ACS research shows social determinants of health linked with profound inequities.
New reports released this week by the American Cancer Society researchers and others show food, housing, and transportation insecurity are associated with disparities in cancer care and patient outcomes. The dissemination papers, released along with an accompanying editorial, were published today in the Journal of the National Cancer Institute (JNCI).
The dissemination papers were led by ACS researchers, as well as those from Baylor College of Medicine and the Hollings Cancer Center at the Medical University of South Carolina. They show how differences in social determinants of health – the conditions in the places where people live, learn, work, and play – are associated with profound inequities in cancer incidence, care delivery, and patient outcomes, including stark disparities in survival. The three papers identified housing, transportation, and food insecurity among patients with cancer, outlining a call to action to address and improve health disparities from a series of webinars sponsored by the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine.
“Reducing long-standing disparities in cancer care and patient outcomes in the United States will require addressing social risks in cancer care, including but not limited to food, housing, and transportation insecurity,” said Dr. Robin Yabroff, ACS scientific vice president, health services research, and senior author of the paper addressing transportation insecurity among patients with cancer and a co-author of the paper addressing housing insecurity. “It’s critical we ensure that the remarkable progress in cancer care is equitably accessible for all patients.”
Researchers authoring the papers summarized existing evidence related to disparities in cancer care and patient outcomes, as well as identifying promising interventions and research opportunities to inform policy and improve health equity. According to the authors, more than 1 in 5 patients with cancer in the United States struggles to meet at least one of these basic needs, and estimates are much higher for patients from historically marginalized populations including those of Black race, Hispanic ethnicity, or living in poverty. Material hardships are associated with delays in cancer diagnosis and initiation of cancer-directed therapy, greater distress and financial toxicity, and a higher risk of relapse and death.
“Accumulating evidence shows that housing insecurity, including lack of safe, affordable, and stable housing, can influence – and be influenced by – cancer care,” said Dr. Qinjin Fan, senior scientist, health services research at ACS and lead author of the paper addressing housing insecurity among patients with cancer. “Systematically identifying and addressing housing insecurity to reduce health disparities will require greater investment at the practice, systems, and broader policy levels.”
ACS programs, including Hope Lodge and Road To Recovery, can help to address some of these challenges, especially those related to transportation and housing near treatment.
