Public Health, Black Culture, Health Equity
Examining Barriers to Cancer Care: A Needs Assessment of African American and Black African Immigrants in Iowa
Gawain J. Williams, Hannah Huang, Megan Schmidt, Kelly Wells Sittig, Natoshia Askelson, Sarah H. Nash
June 12, 2026 at 9:19:55 AM
Abstract
Non-Hispanic Black (NHB) Iowans experience significantly higher cancer incidence and mortality rates compared to non-Hispanic White counterparts. Through key informant interviews with 20 Black Iowans (14 African Americans, 6 Black African immigrants), this study identifies six dominant themes using the Health Equity Framework: health literacy and cultural understanding; structural barriers to care; interpersonal dynamics and communication; trust; strengths and resiliencies; and community-identified solutions. 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. Findings highlight the necessity for tailored, subpopulation-specific interventions.
Qualitative needs assessment of cancer care barriers among 20 Black Iowans, distinguishing the distinct experiences of African Americans and Black African immigrants. The authors argue for tailored, subpopulation-specific interventions rather than a one-size-fits-all approach in rural states with limited racial diversity.