2014 Racial Disparity in
Breast Cancer Mortality Study


Click any city in the interactive map below to view its disparity graph. Each graph presents the mortality rates for black women (the black line) and for white women (the red line) for the 20-year interval from 1990-2009.

Study overview

The 2014 Racial Disparity in Breast Cancer Mortality Study — a national study published by Sinai Urban Health Institute and the Avon Foundation for Women — has found a black:white disparity in breast cancer mortality in 39 of the most populous U.S. cities, with 35 of those cities experiencing a widening disparity over a 20-year period from 1990 to 2009.

This is the largest study of its kind and the first to examine racial disparities in breast cancer mortality in 50 cities over two decades. Published in Cancer Epidemiology, the study found that 1,710 black women — approximately five women per day — die annually on average largely due to racial disparities in screening and breast cancer treatment.

The U.S. cities with the largest disparities are (in order of disparity ratio):

  • Memphis, Tenn.
  • Los Angeles, Calif.
  • Wichita, Kan.
  • Houston, Texas
  • Boston, Mass.
  • Denver, Colo.
  • Chicago, Ill.
  • Phoenix, Ariz.
  • Dallas, Texas
  • Indianapolis, Ind.

The 2014 study expands on a 2012 study that examined the racial disparity in breast cancer mortality over a three-year period (2005-07) in the 24 largest U.S. cities. In an effort to see how these disparities changed over a longer time period, this new study analyzed the number of breast cancer deaths reported across four five-year intervals between 1990 and 2009 in the 50 largest U.S. cities; data were available for 41 of the most populous 50 cities.

The study found that in most cities the white death rate declined between 1990 and 2009, while the black death rate did not change substantially, resulting in an increasing disparity. Although the death rates declined for both white and black women in the United States as a whole over this time period, the white death rate decreased twice as much, leading the researchers to identify four key factors that led to this racial disparity in breast cancer mortality: differential access to screening, quality of the screening process, access to treatment, and quality of treatment.

How this report is designed

Throughout this report, we will describe mortality rates and rate ratios. Mortality rates from breast cancer are age-adjusted per 100,000 women in the population. The graphs accessible via the links in the map above and on this page present the mortality rates for black women (the black line) and for white women (the red line) for the 20-year interval from 1990-2009.

The rate ratio is the rate for black women divided by the rate for white women. If the Black rate is higher than the White rate, then the rate ratio will be greater than one. If it is less, then the rate ratio will be less than one. The significant rate ratios for all time points are denoted in the graph with an asterisk. We use the data for the US as an example of how this works and then repeat similar graphs throughout this report. All of the graphs in this report follow this format.