Black-identifying patients face many barriers to the receipt of equitable breast cancer care; however, little is currently known about the unique needs of this patient population, particularly in Canada. To address this gap, we identified and thematically grouped constructs from the published literature reporting on the needs of Black-identifying patients with breast cancer and compared these findings to a list generated through a virtual nominal consensus group (NG) attended by Canadian patients with breast cancer who self-identified as Black (n = 3). A scoping review was undertaken, and relevant citations published from database inception until January 2025 were identified from MEDLINE, Embase, and CINAHL. The literature review yielded 34 articles from the United States and identified 15 constructs consistent with the NG, which spanned the cancer continuum from screening to survivorship. The NG identified four additional constructs that were not found in the literature: advocacy and outreach, communication and health literacy, comorbidities and personalized care, and end-of-life care. The final set of constructs was then validated and prioritized by an expert panel consisting of patients with lived experience and relevant community partner organizations (n = 9) to drive future research, advocacy, and policy work. Patient navigation was identified as the top need, with financial support, access to culturally tailored information and resources, culturally relevant care, racialized data for treatment decision-making, and emotional support identified as high-priority needs.
In Canada, food insecurity disproportionately affects racialized and marginalized individuals, where Black households experience food insecurity at twice the rate of their non-racialized counterparts. Yet, few studies have examined the intersectional and multidimensional character of anti-Black racism and food insecurity experiences in urban, cosmopolitan high-income settings. This study addresses this gap by examining how anti-Black racism intersects with social identities to influence the experiences of food insecurity among Black households in Toronto. Specifically, it focuses on (a) effects of immigration status, disability, and gender identity on severity of food insecurity and (b) effects of intersectionality between immigration status, disability, and gender identity on severity of food insecurity among Black Canadians. Data for the study was obtained from surveys (n=432) and nine focus group discussions (n=96) conducted in 2024 and 2025. Quantitative and qualitative findings indicate that gender, immigration status, and disability severely impact food insecurity, and that employment, housing, and social assistance intersect with these identities in complex ways to influence the severity of food security. For gender, findings reveal that males were more likely to report severe food insecurity than their female counterparts. For immigration status, we find that employment discrimination, housing, and social assistance barriers play considerable role in the lived experiences of cultural food insecurity, with transportation a particularly notable driver. Unsurprisingly, most individuals with disabilities were severely food insecure compared with those without disabilities. The findings call for place-based and culturally responsive policy interventions that address the social and demographic spatial determinants of food insecurity.