Voices of breast cancer survivors on the US-Mexico border: A grounded theory approach

Background: Mexican-origin breast cancer patients in the United States, particularly those residing in medically underserved areas, face health disparities associated with social, economic, and cultural barriers resulting in poorer health outcomes and lower quality of life. The rural Imperial County, in southern California, is located on the US-Mexico border directly across from the city of Mexicali, the capital of Baja California, Mexico. It has been estimated that up to half the residents on the Texas-Mexico border have crossed into Mexico to utilize some form of health care, yet little is known about this phenomenon for women with breast cancer in California.

Objectives: To examine access and barriers to health care and cross-border cancer care utilization among immigrant women with breast cancer on the US-Mexico border.

Methods: Mexican-origin breast cancer survivors rarely have an opportunity to view their quotidian lives through the lens of a camera. In this project, we apply a grounded theory approach by combining in-depth ethnographic interviews and Photovoice methodology to explore life after cancer by survivors and utilization of services on the US-Mexico border.

Results: Financial burden including lack of proper health insurance and inability to copay is the major reason to cross border for cancer diagnosis and care. Surprisingly, participants return to Mexico for cancer diagnosis but prefer to receive treatment in the United States. Cancer patients believe that quality of cancer treatment is superior in the U.S. health care but feel comfortable with a Mexican doctor due to the race and language concordance.