BMC Public Health, cilt.26, sa.1, 2026 (SCI-Expanded, Scopus)
Introduction: Although there is research on the medical causes and effects of breast cancer, studies on environmental and social factors are quite limited. We aimed to analyze the impact of women's employment and education status, and the role of healthcare expenditures, on breast cancer-related deaths over time. Methods: The study used Turkey's breast cancer mortality rate, updated by the World Health Organization between 2009 and 2023, and women's employment and education data from the World Bank Country Reports. Women's healthy life expectancy and healthcare expenditures were used as control variables. The study was designed in a longitudinal mixed model. Spearman’s rho and Generalized Linear Model analysis were used. Results: Breast cancer mortality was significantly and positively correlated with female education (r = 0.954; p < 0.01) and life expectancy (r = 0.714; p < 0.01). Correlation between breast cancer mortality with female employment and health expenditure were insignificant (p > 0.05). effect of female education on breast cancer mortality was statistically significant (B = 157.661; p < 0.01). Effects of female employment, female life expectancy and health expenditure on breast cancer mortality were statistically insignificant (p > 0.05). There was a strong and positive correlation between female education and breast cancer mortality. Discussion: The higher rate of breast cancer deaths among women with higher education levels, and the statistical significance of this relationship, suggests that educated women also have a poorer rate of breast cancer progression, and those factors such as environmental factors and stress may also contribute to this negative outcome. Our results show that focusing on risk factors caused by education is important in reducing breast cancer mortality.