Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy

Abstract

Although cancer mortality rates declined in the United States in recent decades, some populations experienced little benefit from advances in cancer prevention, early detection, treatment, and survivorship care. In fact, some cancer disparities between populations of low and high socioeconomic status widened during this period. Many potentially preventable cancer deaths continue to occur, and disadvantaged populations bear a disproportionate burden. Reducing the burden of cancer and eliminating cancer‐related disparities will require more focused and coordinated action across multiple sectors and in partnership with communities. This article, part of the American Cancer Society's Cancer Control Blueprint series, introduces a framework for understanding and addressing social determinants to advance cancer health equity and presents actionable recommendations for practice, research, and policy. The article aims to accelerate progress toward eliminating disparities in cancer and achieving health equity.

Social Determinants Associated with COVID-19 Mortality in the United States

“…High cancer mortality rates indicate that a community has insufficient prevention, early diagnosis, and treatment [38]. Low income communities are notably at a disadvantage for cancer treatment due to a lack of resources, as wealth disparities are noted as the most common cause of health disparities [39].…”

How individual and neighborhood characteristics relate to health topic awareness and information seeking

“…Neighborhood characteristics include socioeconomic status (SES), health care spending, and access to health care ( Table 1 ). Specific variables for the analysis were based on both their availability in geographically-linked databases and previous literature that found associations with access to and use of health services ( Cooper, 2008 ) and to health disparities and outcomes ( Alcaraz et al, 2020 ). ZIP Code level SES estimates were obtained from the 2012–2016 American Community Survey (ACS) five years estimates.…”

“…According to behavioral change theories, exposure to health information can lead to related changes in health behaviors ( Hornik et al, 2013 ). In this paper, we examine the extent to which a series of neighborhood level indicators and individual level correlates (e.g., demographics) are associated with communication-related outcomes that are relevant to health behaviors and outcomes ( Alcaraz et al, 2020 ). Often consideration of neighborhood level factors is limited to health outcomes and fail to assess their relationship with variables proximal to behavior, like health information seeking and/or exposure.…”

Identification of Distinct Heterogenic Subtypes and Molecular Signatures Associated With African Ancestry in Triple Negative Breast Cancer Using Quantified Genetic Ancestry Models in Admixed Race Populations

“…According to national surveillance data for the United States (US), non-white minority populations suffer higher mortality rates for most cancers [1]. This has largely been considered as a consequence of poor health care equity and/or access [2,3] related to the prevalence of lower socioeconomic status (SES) for minority populations. However, European Americans (EAs) have historically been diagnosed with a higher incidence of breast cancer, compared to African Americans (AAs).…”