scholarly journals An Overview of Cancer Health Disparities: New Approaches and Insights and Why They Matter

2020 ◽  
Author(s):  
Tsion Zewdu Minas ◽  
Maeve Kiely ◽  
Anuoluwapo Ajao ◽  
Stefan Ambs
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Social Stress ◽  
Access To Health Care ◽  
Health Care Disparities ◽  
Underserved Populations ◽  
Tumor Biology ◽  
Cultural Barriers ◽  
Cancer Therapies ◽  
Cancer Health Disparities

Abstract Cancer health disparities remain stubbornly entrenched in the US health care system. The Affordable Care Act was legislation to target these disparities in health outcomes. Expanded access to health care, reduction in tobacco use, uptake of other preventive measures and cancer screening, and improved cancer therapies greatly reduced cancer mortality among women and men and underserved communities in this country. Yet, disparities in cancer outcomes remain. Underserved populations continue to experience an excessive cancer burden. This burden is largely explained by health care disparities, lifestyle factors, cultural barriers, and disparate exposures to carcinogens and pathogens, as exemplified by the COVID-19 epidemic. However, research also shows that comorbidities, social stress, ancestral and immunobiological factors, and the microbiome, may contribute to health disparities in cancer risk and survival. Recent studies revealed that comorbid conditions can induce an adverse tumor biology, leading to a more aggressive disease and decreased patient survival. In this review, we will discuss unanswered questions and new opportunities in cancer health disparity research related to comorbid chronic diseases, stress signaling, the immune response, and the microbiome, and what contribution these factors may have as causes of cancer health disparities.

scholarly journals The Impact of Disasters on Populations With Health and Health Care Disparities

2010 ◽  
Vol 4 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Jennifer R. Davis ◽  
Sacoby Wilson ◽  
Amy Brock-Martin ◽  
Saundra Glover ◽  
Erik R. Svendsen
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Rural Areas ◽  
Health Care Disparities ◽  
Underserved Populations ◽  
Health Resources ◽  
Medically Underserved ◽  
Disaster Studies ◽  
Before And After ◽  
The Impact

ABSTRACTContext:A disaster is indiscriminate in whom it affects. Limited research has shown that the poor and medically underserved, especially in rural areas, bear an inequitable amount of the burden.Objective:To review the literature on the combined effects of a disaster and living in an area with existing health or health care disparities on a community's health, access to health resources, and quality of life.Methods:We performed a systematic literature review using the following search terms: disaster, health disparities, health care disparities, medically underserved, and rural. Our inclusion criteria were peer-reviewed, US studies that discussed the delayed or persistent health effects of disasters in medically underserved areas.Results:There has been extensive research published on disasters, health disparities, health care disparities, and medically underserved populations individually, but not collectively.Conclusions:The current literature does not capture the strain of health and health care disparities before and after a disaster in medically underserved communities. Future disaster studies and policies should account for differences in health profiles and access to care before and after a disaster.(Disaster Med Public Health Preparedness. 2010;4:30-38)

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Making the Best Use of Resources in Global Cancer Care

2020 ◽  
pp. e361-e366
Author(s):  
Juan Gago ◽  
Dinesh Pendharkar ◽  
Chandramauli Tripathi ◽  
Ophira Ginsburg
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Cancer Prevention ◽  
Social Inequalities ◽  
Cancer Control ◽  
Cancer Diagnostics ◽  
Cancer Health Disparities ◽  
High Quality ◽  
Use Of Resources ◽  
Public Health Challenges

Inequitable access to high-quality cancer control and care remains one of the greatest public health challenges in countries at all resource levels. Core issues include the limited oncology health care workforce and equitable access to affordable (essential) cancer diagnostics, medicines, surgery, systemic therapies, and radiotherapy, compounded by existing social inequalities. To reduce cancer health disparities globally and subnationally, countries can enhance their capabilities to deliver high-quality, affordable care closer to where most people live. Decentralization and integration of health services can be part of the solution, offloading the strained capacity of tertiary facilities where possible and expanding cadres of trained providers to support some aspects of cancer prevention and control that require a lesser degree of specialization. The strategy to eliminate cervical cancer provides a salient example of a data-driven effort that optimizes resources to dramatically reduce one of the greatest cancer health disparities globally. Here, we highlight two responses to meet the challenge through greater engagement of the primary care workforce and by adoption of universal health care coverage to ensure access to cancer prevention.

