Applying Critical Feminist and Critical Race Theory to Address the Cultural and Financial Needs of Black/African American Women With Cancer: A Narrative Review.

This narrative review examines end-of-life (EOL) care for Black/African American women with breast and gynecologic cancers, highlighting how structural racism, gendered oppression, and financial toxicity drive major inequities in outcomes and experiences.

Key points:

• Persistent disparities in EOL care: The authors identify higher symptom burden, poorer access to high-quality palliative care, and disproportionate financial strain for Black/African American women with these cancers.
• Cultural perspectives on death and dying: They review philosophical perspectives on death and dying and describe cultural beliefs and practices around grief and EOL within Black communities, emphasizing that current cancer and palliative care models often fail to reflect these perspectives.
• Intersecting forms of oppression: The paper synthesizes evidence that structural racism, sexism, and economic disadvantage intersect to shape how Black/African American women experience serious illness, decision-making, and access to supportive services at the end of life.
• Limitations of current EOL frameworks: Current EOL care frameworks are critiqued as being insufficiently theory-driven, race-neutral in ways that obscure inequity, and inadequately responsive to cultural, social, and financial realities.
• Use of Critical Race Theory (CRT) and Critical Feminist Theory (CFT): The authors propose using CRT and CFT as guiding frameworks to:
  • Illuminate power and oppression: Make visible the role of power, oppression, and intersecting identities (race, gender, socioeconomic status) in EOL care.
  • Inform inclusive clinical practice: Improve communication, decision support, symptom management, and family engagement.
  • Shape equity-focused research: Center lived experience and address structural drivers of inequity.
  • Guide policy reform: Target financial toxicity, access barriers, and institutional biases in healthcare systems.

The review concludes that embedding CRT and CFT into EOL care design, delivery, research, and policy is essential to build justice-oriented, culturally grounded models of care that better support dignity, equity, and culturally attuned end-of-life experiences for Black/African American women with breast and gynecologic cancers.