Spotlight on Health Equity
Each month, the Cancer Policy Institute profiles advocates who have been engaged in health advocacy. This month, for National Minority Health Month, we are spotlighting health equity in cancer care. Read on to learn more about this important topic from Eucharia Borden, MSW, LCSW, OSW-C, FAOSW, CSC’s Senior Director of Health Equity and Clinical Services.
Tell us a bit about National Minority Health Month and what we know about disparities in cancer care.
April is National Minority Health Month, focused on raising awareness about the health disparities that continue to affect communities of color. Within cancer, we call these cancer disparities. While cancer can impact us all, certain communities bear a greater burden of cancer compared to others, due to health and socioeconomic (social, environmental, and economic) disadvantages. Cancer disparities occur because of a host of factors including systemic racism; lack of trust of the healthcare system; lower levels of prevention, screening, and early detection; challenges around access to high quality cancer care; and cost of care.
Despite innovation and advancements in cancer diagnosis, prevention, and treatments, cancer care disparities persist in every area of care, from cancer screening to survivorship. For example:
- Black women have a 40% higher breast cancer death rate than white women, even though their diagnoses rates are slightly lower (American Cancer Society, 2019)
- Nearly 22% of American Indian and Alaska Natives do not have health insurance, compared to less than 8% of white individuals (Kaiser Family Foundation, 2019)
- Black men experience higher rates of new cases (incidence) and death than white men in certain cancers such as prostate cancer and kidney cancer (Esnaola & Ford, 2012)
- Oncology clinical trials continue to be disproportionately white (80%) and male (60%) (Nazha et al., 2019)
- Cervical cancer cases and death rates are highest among non-Hispanic Black, American Indian, Alaska Native, and Hispanic women (American Cancer Society Cancer Action Network, 2021)
The COVID-19 pandemic has posed increased risks and burdens on cancer patients and survivors and has illuminated existing disparities in our healthcare system. Health disparities can only meaningfully be addressed when all individuals have access to, and can afford, healthcare insurance and services.
How has CSC been committed to health equity?
CSC is committed to supporting efforts to advance health equity. Health equity is achieved when everyone has the opportunity to be as healthy as possible and no one is disadvantaged from achieving these health outcomes because of socially determined circumstances (National Cancer Institute, 2020). The inequitable access to quality, affordable cancer care is a public health crisis. It is vital that all people impacted by cancer have an opportunity to achieve the best health outcomes, no matter their race, ethnicity, gender, age, sexual orientation, socioeconomic status, or zip code.
For example, CSC worked with Tuba City Regional Health Care Corporation on the Navajo Nation to bring the first-ever cancer treatment facility to tribal lands in the United States. We are currently in the process of recreating this model in Montana to continue our community-based partnership efforts to provide culturally adapted cancer care services on tribal lands.
As an organization, CSC is committed to offering a diverse, equitable, and inclusive environment, internally for CSC headquarters staff and externally for patients, caregivers, and other stakeholders. This, combined with recent events, led to the creation of the Activating Change Through Intentional Voices for Equity (ACTIVE) Task Force to ensure and advance CSC's commitment to such an environment.
Tell us a little bit about your role at the Cancer Support Community (CSC).
In my role as the Senior Director of Health Equity and Clinical Services, I am responsible for ensuring that CSC headquarters, research, programs, policy, and operations integrate relevant components of health equity, inclusion, and social determinants of health across all activities. I also work with the leadership of the Institute for Excellence in Psychosocial Care to inform the CSC Affiliate Network (including healthcare partners) on best practices in health equity. Additionally, I am the chair of CSC’s ACTIVE Task Force.
How will CSC continue to work to reduce disparities in cancer care?
Consistent with our core belief that empowered patients should be at the center of healthcare decision making, CSC will continue to work to break down these inequities and enable all individuals to have access to affordable medical care and the support they need and deserve.
We are currently in the process of building CSC Washington, D.C., to provide direct patient support and navigation as well as house a think tank focused on the challenges of health equity.
Stay tuned for more announcements on how CSC is working towards health equity.
American Cancer Society. (2019). Breast Cancer Facts & Figures.
Esnaola, N. F., & Ford, M. E. (2012). Racial differences and disparities in cancer care and outcomes: where's the rub? Surgical oncology clinics of North America, 21(3), 417–viii.
Kaiser Family Foundation. (2019). Uninsured Rates for the Nonelderly by Race/Ethnicity.
National Cancer Institute. (2020). Cancer Disparities.
Nazha, B., Mishra, M., Pentz, R., & Owonikoko, T. K. (2019). Enrollment of Racial Minorities in Clinical Trials: Old Problem Assumes New Urgency in the Age of Immunotherapy. American Society of Clinical Oncology Educational Book, 39, 3-10.