Fluorescent lights shine against the white exterior of the towering mammogram machine. A nurse motions from the side for you to place your breast onto a plate located on this machine and allows it to gently compress your breast against its padell to generate x-ray photographs for cancer screenings. On the surface, it’s a seemingly simple procedure. However, for women of color, this can be a daunting experience.

The surge of the Black Lives Matter movement and the murder of George Floyd in 2020 has increased tensions between people of color and the government. More research has been done showing large disparities not only in incarceration rates and police brutality, but also within the medical field. One of the most prominent examples of this is the shocking rate at which Black women have died from breast cancer in the U.S. According to the National Center for Biotechnology Information, Black women are “42% more likely to die” from breast cancer than white women, despite breast cancer occurring naturally within a population at nearly the same rate in either group.

Breast cancer is treatable if caught early enough, which indicates discrepancies in the amount of screenings done in Black communities. According to a Q&A done by Dr. Karen Winkfield, MD, “poverty, socioeconomic factors, lack of trust in doctors and medicine, low literacy, and inadequate health insurance” are all barriers that make treatment more difficult to obtain.

So, why does this happen, and why is this a complex issue?

To begin, it’s not just about higher levels of poverty, less educational programs to spread awareness, and a lack of opportunities to get screenings (although all of these are issues that contribute to this higher mortality rate). This also concerns culture and systemic tensions surrounding people of color, specifically Black women and government services. A study done by Monica E. Peek, the Associate Director of the Chicago Center for Diabetes Translational Research, looked into 29 low-income black women in Chicago, a city where the mortality rate of breast cancer for Black women is 73% higher than that of white women. The study focused on personal experiences of Black women in the area, in which not one of the 29 women stated a positive experience when getting a mammography.

Regarding the behaviors of the clinicians and doctors, one woman stated, “I’m a human being; I’m not a dog. Even dogs get treated better than us… Do you think these people would take extra care during a mammogram? They don’t care about your pain.” Another woman described fears that impacted the larger community— she explained, “Young women today are scared. Young women in this building today may not even [go] to the doctor.”

A third said, “sometimes our social background discourages us, our people, from getting any type of care, medical care.”

This shows a larger issue of the psychological effects of an underdeveloped and lacking health system that has for years been exclusionary of people of color, especially Black Americans. It exemplifies years of mistrust and agony present within the healthcare system and is proof of a larger division dating back to before a developed healthcare system was even developed.

PhD student Natalie Pasquinelli explains, “the way racial differences and health outcomes are talked about in medical research and in federal guidelines can suggest that there are genetic differences between different racial groups.”

This way of thinking within the medical field dates back to ideas of Social Darwinism, colonialism, and the justification of imperialism through the use of science. While these theories are no longer accepted today, the social structures they created still persist. The lack of research done from the late 1800s until the 1960s on communities of color, specifically segregated Black communities, made it so that data in textbooks were often skewed. This coupled with social stereotypes such as that of the ‘welfare queen,’ leak into the patient-doctor relationships, affecting diagnosis’ and breeding distrust.

“The ways that these differences are talked about can actually reproduce biological ideas about race, when in actuality, we should be looking at racism instead of race,” continues Pasquinelli.

It’s in this way that Black communities have less access to resources and less incentive to take resources when they are given.

“Structural inequality produces disparities of all kinds including physical and mental health disparities. So, if we saw more economic equality, for example housing equality, educational equality, we would begin to see much more equality in other kinds of outcomes at the same time,” Pasquinelli notes.

It’s only through improvement in these other areas that we can hope to see shifts in disparities such as breast cancer amongst Black women. Perhaps then, the daunting clicks of a mammogram machine could potentially save the lives of thousands.