The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States

Abstract

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.

The Impact of a Grocery Store Closure in One Rural Highly Obese Appalachian Community on Shopping Behavior and Dietary Intake

“…Martin County, Kentucky, is in the Central Appalachian region of the U.S. and has an adult obesity prevalence greater than 40%. In addition to high obesity prevalence, the county experiences high rates of cancer prevalence and other obesity-related chronic illnesses such as Type II diabetes and heart disease [ 13 , 14 ]. The county also faces persistent poverty [ 15 ], with a median household income of approximately $30,320, and 32% of residents currently living in poverty [ 16 ].…”

Geographic determinants of colorectal cancer in Louisiana

“…Geographic disparities in cancer incidence and outcomes can be due to numerous factors. At the individual level, demographic factors, occupation, poverty, and health behaviors or beliefs can contribute to cancer risk [1][2][3]. Additionally, there are many well-established cancer risk factors beyond the individual level, including healthcare access, living environment (social and physical), and large-scale policy and systems [2].…”

Engaging rural communities in cancer prevention and control research: Development and preliminary insights from a community‐based research registry

“…[39][40][41] When stratified by race, AA/Black participants reported fewer cancer risk behaviors (i.e., lower alcohol use, greater mammography screening), similar smoking status, and higher overweight/obesity compared with White respondents. Given well-documented links between several cancers and obesity 35 and known disparities in cancer incidence and mortality among AA/Black and rural residents both nationally 13,36 and in Virginia, 14,37 a more nuanced examination stratified by geography and race/ ethnicity that specifically examines multiple levels of influence (individual, interpersonal, and community) and domains of influence (behavioral, biological, physical environment, and sociocultural environment) 38 are needed.…”