Date of Award

3-10-2021

Publication Type

Doctoral Thesis

Degree Name

Ph.D.

Department

Sociology, Anthropology, and Criminology

First Advisor

Jane Ku

Keywords

breast cancer, environment, occupation, prevention, public health, women

Rights

info:eu-repo/semantics/openAccess

Abstract

Worldwide, almost 630,000 women died from breast cancer last year. North American women face a lifetime risk for breast cancer of one in eight, with nearly 500 new breast cancer diagnoses each week in Canada. The overall global incidence of breast cancer continues to rise. Five to ten % of cases are related to genetics, family history, lifestyle and behaviour, all factoring into overall incidence. Fewer than 50% of breast cancers can be explained by the known or traditionally suspected risk factors. The complexity of the varied contexts, which produce disparate degrees of risk, should be incorporated into prevention strategies. Increased attention to environmental and occupational risk factors represents a significant site where primary prevention interventions could be effective. This qualitative study examines how women who work in an environment with an identified risk of breast cancer construct understandings and narratives of their risks and how women perceive and exercise agency in the acceptance, avoidance or negotiation of those risks. Personal narratives were gathered through in-depth individual interviews from 25 women who are current or former employees of the Ambassador Bridge in Windsor, Ontario, Canada. The research draws on Kleinman's ecological approach, where the subject location is key to the framework for understanding health information within its socio-cultural context. Kleinman's approach is further developed in this study by incorporating feminist standpoint theory and a socio-ecological framework. The theoretical approach constructed by incorporating these multiple perspectives frames women's subjective understandings as situated in their socio-cultural contexts and allows understanding subject location and, importantly, agency—or control over breast cancer risks—as seen through the subject in her location. The narratives reveal how women construct their understanding of breast cancer risks, particularly concerning environmental factors, based on personal knowledge, occupational experience, and through the lens of gender. The exploration uncovers and analyzes how women's subject location influences understandings, interpretations and use of knowledge about perceived risks for breast cancer in a risk-bearing environment and their related ideas about agency directed at risk mitigation. Policy, regulation, and risk mitigation strategies are enhanced by understanding how women make meaning in their knowledge of breast cancer risks and how they perceive the possibilities and barriers to agency to mitigate risks. The way women understand breast cancer risk is dynamic, contextualized, multisectoral, and relational and offers insights into understanding spaces. As seen from women’s standpoint, breast cancer risk is not solely a biomedical phenomenon residing in the body, determined by genetics or lifestyle choices, but is experienced by women in a nested set of social, cultural and political relationships. Increased understanding and collaborative partnerships between medical science and social science would improve breast cancer prevention strategies, particularly where risks are related to involuntary, environmental exposures. The findings contribute to efforts to address environmental health risks at the Ambassador Bridge and other workplaces and communities.

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