&#8217;t need chemo, or bypasses or any other procedure that can help them live. If we were treated equally there would be no need for white supremacy, and that would turn the nation on its head.</p>
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		<title>By: zenzicube</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37295</link>
		<dc:creator>zenzicube</dc:creator>
		<pubDate>Thu, 23 Mar 2006 05:04:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37295</guid>
		<description>Hi.  Delurking to comment that, yes, the medical/biotech industry primarily focuses on whites and especially white men.  However, I think there are efforts being made to address differences in disease risks in specific populations.  For instance, I work in a genetic epidemiology laboratory which studies African American women to identify specific genetic markers that could indicate higher risk of breast cancer.  Granted, this type of research is pioneering and not at all common, but I think (and hope) that it&#039;s the beginning of a broader trend.  

As for strategies to help this type of research along....The limiting factor for all biological research is grant money, which is doled out primarily by government institutions (NIH happens to be particularly parsimonious right now), which have quite a bit of leeway in choosing projects to fund.  That said, they do tend to give money to research topics that focus on human health, so genetic epidemiology, although a small field, can rake in quite a bit of money.  I think encouraging researchers to focus on genetic epidemiology and similar topics could help....although I&#039;ve noticed that the majority of professors in my department are female, which could also be a factor.  Moreover, recent advances in technology are allowing complicated genetic analyses that simply weren&#039;t available before and in quantities that allow for statistical modeling.  Suffice to say, there are a variety of reasons related to the current structure of biotech and biomedical research that prevent the type of research to which you&#039;re referring..  </description>
		<content:encoded><![CDATA[<p>Hi.  Delurking to comment that, yes, the medical/biotech industry primarily focuses on whites and especially white men.  However, I think there are efforts being made to address differences in disease risks in specific populations.  For instance, I work in a genetic epidemiology laboratory which studies African American women to identify specific genetic markers that could indicate higher risk of breast cancer.  Granted, this type of research is pioneering and not at all common, but I think (and hope) that it&#8217;s the beginning of a broader trend.  </p>
<p>As for strategies to help this type of research along&#8230;.The limiting factor for all biological research is grant money, which is doled out primarily by government institutions (NIH happens to be particularly parsimonious right now), which have quite a bit of leeway in choosing projects to fund.  That said, they do tend to give money to research topics that focus on human health, so genetic epidemiology, although a small field, can rake in quite a bit of money.  I think encouraging researchers to focus on genetic epidemiology and similar topics could help&#8230;.although I&#8217;ve noticed that the majority of professors in my department are female, which could also be a factor.  Moreover, recent advances in technology are allowing complicated genetic analyses that simply weren&#8217;t available before and in quantities that allow for statistical modeling.  Suffice to say, there are a variety of reasons related to the current structure of biotech and biomedical research that prevent the type of research to which you&#8217;re referring..</p>
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		<title>By: Spit</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37178</link>
		<dc:creator>Spit</dc:creator>
		<pubDate>Wed, 22 Mar 2006 22:27:19 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37178</guid>
		<description>Thomas -- good point. It wouldn&#039;t necessarily solve the problem, but it would at least force people to realize that their studies do not necessarily generalize outside of the specific demographic groups where they got a significant sample. Whether it would encourage the other specific studies well enough, though, I&#039;m not sure. I&#039;ll have to think about it.</description>
		<content:encoded><![CDATA[<p>Thomas &#8212; good point. It wouldn&#8217;t necessarily solve the problem, but it would at least force people to realize that their studies do not necessarily generalize outside of the specific demographic groups where they got a significant sample. Whether it would encourage the other specific studies well enough, though, I&#8217;m not sure. I&#8217;ll have to think about it.</p>
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		<title>By: Thomas</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37174</link>
		<dc:creator>Thomas</dc:creator>
		<pubDate>Wed, 22 Mar 2006 22:10:02 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37174</guid>
		<description>I don&#039;t know much about medical academics, but isn&#039;t there a critical pressure point in the juried journals?  If Jama always sees questions and comments about whether results are properly generalized to all demographics, won&#039;t they react to that?  If studies start simply saying, &quot;we did not have enough African-American men in our sample to determine if the results are statistically significant for that demographic,&quot; won&#039;t it draw other authors to fill those holes as a way to get published? </description>
		<content:encoded><![CDATA[<p>I don&#8217;t know much about medical academics, but isn&#8217;t there a critical pressure point in the juried journals?  If Jama always sees questions and comments about whether results are properly generalized to all demographics, won&#8217;t they react to that?  If studies start simply saying, &#8220;we did not have enough African-American men in our sample to determine if the results are statistically significant for that demographic,&#8221; won&#8217;t it draw other authors to fill those holes as a way to get published?</p>
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		<title>By: Spit</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37168</link>
		<dc:creator>Spit</dc:creator>
		<pubDate>Wed, 22 Mar 2006 22:03:52 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37168</guid>
		<description>As a bit of an aside, the horrors of residency are, in my opinion, exactly what keeps many of the people who would make the best doctors from going to med school. 

But the thing that gets me is, before they&#039;re even in med school, they&#039;re being given this biology education that never even talks about bias or the strange idea that maybe the way we design studies is based on our culture&#039;s perception of what&#039;s important.

And that sticks with them whether they become doctors -- where this issue is a matter of life and death -- or whether they become animal behaviorists who essentially interpret other animals through socialized human eyes and then all too often turn it back and use that work to say something about &quot;natural&quot; human behavior (props to those who don&#039;t, but I&#039;ve seen it happen, and it&#039;s never pretty).

