Examining Barriers to Cancer Care

A Needs Assessment of African American and Black African Immigrants in Iowa

Bibliographic Data

ID19228311
AuthorsGawain Williams (0009-0009-2466-3056, University of Iowa, corresponding author), Hannah Huang (0000-0002-6768-0405, University of Iowa Health Care), Megan Schmidt (0000-0002-4818-4959, University of Iowa), Kelly Wells Sittig (0009-0001-6186-0405, University of Iowa Health Care), Natoshia M Askelson (0000-0002-3464-8214, University of Iowa), Sarah H Nash (0000-0002-9038-6001, University of Iowa)
Year2026
Publication date2026-06-11
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueJournal of Racial and Ethnic Health Disparities (JOURNAL)
Journal identifiersISSN: 2196-8837 • E-ISSN: 2197-3792
PublisherSpringer Science+Business Media (PUBLISHER • DE)
DOI10.1007/s40615-026-03040-9
PMID42274944
OpenAlexW7164302587
LanguageEN
References cited50

INTRODUCTION: Non-Hispanic Black (NHB) Iowans experience significantly higher cancer incidence and mortality rates compared to their non-Hispanic White (NHW) counterparts. Yet, their unique barriers to cancer-related care remain understudied, particularly in the context of a geographically rural state with limited racial and ethnic diversity like Iowa. A deeper understanding of the nuanced challenges faced by this population is essential to the creation of equitable, community-based solutions to cancer care across the continuum. METHODS: We conducted key informant interviews with 20 Black Iowans: 14 African Americans and 6 Black African immigrants. Using descriptive thematic analysis, we organized themes according to the Health Equity Framework. RESULTS: Six dominant themes emerged: health literacy and cultural understanding; structural barriers to care; interpersonal dynamics and communication; trust; strengths and resiliencies; and, community identified solutions. These themes revealed distinct experiences across subpopulations, highlighting both similarities and differences in barriers to care. Differences between groups primarily occurred within health literacy, and trust. For example, African Americans often understood the health system but reported distrust shaped by historical and cultural trauma, whereas Black African immigrants' mistrust frequently co-occurred with limited health literacy and unfamiliarity with the local health system. CONCLUSION: Black Iowans face multifaceted barriers to accessing cancer care, underscored by heterogeneity in cultural and social norms, resource limitations, and variations in cancer-related health literacy. Given differences between African Americans and Black African immigrants, our findings highlight the necessity for tailored interventions for specific subpopulations to effectively address inequities and improve cancer-related care outcomes

Cultural diversity · Ethnic group · Health care · Health equity · Health literacy · Immigration · Population · Public health · Thematic analysis · Cancer survivorship and care · Global Cancer Incidence and Screening · Migration, Health and Trauma

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