Cancer Health Disparities : From Determinants of Disparities to Solutions for Equity

Despite improvements in strategies for early detection and cancer treatment, racial and ethnic groups and individuals from other medically underserved populations continue to experience disparities in cancer morbidity and mortality. Research in cancer health disparities has evolved from first generation studies that described racial differences in morbidity and mortality to research that examines the efforts of interventions that focus on increasing access to early detection and treatment. As a result of these efforts, racial background, socioeconomic characteristics, access to high quality cancer care, and psychological and social factors have been documented as important determinants of cancer health disparities; these factors provide the context within which cancer is detected, treated, and prevented. The field of cancer health disparities is now at a critical juncture where it is essential to move beyond descriptive information on determinants of disparities in cancer morbidity and mortality to translational studies that examine basic biological processes and how these processes interact with social, psychological, and behavioral factors to contribute to disparities in cancer risk and outcomes. Empirical evidence about the influence of multilevel determinants has grown, and now, more than ever, efforts are being made to understand the independent and interactive effects of biological, psychological, behavioral, and social determinants of cancer health disparities and to translate this information into sustainable interventions for cancer prevention, control, and treatment. Provides an in-depth examination of emerging evidence about multilevel determinants of cancer health disparities Describes novel frameworks and approaches that are being used to understand and address cancer health disparities Presents evidence-based interventions that have potential to achieve equity in cancer outcomes Reviews the effects of previous and ongoing approaches to address disparities Preface Acknowledgements Contents Multilevel Determinants of Cancer Health Disparities Introduction Multilevel Determinants of Cancer Health Disparities A Call to Action for Cancer Health Equity and Future Directions References Basic Science Research in Cancer Health Disparities Introduction Foundations of Basic Science Research in Cancer Current Efforts in Basic Science Research to Address Cancer Health Disparities Future Directions and Conclusions References Chronic Stress, Biobehavioral Processes and Health Implications in Understanding Disparities Integrated Biopsychosocial Models of Stress, Adversity, and Disparities in Health Outcomes Prevalent Chronic Stressors and Processes in Specific Communities Impact of Chronic Stressors and Intra- and Interpersonal Processes on Biobehavioral Mechanisms in Cancer in Specific Communities Psychosocial Intervention Effects on Stress, Biobehavioral Processes, and Outcomes in Cancer Patients Conclusions and Future Directions References Translational Efforts in Precision Medicine to Address Disparities Overview of Translational Research The Arc of Health Justice: Overcoming a History of Medical Abuse and Neglect The Transformative Power of Precision Medicine on Disparities with Diversity in Translational Research Bridging the Clinical Gap of Cancer Survival Disparities with Translational Research Race-Conscious Data Science and Artificial Intelligence Emerging Opportunities and Priorities for the Future Translational Research References Patient Navigation for Cancer Screening and Treatment Introduction What Is Patient Navigation? What Do Patient Navigators Do? Why Is Patient Navigation an Appealing Strategy to Reduce Disparities in Cancer Care and Outcomes? Efficacy of Patient Navigation at Reducing Racial and Ethnic, Socioeconomic, and Geographic Disparities in Outcomes Across the Cancer Care Continuum Race and Ethnic Minorities Patients Who Are Low Income, Underinsured, or Treated at Safety-Net Hospitals Geography Practical Considerations for the Implementation of Effective PN Programs to Eliminate Cancer Disparities Types of Patient Navigators Navigator Training, Certification, and Evaluation Having a Patient Navigator Champion Cost and Economic Feasibility of Patient Navigation Conclusions References Tobacco Control and Lung Cancer Screening to Address Disparities Introduction Cigarette Smoking and Cessation Among African Americans Smoking