Effects of Perceived Discrimination and Trust on Breast Cancer Screening among Korean American Women

Womens Health Issues. Mar-Apr 2018;28(2):188-196. doi: 10.1016/j.whi.2017.11.001. Epub 2017 Dec 6.


Objective: Korean American (KA) women continue to have lower breast cancer screening rates than other racial groups. Perceived discrimination and trust have been associated with breast cancer screening adherence, but little is known about the associations in KA women.

Methods: Surveys were completed by 196 KA women in the Chicago metropolitan area. Multiple and Firth logistic regression analyses were performed to identify factors (perceived discrimination, trust, acculturation, cultural beliefs, health care access) influencing breast cancer screening adherence (mammogram). In addition, SPSS macro PROCESS was used to examine the mediating role of trust between perceived discrimination and breast cancer screening adherence.

Results: Ninety-three percent of the women surveyed had health insurance and 54% reported having a mammogram in the past 2 years. Predictors of having a mammogram were knowing where to go for a mammogram, having a regular doctor or usual place for health care, greater trust in health care providers, and lower distrust in the health care system. Perceived discrimination had an indirect effect on breast cancer screening through trust.

Conclusions: The breast cancer screening rate among KA women is low. Perceived discrimination in health care, trust in health care providers, and distrust in the health care system directly or indirectly influenced breast cancer screening adherence in KA women. Trust is a factor that can be strengthened with educational interventions.

MeSH terms

  • Acculturation
  • Aged
  • Asian Americans / psychology*
  • Asian Americans / statistics & numerical data
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / ethnology
  • Breast Neoplasms / psychology
  • Chicago / epidemiology
  • Cross-Sectional Studies
  • Discrimination, Psychological*
  • Early Detection of Cancer / statistics & numerical data
  • Emigrants and Immigrants / psychology
  • Female
  • Health Services Accessibility
  • Humans
  • Korea / ethnology
  • Mammography / psychology
  • Mammography / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / ethnology*
  • Perception*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Trust*