Jane McArthur

Poster: Investigating Women's Understandings Of Breast Cancer Risks: Exploring Environmental Health Literacy in a Population at Risk Preliminary findings of dissertation research, presented at Windsor Cancer Research Group International Conference, November 17, 2018

Healthcare workers (HCWs) in Ontario, Canada have faced unprecedented risks during the COVID-19 pandemic. They have been infected at an elevated rate compared to the general public. HCWs have argued for better protections with minimal success. A worldwide shortage of N95s and comparable respirators appears to have influenced guidelines for protection, which stand at odds with increasing scientific evidence. In-depth interviews were conducted with ten frontline HCWs about their concerns. They reported that the risk of contracting COVID-19 and infecting family members has created intense anxiety. This, in conjunction with understaffing and an increased workload, has resulted in exhaustion and burnout. HCWs feel abandoned by their governments, which failed to prepare for an inevitable epidemic, despite recommendations. The knowledge that they are at increased risk of infection due to lack of protection has resulted in anger, frustration, fear, and a sense of violation that may have lon...

Research on media coverage of breast cancer has illustrated a tendency to report most often on prevalence, detection and treatment with a general lack of environmental and prevention oriented stories. In spite of growing evidence of links between environmental and occupational exposures and breast cancer causation, the media seem generally to omit these factors. A detailed critical discourse analysis (CDA) was conducted on 125 articles from the Toronto Star in the year 2012, with the Propaganda Model (PM) as the theoretical framework. Seven different themes were found in the coverage of breast cancer and CDA was utilized to expose how the dominant ideology came to bear on those texts, including the general omission and/or downplaying of environmental and occupational exposures in relation to breast cancer, as well as primary prevention. Given the significance for public health, understanding how the media cover the breast cancer epidemic can reveal necessary paradigm shifts.

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.

Healthcare workers (HCWs) in Ontario, Canada have faced unprecedented risks during the COVID-19 pandemic. They have been infected at an elevated rate compared to the general public. HCWs have argued for better protections with minimal success. A worldwide shortage of N95s and comparable respirators appears to have influenced guidelines for protection, which stand at odds with increasing scientific evidence. In-depth interviews were conducted with ten frontline HCWs about their concerns. They reported that the risk of contracting COVID-19 and infecting family members has created intense anxiety. This, in conjunction with understaffing and an increased workload, has resulted in exhaustion and burnout. HCWs feel abandoned by their governments, which failed to prepare for an inevitable epidemic, despite recommendations. The knowledge that they are at increased risk of infection due to lack of protection has resulted in anger, frustration, fear, and a sense of violation that may have long-lasting implications.

Chapter in the Edited book "Sick and Tired: Health and Safety Inequalities", Edited by Stephanie Premji

Recognition, prevention and compensation are predicated on prevailing social discourses about hazards and health problems. Jane McArthur, in Chapter 6, considers the role of the media in perpetuating dominant representations of breast cancer, a disease that claims the lives of over half a million women worldwide each year (WHO 2016). Based on an analysis of Toronto Star newspaper articles, McArthur determines that constructions of breast cancer risk in media discourses centre on lifestyle, genetics and personal responsibility, while occupational and environmental risks and primary prevention are largely omitted. She argues that discourses that emphasize individual choice and modifiable personal behaviours fail to account for the current scientific understandings of breast cancer risks and reflect neoliberal dogmas and policies.

Poster: Investigating Women's Understandings Of Breast Cancer Risks: Exploring Environmental Health Literacy in a Population at Risk

Preliminary findings of dissertation research, presented at Windsor Cancer Research Group International Conference, November 17, 2018

Dedicated to all the brave, insightful, powerful women who participated in the study. Each story contributed significantly. Thank you for giving your voices to this issue. PREAMBLE Breast cancer connects dots between economic, political, health and social systems. The narratives of the women in this study bring out missing links of the traditional breast cancer narratives. They centre the marginalization of women's experiences and make significant contributions to new strategies for the primary prevention of breast cancer in workplaces, communities, and beyond. This project concluded during the Covid-19 pandemic. The implication that individuals are to blame for health problems and how governance matters to health were apparent through Covid-19. The virus and public health responses illustrated how health is nested in the conditions in which the individuals live, work and play. Covid-19 is an environmental health issue. So too is breast cancer.