Cessation in African Americans Improving the Precision of Smoking Cessation Interventions Early Detection for Lung Cancer Conclusions and Future Directions References Evidence-Based Interventions for Cancer Equity, Clinic-Based Interventions to Promote Patient-Centered Care, and Weight Loss and Management Introduction Theoretical Foundations and Conceptual Frameworks The Chronic Care Model Framework for Integrated Clinical and Community Systems of Care PCP-Delivered Approaches for Adult Obesity Treatment PCP-Delivered Approaches for Pediatric Obesity Treatment Conclusion References Integrating Social Determinants into Health Care Introduction The Intersection of Social Influence and Health A Framework for the Relationship Between Social Factors and Cancer Disparities Social Determinants and Social Needs Interventions to Address Individual-Level Social Needs Social Needs Screening in Health Care Currently Available Screening Tools Screening Tool Accessibility, Acceptability, and Adoptability User Testing Interventions to Address Social Needs Partnering to Address Patients’ Social Needs Evidence from Integrating Social Interventions into Care Overall Acceptance of Social Interventions in Health Care The Success of Social Interventions in Cancer Considerations for Social Interventions to Further Promote Equity Summary References Community-Based Interventions to Address Obesity in the Context of Health Equity Introduction Community-Based Interventions: Obesity Prevention Focused on Diet and Nutrition Race and Ethnicity Income Rural vs Urban Community-Based Interventions: Obesity Prevention Focused on Physical Activity Race and Ethnicity Income Rural vs Urban Future Directions: Implementation Strategies and Measures for Success References Community-Based Interventions for HPV Vaccination Overview/Introduction HPV Vaccination Among Individuals Living in Rural Communities Rural vs. Urban HPV Vaccination Rates Unique Challenges, Barriers, and Facilitators for Rural Populations Interventions to Address Rural Disparities in HPV Vaccine Initiation and Completion HPV Vaccination Among Medically Underserved Individuals and Those of Limited Financial Resources HPV Vaccine Initiation and Completion Among Medically Underserved Individuals and Those of Limited Financial Resources Barriers and Facilitators to HPV Vaccination Among Medically Underserved Individuals and Those of Limited Financial Resources Interventions to Increase HPV Vaccination Among Medically Underserved Individuals and Those of Limited Financial Resources HPV Vaccination Among Individuals from Racial/Ethnic Minority Groups and/or Individuals Born Outside of the USA HPV Vaccination Rates Among Racial/Ethnic Minority Groups and/or Individuals Born Outside of the USA Unique Challenges, Barriers, and Facilitators for Racial/Ethnic Minority Groups and/or Individuals Born Outside of the USA HPV Vaccine Interventions for Racial/Ethnic Minority Groups and/or Individuals Born Outside of the USA HPV Vaccination Among Young Adults HPV Vaccination Rates Among Young Adults Barriers, Facilitators, and Challenges to HPV Vaccination for Young Adults Targeted HPV Vaccination Interventions for Young Adults HPV Vaccination Among Sexual and Gender Minority Individuals HPV Vaccination Rates Among Sexual and Gender Minority Individuals Barriers and Facilitators for HPV Vaccine Series Initiation and Completion Among Sexual and Gender Minority Individuals Interventions to Address Disparities in HPV Vaccine Initiation and Completion Among Sexual and Gender Minority Individuals HPV Vaccination in Novel Settings Settings Pharmacies Schools Dental Practices Using Immunization Registry and Immunization Information Systems Data Gaps and Future Directions References Opportunities, Challenges, and Priorities for Achieving Equity in Cancer Outcomes Introduction Opportunities Reducing Disparities in Minority Populations Will Help Lower the Cancer Burden Studies Among Minority Populations Can Help Understand Cancer Etiology Challenges Challenges That Affect Understanding of the Contribution of Biology to Health Disparities Lack of Representation in Tumor Sequencing Studies Lack of Representation in Biospecimen Efforts to Foster New Mechanistic Studies Lack of Representation in Clinical Trials Behavioral Challenges in Achieving Health Equity Challenges with Biomedical Research Infrastructure and Environments Challenges in the Sociocultural Environment Challenges with the Healthcare System Priorities References Index