Derveeuw S, Van Landschoot F, Willems S, Vanthomme K, Toma S. Navigating racialised healthcare: Intersectional experiences shaping cancer screening among Black women in Belgium. Soc Sci Med. 2026 Aug;403:119449. doi: 10.1016/j.socscimed.2026.119449.
Abstract
Background: Research on cancer screening disparities among racially minoritised populations in Europe has largely relied on migration-focused frameworks, overlooking how racialisation itself structures engagement with preventive care. Qualitative evidence on how racially minoritised women experience and navigate European healthcare therefore remains scarce, with existing literature predominantly situated in the United States.
Aims: This study examines how prior healthcare experiences, including experiences of racism, shape breast and cervical cancer screening engagement among Black women of African descent in Flanders, Belgium, and how women make sense of and respond to these experiences through developing coping strategies. Methods: Semi-structured interviews were conducted with 36 women (aged 25-68), purposively sampled across migration generations, (parents') country of origin, socioeconomic positions, and language backgrounds. Data were analysed using reflexive thematic analysis, guided by a racialisation framework and intersectional lens.
Analyses: We generated three themes from the interview data; Naming racism captured a spectrum from overt discrimination, particularly pain minimisation rooted in racialised assumptions, to ambiguous microaggressions and vicarious racism, with the capacity to articulate racism shaped by migration generation and education; (Il)legitimacy captured how first-generation women internalised hierarchies of deservingness, framing respectful care as earned through gratitude, legal status, or linguistic assimilation; Divergent coping: persistence vs withdrawal described persistent covert coping strategies including mobilising family as linguistic intermediaries and switching providers while also illustrating how cumulative negative experiences led some women to disengage from healthcare entirely, including screening. Notably, no participants reported confrontational coping strategies.
Discussion: These findings demonstrate that screening disparities cannot be understood through migration-related factors alone. Centring racialisation makes visible structural dynamics that cultural or linguistic explanations obscure, arguing for institutional accountability over individual adaptation.
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