October is Breast Cancer Awareness Month. I see the messages in the media, the pleas for donations, the pledge sheets coming home from my children’s school. As someone working in cancer research and advocacy for two decades, I too have a plea for this October: take off the rose-coloured glasses and realize we need to do more when it comes to breast cancer prevention. Awareness is not enough.

Water officials in Canada now seem to be using the PR playbook for denial and manufacture of doubt. Responding to the findings of a disturbing investigation into the lead in Canadian tap water released on November 4, 2019, public officials seem to be taking their cues from the tobacco, oil, asbestos, and plastics industries as they downplay serious public health concerns. Discrediting science as a political strategy goes against our values in Windsor-Essex where building relationships between citizens, their governments and public institutions is a stated mission.

Had government and public health officials been applying the precautionary principle, as opposed to waiting for evidence the virus was here, governments at all levels, in a coordinated strategy, could have been taking action well in advance of the first confirmed case. Instead, we are dealing with a COVID-19 response of slapdashery and catch-up measures being mobilized to a public who doesn’t know what messages to believe or who to trust.

The COVID-19 virus pandemic that began in late 2019 has spurned emergency actions across the globe. The global, national, and regional responses have been varied and changing as the situation escalates in some regions and settles down in others. Just as the success of the climate youth movement has been attributed to the clarity and consistency of messaging, we need this same strategy with COVID-19. We also need that clarity as we move beyond the current pandemic and address ongoing societal challenges, using it as a transformative force to move forward as a global community.

The message we need now and for the future is one of collective values—values that place people, their needs, and their health over the economy as disconnected from those human needs.

From economic difficulties to mental health, mobility and surveillance concerns to gendered, racialized and class disparities, the public health measures taken in response to the novel coronavirus are taking their toll. And as public health officials and governments begin to plan for transitioning out of these measures, there are many lessons to be learned from how things have been handled thus far.

A primary lesson that should come out of what has transpired is the value of the precautionary principle.

Breast cancer is an international public health issue. Much of the messaging on breast cancer suggests women’s individual lifestyle factors are to blame. This approach blinds us to underlying social and structural influences on breast cancer — namely environmental and workplace conditions and exposures, and health inequalities.

The health crisis unfolding around the globe with the arrival of the novel coronavirus, COVID-19, has already had monumental impacts. News media report the pandemic is an unprecedented event. However, casting this crisis as exceptional narrows the focus. While the COVID-19 virus is unprecedented in its transmissibility, the lack of preparedness and inadequate protection for health-care workers (HCWs) is an old story. If we look through the lens of worker protection, the COVID-19 pandemic is neither novel nor unforeseen. In many ways, it is an escalation of the ongoing failure of health and safety regulatory oversight. It also underscores the chronic underfunding and increasing privatization of the health-care sector.

October is Breast Cancer Awareness month and every year thousands of people don pink outfits and collect money for a variety of breast cancer charities.  This session will highlight some of the preventable occupational risks to breast cancer. Our fantastic speakers include:
Jane McArthur - Work and Prevention SSHRC, University of Windsor, Canada
Helen Lynn - Alliance for Cancer prevention , Health and Environment Researcher
Jane Stewart - TUC General Council, Unite NEC and Chair Womens Committee, Unite Convener at Unilever Port sunlight

On International WomensDay Women & Gender Studies at the University of Windsor held a panel on breast cancer, the experience of the disease, causes beyond individual and influences that shape the breast cancer movement - with Sharon Batt and Mercedes Buhagiar &  Jane McArthur

What if you got sick with a disease you didn't know you were at risk of getting? What if several of your co-workers got the same disease? This is the story unfolding in my research at the Ambassador Bridge where women are getting breast cancer at unexpected rates.