Dunno, maybe it&#039;s just a major pet peeve of mine because I have to listen to it too often.

At any rate, I think as long as we act like white and male are the normal human condition, I think we&#039;re going to have these problems in studies -- personally, I get pissed everytime I see sections for &quot;health&quot; and &quot;women&#039;s health&quot; in anything. And you and many others are already clearly far too aware that that has a direct impact on people&#039;s lives.</description>
		<content:encoded><![CDATA[<p>As a bit of an aside, the horrors of residency are, in my opinion, exactly what keeps many of the people who would make the best doctors from going to med school. </p>
<p>But the thing that gets me is, before they&#8217;re even in med school, they&#8217;re being given this biology education that never even talks about bias or the strange idea that maybe the way we design studies is based on our culture&#8217;s perception of what&#8217;s important.</p>
<p>And that sticks with them whether they become doctors &#8212; where this issue is a matter of life and death &#8212; or whether they become animal behaviorists who essentially interpret other animals through socialized human eyes and then all too often turn it back and use that work to say something about &#8220;natural&#8221; human behavior (props to those who don&#8217;t, but I&#8217;ve seen it happen, and it&#8217;s never pretty).</p>
<p>Dunno, maybe it&#8217;s just a major pet peeve of mine because I have to listen to it too often.</p>
<p>At any rate, I think as long as we act like white and male are the normal human condition, I think we&#8217;re going to have these problems in studies &#8212; personally, I get pissed everytime I see sections for &#8220;health&#8221; and &#8220;women&#8217;s health&#8221; in anything. And you and many others are already clearly far too aware that that has a direct impact on people&#8217;s lives.</p>
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		<title>By: zuzu</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37156</link>
		<dc:creator>zuzu</dc:creator>
		<pubDate>Wed, 22 Mar 2006 21:48:14 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37156</guid>
		<description>&lt;blockquote&gt;I’m sorry about your mom, too, zuzu. I should have said that.&lt;/blockquote&gt;

Thanks, I&#039;m sorry about yours, too.

Spit, interesting about your background informing your scientific studies.  Medical education, from what I&#039;ve been told, tends to do things in certain ways because that&#039;s how they&#039;ve always been done -- such as 36-hour shifts during residency.  It&#039;s easy to see how that would stifle efforts to expose bias.</description>
		<content:encoded><![CDATA[<blockquote><p>I’m sorry about your mom, too, zuzu. I should have said that.</p></blockquote>
<p>Thanks, I&#8217;m sorry about yours, too.</p>
<p>Spit, interesting about your background informing your scientific studies.  Medical education, from what I&#8217;ve been told, tends to do things in certain ways because that&#8217;s how they&#8217;ve always been done &#8212; such as 36-hour shifts during residency.  It&#8217;s easy to see how that would stifle efforts to expose bias.</p>
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		<title>By: Spit</title>
		<link>http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37153</link>
		<dc:creator>Spit</dc:creator>
		<pubDate>Wed, 22 Mar 2006 21:42:40 +0000</pubDate>
		<guid isPermaLink="false">http://www.feministe.us/blog/archives/2006/03/22/breast-cancer-death-rate-disparity/#comment-37153</guid>
		<description>It&#039;s a huge structural problem, is part of why it&#039;s so hard to fight. Given that the &quot;default&quot; for &quot;generalized human&quot; in this culture is white and male (among other things), this stuff is sort of a given -- and while it would help to have greater representation of people who are not white and male in medical textbooks and whatnot, the problem is deeper rooted than that.

I also personally wish that every undergrad in the life sciences had to take a class on science&#039;s interactions with society -- both in terms of the effects on society of &quot;pop science&quot; and of the effects on science of widespread social bias. I come at my current sciency-ness from a decently strong background in sociology and gender studies, and I just cannot believe the assumptions that get made by students all the time -- hell, even by some of the profs. They really think that their scientific reasoning is immune from bias. That&#039;s how we keep getting really stupid studies on race and gender that have fundamental flaws not just in methodology but in the initial questions themselves.

That&#039;s sort of peripheral, but I think that &quot;we&#039;re above social bias&quot; thing is part of what feeds the lack of focus on the differential treatment that people receive, at least within the medical community.</description>
		<content:encoded><![CDATA[<p>It&#8217;s a huge structural problem, is part of why it&#8217;s so hard to fight. Given that the &#8220;default&#8221; for &#8220;generalized human&#8221; in this culture is white and male (among other things), this stuff is sort of a given &#8212; and while it would help to have greater representation of people who are not white and male in medical textbooks and whatnot, the problem is deeper rooted than that.</p>
<p>I also personally wish that every undergrad in the life sciences had to take a class on science&#8217;s interactions with society &#8212; both in terms of the effects on society of &#8220;pop science&#8221; and of the effects on science of widespread social bias. I come at my current sciency-ness from a decently strong background in sociology and gender studies, and I just cannot believe the assumptions that get made by students all the time &#8212; hell, even by some of the profs. They really think that their scientific reasoning is immune from bias. That&#8217;s how we keep getting really stupid studies on race and gender that have fundamental flaws not just in methodology but in the initial questions themselves.</p>
<p>That&#8217;s sort of peripheral, but I think that &#8220;we&#8217;re above social bias&#8221; thing is part of what feeds the lack of focus on the differential treatment that people receive, at least within the medical community.</p>
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