A Qualitative Evaluation of Structural and Social Determinants of Health, Black Race, and Perspectives of Prostate Cancer Risk and Early Detection.

Authors

Dante' Morehead, Jenney R Lee, Ben Young, Victor Tolbert, John Masembe, Sung Min Kim, Solange H Mecham, Liz Sage, Elizabeth J Austin, Erika M Wolff, John L Gore, Yaw A Nyame, BACPAC Collaborative

Published in

Journal of racial and ethnic health disparities. Jul 27, 2026. Epub Jul 27, 2026.

Abstract

Black men in the United States face disproportionately high rates of prostate cancer incidence and mortality. Despite this, few prostate-specific antigen (PSA) testing guidelines include race-conscious guidelines, and few studies exists on specific, equity-related barriers to accessing PSA testing for Black men. This qualitative study, conducted in collaboration with the Black and African Descent Collaborative for Prostate Cancer Action (BACPAC), explores the perspectives, beliefs, and equity-related barriers affecting PSA testing access among Black men in Washington State. Using a community-engaged approach, semi-structured interviews were conducted with 29 Black men, both with and without a history of prostate cancer. Interviews were analyzed using a framework that considered structural, social, and health-related determinants of equity. Five key themes emerged: (1) trust and patient-provider relationships are essential but often challenged by historical and personal experiences of systemic racism; (2) PSA testing is viewed as an important component of routine healthcare, but is inconsistently offered; (3) participants reported a lack of accessible, accurate, and culturally relevant information about prostate cancer risks for Black men; (4) family and community support plays a critical role in promoting awareness and screening; and (5) masculinity, sexual health concerns, and stigma act as barriers to seeking care. Our findings highlight the need for culturally tailored educational materials, improvements in provider communication, and community-driven efforts to normalize conversations about PSA testing and health. Addressing these factors through culturally responsive and patient-centered strategies can improve access to PSA testing and early detection and reduce prostate cancer inequities among Black men.

PMID:
42509517
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

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