The Association Between Fatalism and Mammography Use in Korean American Immigrant Women

Mi Hwa Lee, Saahoon Hong, Joseph R. Merighi

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Fatalism is reported as a salient cultural belief that influences cancer screening disparities in racial and ethnic minority groups. Previous studies provide a range of measures and descriptions of cancer fatalism, but no studies to our knowledge have analyzed how fatalistic views cluster together within subgroups to form distinct profiles, and how these profiles can be predicted. This study identified subgroups of Korean American immigrants with similar fatalistic beliefs toward cancer and examined the influence of fatalism, health belief variables, and health literacy on mammography use. A cross-sectional survey design was used to obtain a convenience sample of 240 Korean American immigrant women in Los Angeles, California. Latent class analysis was used to identify unobserved subgroups of fatalism. Hierarchical logistic regression models were used to identify predisposing, enabling, and need factors associated with recent mammography use. The latent class analysis model identified three cancer fatalism subgroups: high fatalism (17.8%), moderate fatalism (36.7%), and low fatalism (45.5%). Women in the high fatalism subgroup were more likely to have had a mammogram within the past 2 years than women in the low fatalism subgroup. Regression analysis revealed three facilitators of recent mammogram use: level of fatalism, perceived barriers to mammogram, and family history of cancer. Although cultural beliefs can have a powerful influence on health-seeking behavior, it is important to weigh individual and contextual factors that may weaken or mediate the relationship between fatalism and engaging in preventive care such as having a mammogram.

Original languageEnglish (US)
Pages (from-to)740-749
Number of pages10
JournalHealth Education and Behavior
Issue number4
Early online dateAug 15 2021
StatePublished - Aug 15 2021

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by an American Cancer Society Doctoral Training Grant in Oncology Social Work (DSW16-069-01-SW), which provided funding for part of the first author’s doctoral dissertation research.

Publisher Copyright:
© 2021 Society for Public Health Education.


  • Asian
  • cancer
  • cancer prevention and screening
  • health disparities
  • health equity
  • latent class analysis
  • population groups
  • women’s health

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't


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