What does 'access to health care' mean?

2002 ◽  
Vol 7 (3) ◽  
pp. 186-188 ◽  
Author(s):  
Martin Gulliford ◽  
Jose Figueroa-Munoz ◽  
Myfanwy Morgan ◽  
David Hughes ◽  
Barry Gibson ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Cultural Barriers ◽  
Complex Concept ◽  
Barriers To Access ◽  
Access To Health ◽  
Equity Of Access ◽  
Diverse Groups ◽  
Physical Accessibility ◽  
Gain Access

Facilitating access is concerned with helping people to command appropriate health care resources in order to preserve or improve their health. Access is a complex concept and at least four aspects require evaluation. If services are available and there is an adequate supply of services, then the opportunity to obtain health care exists, and a population may 'have access' to services. The extent to which a population 'gains access' also depends on financial, organisational and social or cultural barriers that limit the utilisation of services. Thus access measured in terms of utilisation is dependent on the affordability, physical accessibility and acceptability of services and not merely adequacy of supply. Services available must be relevant and effective if the population is to 'gain access to satisfactory health outcomes'. The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society. Equity of access may be measured in terms of the availability, utilisation or outcomes of services. Both horizontal and vertical dimensions of equity require consideration.

Health and Health Care Among Transgender Adults in the United States

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Ayden I. Scheim ◽  
Kellan E. Baker ◽  
Arjee J. Restar ◽  
Randall L. Sell
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Disparities ◽  
Access To Health Care ◽  
The United States ◽  
Social Contexts ◽  
Annual Review ◽  
Publication Date ◽  
Physical And Mental Health ◽  
The Usa

Transgender (trans) communities in the USA and globally have long organized for health and social equity but have only recently gained increased visibility within public health. In this review, we synthesize evidence demonstrating that trans adults in the USA are affected by disparities in physical and mental health and in access to health care, relative to cisgender (nontrans) persons. We draw on theory and data to situate these disparities in their social contexts, explicating the roles of gender affirmation, multilevel and intersectional stigmas, and public policies in reproducing or ameliorating trans health disparities. Until recently, trans health disparities were largely made invisible by exclusionary data collection practices. We highlight the importance of, and methodological considerations for, collecting inclusive sex and gender data. Moving forward, we recommend routine collection of gender identity data, an emphasis on intervention research to achieve trans health equity, public policy advocacy, and investment in supporting gender-diverse public health leadership. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

An Interinstitutional Academic Collaborative Partnership to End Health Disparities

2010 ◽  
Vol 37 (4) ◽  
pp. 580-592 ◽  
Author(s):  
Barbara N. Logan ◽  
Leroy Davis ◽  
Veronica G. Parker
Keyword(s):  
Health Care ◽  
South Carolina ◽  
Health Disparities ◽  
Underserved Populations ◽  
Descriptive Analysis ◽  
Lessons Learned ◽  
Collaborative Partnerships ◽  
Academic Institutions ◽  
Human Relationships ◽  
Improve Health

Much has been published in the health care literature describing partnerships between academic institutions and community or health care agencies that are designed to improve health outcomes in medically underserved populations. However, little has been published regarding partnerships between minority- and majority-serving academic institutions with this same aim. Key principles of collaborative partnerships are used in a descriptive analysis of the development, functions, and benefits of such an interinstitutional academic partnership that was formed to reduce and ultimately eliminate health disparities in rural South Carolina. Lessons learned from the partnership parallel other human relationships where mutual respect and trust, open and clear communication, and shared decision and problem solving are important for building and sustaining partnerships.

