What's Being Done about Inequality in Health Care?
Jane Farrell
Although there has been substantial progress in cancer treatment, screening, diagnosis, and prevention over the past several decades, addressing cancer health disparities—such as higher cancer death rates, less frequent use of proven screening tests, and higher rates of advanced cancer diagnoses—in certain populations is an area in which progress has not kept pace.
These disparities are frequently seen in people from low-socioeconomic groups, certain racial/ethnic populations, and those who live in geographically isolated areas.
Documented cancer health disparities include:
A higher incidence of a particularly aggressive form of breast cancer (the triple-negative subtype) among African American women than women of other racial/ethnic groups
Substantially higher rates of prostate cancer incidence and death among African-American men than men of other racial/ethnic groups
Higher rates of kidney cancer among American Indian and Alaska Natives than other racial/ethnic groups
Higher rates of liver cancer among Asian and Pacific Islanders than other racial/ethnic groups
Higher rates of cervical cancer incidence and death among Hispanic and African American women than women of other racial/ethnic groups
Many of the same population groups that experience cancer health disparities are also significantly underrepresented in cancer clinical trials.
There has been some recent evidence of progress against cancer health disparities, including reductions in lung and prostate cancer deaths among African-American men over the past decade. But researchers and public health officials agree that progress has come too slowly, and the cost of disparities—in terms of premature deaths, lost productivity, and the impact on communities—remains substantial and must be addressed.
Cancer Health Disparities Research
As recognition of cancer health disparities has grown, so have efforts to move beyond simply documenting the problem toward understanding all of its causes and developing and testing interventions to remedy it.
Numerous studies have shown that access to care is a critical element that contributes to cancer health disparities. Access to care is influenced by a web of factors, such as insurance status and proximity to health care facilities. Changes that have been implemented as a result of the Affordable Care Act are already helping to address the issue of access to health care by making recommended cancer screening and prevention interventions more affordable and expanding Medicaid.
Patient navigation, which is a strategy to help patients maneuver through our complex health care system, has also shown promise as a means of addressing cancer health disparities. Navigators can help patients overcome the multitude of barriers that can derail access to quality care, such as insufficient finances and lack of transportation.
