BREAST CANCER: Job Loss Reduces Early Detection
A study in this month's issue of the Journal of American Public Health suggests that increases in the unemployment level are linked to decreasing rates of detecting breast cancer at an early stage. Two researchers at the University of California-Berkeley compared unemployment data for the San Francisco Bay Area over an 11-year period (January 1983 to December 1993) with cancer surveillance data for the region. The authors said their "results suggest that the odds of breast cancers' being localized at diagnosis are lower when the number of unemployed persons increases unexpectedly." They note that the "pattern was especially pronounced for African-American women, which may suggest greater vulnerability and sensitivity in the African-American population to the effects of unemployment." Further, the "findings provide additional evidence that race and socioeconomic factors are associated with the stage of breast cancer at diagnosis and consequently with the length and quality of life for women with the disease."
"Women who lose their jobs, or whose partners lose theirs," the authors write, "may not have employer-provided health insurance and may therefore be less likely to visit a physician than when they or their partners are employed." Job loss can also pose a direct economic burden, where "less money may be available for child care or transportation to obtain medical attention." Further, the researchers suggest that unemployment "may distract women from their regular activities." Noting that "[s]uspicious breast signs are more likely to be detected first by women themselves," the authors state that it "may be, therefore, that coping with their own unemployment or that of their partner may distract women from subtle changes in their breasts." In their conclusion, the authors write that the "direct and ecological effects of unemployment on breast self-examination and access to screening and treatment should be given special attention." They also state that their findings "may indicate that breast cancer control efforts should be intensified during periods of unexpectedly high unemployment" (Catalano/Satariano, 4/98 issue).