scholarly journals Third-Year Medical Students’ Self-perceived Knowledge About Health Disparities and Community Medicine

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Rashida S. Smith ◽  
Alexis Silverio ◽  
Allison R. Casola ◽  
Erin L. Kelly ◽  
Maria Syl de la Cruz
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Medical Students ◽  
Community Health ◽  
Vulnerable Populations ◽  
Underserved Populations ◽  
Community Medicine ◽  
Perceived Knowledge ◽  
Medicine Clerkship ◽  
Knowledge And Attitudes

Introduction: Medical providers’ attitudes about caring for vulnerable populations have significant implications for persistent health disparities. Therefore, assessing medical students’ self-perceived knowledge about community-based medicine and care for underserved populations can provide insights for improving health care delivery to achieve health equity. We evaluated third-year medical students’ perceptions of their knowledge and attitudes about community medicine, and addressing health care needs of vulnerable populations. Methods: From October 2, 2017 to July 12, 2019, third-year medical students at a private, urban medical school were asked to complete an assessment survey during their family medicine clerkship orientation. The anonymous survey assessed students’ self-perceived knowledge and attitudes regarding community medicine and care of vulnerable populations. We examined differences in survey responses by student demographics. Results: A total of 401 students participated in the survey; 50.5% of respondents agreed that they had knowledge to assess health literacy of the patient, while only 22.2% of students agreed that they had knowledge about how to identify a community and conduct a community health needs assessment. Additionally, students agreed with being most comfortable providing care to adolescents (73.0%) and the elderly (69.5%), and that they were least comfortable caring for incarcerated individuals (31.7%) and immigrants/refugees (44.1%). Conclusion: Assessment of learners’ self-perceived knowledge can help highlight areas for educational interventions. Our findings suggest the need for improving medical student knowledge in areas of community health and health care for specific vulnerable populations.

scholarly journals Health Disparities: Challenges, Opportunities, and What You Can Do About It

2018 ◽  
Vol 28 (3) ◽  
pp. 223-231 ◽  
Author(s):  
Hani K. Atrash
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
The United States ◽  
Care Providers ◽  
Access To Health ◽  
Race Ethnicity

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.  

scholarly journals A Longitudinal Underserved Community Curriculum for Family Medicine Residents

2019 ◽  
Vol 51 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Christine Jacobs ◽  
Adam Seehaver ◽  
Sarah Skiold-Hanlin
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Family Medicine ◽  
Cultural Competence ◽  
Community Health ◽  
Underserved Populations ◽  
Treatment Plan ◽  
Knowledge Gain ◽  
Underserved Community ◽  
Family Medicine Residents

Background and Objectives: Postgraduate education in cultural competence and community health is a key strategy for eliminating health disparities in underserved populations. Evidence suggests that an experiential, rather than knowledge-based approach equips physicians with practical and effective communication tools that generalize to a greater diversity of patients and cultures. However, there is limited data about the efficacy of a longitudinal, experiential residency curriculum. This study details the results of a longitudinal underserved community curriculum for family medicine residents training in a federally qualified health center. Methods: All residents in the first 5 years of a new residency participated in a longitudinal curriculum of workshops and seminars focused on social determinants of health and cultural competency for underserved patients. Pre- and postcurriculum surveys assessed knowledge gain. Self-reported Likert scale ratings assessed attitudes and confidence related to underserved care. Results: Pre/post learning evaluations after each seminar documented average knowledge increase of 31.0% and 28.8%, respectively. At the end of the 3-year curriculum, 81.8% of residents reported confidence in their ability to incorporate culturally relevant information into a treatment plan and 57.1% of residents reported feeling very aware of obstacles faced by underserved populations seeking health care and of the relationship between sociocultural background, health, and medicine. Conclusions: A longitudinal, experiential curriculum in underserved community health and cultural competence can improve resident knowledge and attitudes with respect to health disparities and delivering health care to diverse patient populations.

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