African-American women are less likely to get breast cancer but more likely to die from it compared to white women, and researchers from Washington University are trying to figure out why.

Sarah Bollinger, 30, is a doctoral student in social work whose dissertation deals with the disparities in breast cancer for black women. The city of St. Louis is her lab, she said, and she soon will start interviewing women from targeted neighborhoods who have been newly diagnosed with breast cancer. She wants to find out what their barriers are to getting treatment.

A lack of access to care has already been identified as a problem for low-income and minority patients. Bollinger hopes to identify the reasons women aren't getting to treatment, and how cancer centers might help with solutions, whether the concerns are child care, transportation or money.

But it's not just access to care that's leading to a higher death rate. Bollinger plans to focus her research on a particularly deadly subtype of breast cancer known as triple negative that develops more frequently in young black women.

Researchers have learned through animal studies about a link between the cancer subtype and stress factors that could include neighborhood crime, single motherhood, domestic violence, depression and poverty. It's believed that stress can create chemical changes in a woman's body that can make her more susceptible to tumors.

"We know this link exists, but we don't know what these key stressors are," Bollinger said.

Bollinger, who grew up in south St. Louis County, said she became passionate about social justice as an undergraduate at Webster University. She moved in as a full-time volunteer at the Karen House, a Catholic Worker facility for homeless women and children in north St. Louis.

One week after their wedding, Bollinger's husband was diagnosed with thyroid cancer. The couple moved to New York, where Bollinger was studying for a master's degree in social work. She was assigned to an internship at a palliative care program in Brooklyn, working with people who had limited resources and were dying of cancer.

Bollinger said those personal and professional experiences with cancer and economic disparities inspired her research (and added that her husband has been cancer-free for more than five years).

For her dissertation, Bollinger would like to recruit 12 to 20 young black women with a recent diagnosis of triple negative breast cancer. She received a two-year, $40,000 grant from the American Cancer Society to help fund the research.

In the long run, Bollinger hopes that identifying similarities in the women's histories can inspire societal changes to minimize their exposure to health risks.

"Nobody's been listening to them in the past," she said.