One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There is a critical need for additional research to understand the disparities experienced by all rural racial/ethnic minority populations. We propose that policies aim to increase access to care and healthcare resources for these communities. Further, that observational and interventional research should more effectively address the intersections of rurality and race/ethnicity through reduced structural and interpersonal biases in cancer care, increased data access, more research on newer cancer screening and treatment modalities, and continued intervention and implementation research to understand how evidence-based practices can most effectively reduce disparities among these populations.
What is already known on this topic? States, territories, and tribal organizations are required to develop comprehensive cancer control plans that describe the cancer burden and disparities in their jurisdiction and provide goals, objectives, and strategies to address cancer.What is added by this report? About two-thirds of states, territories, and tribal organizations considered "rural" in their plans; only about one-third of plans included a rural-specific strategy.What are the implications for public health practice?These findings suggest that additional financial resources and technical assistance are needed to help jurisdictions address rural cancer disparities more comprehensively.
Regardless of infection control experience, Australian infection control professionals must be adequately prepared to contribute to, access, appraise, and where appropriate, apply best evidence to their practice. We suggest that computer literacy, an understanding of research principles, and familiarity with infection control literature are three essential skills that infection control professionals must possess and regularly exercise.
In early 2003, the global infection control community faced a great challenge, sudden acute respiratory syndrome (SARS). The rapid spread of SARS, its capacity to infect health care workers, and its many unknown features in the early days of the outbreak meant that health care workers were unsure of the most effective methods of infection control to prevent disease transmission. These conditions made designing appropriate, effective and standard infection control responses difficult. Innovation was necessary. This article provides a brief overview of global challenges in infection control and SARS. The author reports field observations and describes five selected examples of highly innovative, SARS-related infection control practices observed in three affected countries during the height of the 2003 outbreak. These examples relate to risk assessment, patient segregation, strategies to limit access to clinical areas, health care worker protection, and efforts to promote public confidence. Many of these strategies could be considered for use in the post-2003 SARS era, especially in preparation for an influenza or Avian influenza pandemic.
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