Spirituality, Perceived Ethnic Discrimination and Breast/Cervical Cancer Screening for Muslim American Women in New York City

Background: As of 2017, there were about 3.45 million Muslims living in the U.S., making up about 1.1% of the total population. By 2050, the Muslim American population is projected to reach 8.1 million, or 2.1% of the nation’s total population— nearly twice today’s proportion. Despite this increase in population size, healthcare disparities among Muslim Americans have largely remained under-investigated in scholarship, particularly as they relate to the sexual and reproductive health of Muslim American women. Muslim American women have lower rates of breast and cervical cancer screening utilization. Experiences of discrimination may deter Muslim American women in New York City from obtaining up-to-date breast and cervical cancer screenings. We sought to better understand the impacts that perceived discrimination and spiritual beliefs have on the likelihood of obtaining breast and cervical cancer screening for Muslim American women.

Methods: We surveyed 421 Muslim American women on their experiences with breast and cervical cancer screening. Discrimination was measured using the Perceived Ethnic Discrimination Questionnaire (PED-Q). Subscales within this scale included the Social Exclusion, Stigmatization, Discrimination at Work/School, and Threat/Aggression Scales. Spirituality was measured using the Spiritual Health Locus of Control Scale. Subscales within this scale included the Spiritual/Life Faith Scale, the Active/Spiritual Scale, God’s Grace Scale, and the Passive Spiritual Scale. Multivariable logistic regression models were used to predict the likelihood of having obtained an up-to-date (1) mammogram and (2) Pap test, controlling for sociodemographic variables.

Results: By ethnicity, participants identified as South Asian (63.2%), Middle Eastern (30.9%), Southeast Asian (8.1%), and African (1.7%). The majority were foreign-born (98.0%) and had a household income under $30,000 (19.5%). Most Muslim women preferred to receive medical care from a healthcare provider of their same race, ethnicity or religion (62.1%) and of their same gender (75.2%). In the final adjusted logistic regression model controlling for age and insurance status, holding passive spiritual beliefs decreased the likelihood of obtaining a mammogram (p=0.03). Similarly, in the final adjusted logistic regression model controlling for age and insurance status, holding beliefs in God’s grace decreased the likelihood of obtaining a Pap test (p=0.01).

Conclusion & Implications: Muslim American women who hold passive beliefs regarding the link between spirituality and health are less likely to obtain up-to-date breast cancer screenings while Muslim American women who hold beliefs in God’s grace are less likely to obtain up-to-date cervical cancer screenings. These associations may help explain how Muslim women choose whether or not to access sexual and reproductive healthcare. By bridging the gap between Muslim cultural traditions and healthcare accommodations, we can better address the health needs of the Muslim American community.