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Welcome to my column on advancing black feminism in public health which builds upon my work as an HPHR Fellow, where I put 10 key principles into practice in addressing determinants of black women’s health and well-being.
As breast cancer and domestic violence awareness months come to a close for 2022, I want to bring attention to the intersection of these health threats. Although domestic violence is under-reported in general, one study revealed that 55% of women are exposed to various forms of violence after being diagnosed with breast cancer. Additionally, I want to highlight the work of Donna Amtsberg and Chiara Acquati who collaborated on a blog highlighting the intersection of breast cancer and intimate partner violence where they graphically depicted the overlap of these epidemics.
One of the key distinguishing features of black feminism as a conceptual framework is its application of “intersectionality” to highlight how multiple inequities shape black women’s experiences. In this column I advance black feminism in public health to make the case for why “the color mauve matters” in terms of the intersectionality of breast cancer and intimate partner violence.
The strength of self-definition and self-valuation at the intersection of breast cancer and intimate partner violence is the potential for black women to co-create health solutions that fit her reality and goals in addressing both threats. However, addressing “violence” requires some reframing of the conversation because some women are reluctant to self-define their partners as “violent.” A more effective approach may be to engage women in conversations about the “difficulties” and “troubles” facing some couples when women are battling breast cancer. Include examples of neglect and abandonment as less severe levels of abuse, thereby paving the way for women experiencing more aggressive partner behavior to share their truth.
Controlling images of breast cancer survivors as “strong” and “resilient” may prevent some oncology professionals and advocates from assessing for violence, abuse, or neglect as some project onto breast cancer survivors the identity of “super women”. Additionally, implicit bias among some healthcare staff of black women as “angry”, “hostile”, and “less vulnerable” in comparison to their white counterparts could result in ignoring warning signs of black women’s abuse.
Black feminists assert that race, class, and gender are equally oppressive inequities, and serve as the cornerstone for unpacking multiple variants of intersectionality. Intersectionality supports black feminist in public health as a way to emphasize health threats in the lives of black women that may by under-researched. Moreover, it is necessary to augment statistical studies on intersectionality with profiles of the lived experiences of people represented in the statistics in a way that humanizes hardships depicted in epidemiological studies.
Engaging women uniquely affected by breast cancer and violence should prioritize trauma-informed approaches where survivors feel safe and supported in sharing unpleasant aspects of the troubles they face in their intimate relationships.
Violence against women is a prime example of the matrix of domination, and must be eradicated at all levels so that women fighting breast cancer do not have to reside with someone who is fighting them. The matrix of domination as articulated in black feminism supports a more critical analysis of the social and structural determinants of health that place women at greater risk for violence while fighting breast cancer. In fact there is research that suggests that women who experience violence during cancer are more likely to have experienced child neglect and abuse, and violence in their adolescent and young adult dating relationships.
Non-profit and civic organizations can lead the charge for changing policies and procedures to enhance collaborations between breast cancer and intimate partner violence serving organizations. Breast cancer screening and oncology treatment entities should benchmark with reproductive health as it relates to screening pregnant and post-partum women for exposure to violence. Equally as important is having intimate partner violence organizations collaborate with breast cancer screening agencies as women fleeing violence may not have access to breast cancer screening resources.
Understanding the daily lives of breast cancer survivors highlights the complexities of neglect, abandonment, and violence. First, paradoxically, women experiencing pre-existing hostilities may see their partners become less abusive as she takes on the sick role and appears more frail over time. Second, some women cope by giving their partners a “hall pass” to have sex outside the relationship, thereby relieving the tension around forced sex. Third, partners who were not abusive or aggressive in any way prior to a partner’s breast cancer diagnosis need unique interventions to address frustrations, resentments, and perhaps even anger due to the strain of taking on multiple roles during a partner’s breast cancer treatment.
There is a need for more empirical studies of the relationship between breast cancer and intimate partner violence. Additionally, there is a need for evidence-based interventions to provide guidance on protocols that are culturally-appropriate and gender-specific to meet the needs of all parties involved. It is my hope that emerging scholars in advancing black feminism in public heath will take on this topic for thesis, capstone, PhD, or early career research projects. Here are the links to five studies that can help scholars interested in pursuing this research topic:
4. Breast Cancer in the Context of Intimate Partner Violence: A Qualitative Study (2009)
There are three things I want to highlight about comprehensively addressing the intersection of breast cancer and intimate partner violence. First, I am an advocate of mental wellness as key to comprehensive solutions to health threats. Breast cancer certainly meets the threshold for enhanced mental wellness as it affects women physically, mentally, socially, and intimately. Second, given the pervasiveness of child abuse, and teen dating violence, there is a broader need for age-appropriate prevention education on key distinctions of “healthy” and “unhealthy” relationships. Finally, from a womanist standpoint, we need men leading conversation with younger men about stopping violence, normalizing mental therapy for men, and breaking gender stereotypes related to caregiving and emotional support.
Collective empowerment is paramount in addressing the intersection of breast cancer and intimate partner violence. In an effort to bring awareness to the fact that some women experience both health threats in her lifetime, I am launching a campaign called “Empowering MAUVELOUS Survivors”.
More by Dr. Quinn M. Gentry here.
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