Download DiversityRx2010

New Cancer Health Promotion
Strategies to Reduce Social
Inequities in Health among
Culturally and Linguistically
Diverse Populations
Carolina Casares, MD MPH
What We Know
 Cancer is the second leading cause of death in
the United States
 Suffering and death could be prevented by more
systematic and innovative health screening and
promotion.
 A disproportionate number of minority and
other medically underserved populations are not
fully benefiting from available resources.
 Underlying causes of cancer disparities are
interrelated and complex
Health disparities are differences in:





Incidence
Prevalence
Mortality
Burden of disease and
Related adverse health conditions
and are…beyond what would be expected under
equitable circumstances and are directly
influenced by the social determinants of health.
- Adapted from the National Cancer Institute, Division of Cancer Control and Population
Sciences
Social Determinants of Health
They are the
economic
and social
conditions
under which
people live
which
determine
their health,
such as:
Income
Wealth
Health Insurance,
Access to Care
Social Status,
Education Level
Physical Environment unhealthy environments
Available Health Services,
Risky Behaviors
Employment/Working
Conditions
Social Environments,
Health Literacy,
Language Barriers
Biology
Genetic Makeup
Sexism,
Cultural Bias,
Ageism,
Racism/Bias
Stress
Coping Skills
Control
Causes of Cancer Disparities
Can be linked to the social determinants of health,
such as:




Inequalities in access to care,
Language barriers,
Unhealthy environments, and
Racial discrimination
Disparities In Outcomes Are Related With:
1. Disparities in Treatment…
Minority* groups are more likely to be living in poverty and are less likely to
receive recommended treatment.
2. Disparities in Screening…
Minority groups are more likely to be uninsured and are less likely to receive
timely screening.
3. Disparities in Incidence…
Minority groups are more likely to be diagnosed with later-stage preventable
cancers.
4. Disparities in Mortality…
Minority groups are more likely to earn a lower income and are more likely to die
from preventable cancers.
5. Disparities in Risk Factors…
Minority groups are more likely to report cancer related risk factors.
Eliminating disparities in
cancer screening,
diagnosis, treatment, and
mortality is an essential
step toward achieving
health equity, increasing
access and improving
health outcomes for
patients with cancer
Rx/Prescription for Better Health

Don't be poor. If you can, stop. If you can't, try not to be poor for long.

Don't have poor parents.

Own a car.

Don't work in a stressful, low-paid manual job.

Don't live in damp, low-quality housing.

Be able to afford to go on a foreign holiday.

Practice not losing your job and don't become unemployed.

Take up all benefits you are entitled to, if you are unemployed, retired, sick or disabled.

Don't live next to a busy major road or near a polluting factory.

Learn how to fill in the complex housing benefit application forms before you become
homeless and destitute.
Source: D. Gordon, Ten Tips for Better Health, 1999. Message posted on the Spirit of 1848 Listserv.
What Are We Doing?
 Increasing the trust and credibility of the Society
among populations of color.
 Ensuring that effective disparities reducing
practices are being provided through strategic
guidance and resources.
 Enhancing and strengthening our capacity to
enable community-based engagement,
mobilization and outreach in diverse and low
income communities.
 Diversifying our volunteer, staff, leadership and
donor base through all levels of the organization
to achieve the Society’s disparities goals.
How Are We Doing This?
 Developing the appropriate tools to
effectively communicate health
information and resources as it pertains
to reaching minority and underserved
populations
 Strengthening our current partnerships
and creating new collaborations to do
the work in the community
The Challenges
 Relevance in the community
 The development of evidence based culturally
appropriate and effective health policies and
programs
 Disparities data and cancer-specific data need to
be in formats and at a geographic resolutions
that are useful for program development
 Communications strategies need to be tailored
to the community
How Will We Get There?
Evidence-based Program and Policy Development
 Implement programs proven by empirical and experiential evidence to be effective disparities
reducing activities
 Acknowledge health disparities from a broad-based systems perspective while focusing on access
to care as a central theme.
Data
 Refine the current data collection methodology with national data, demographic, social
determinant and market data and infrastructure indicators to enable detailed needs assessments
and program evaluation. MapPlace is the proposed tool for this objective.
Communications Strategies
 Determine the appropriate and culturally relevant messages and delivery mechanisms for the
target audience. Web portals, etc.
Strategic Partnerships
 Identify high-level partners who can assist in trust-building, program implementation and extend
its credibility among populations underserved by the Society.
Cultural Competency
 Build the Society’s ability and comfort at all levels to engage low income, rural and minority
populations and communities in a manner that is meaningful, respectful and communicates the
Society’s long-term commitment to meeting their needs.
Personal/Organizational Objectives
 Develop performance evaluation criteria, suitable metrics and business processes to ensure the
health disparities goals of the Society are met.
What tools will we use to achieve this?
MapPlace
 A web-based mapping and reporting environment that
will help support mission related strategic planning and
resource allocation at ACS related to cancer disparities.
 Generate maps and other special visuals that will
illustrate specific cancer disparities and associated social
determinants of health and help ACS identify and
implement evidence based cancer disparity reducing
initiatives more effectively.
Web portals
 Designed and developed to be culturally and linguistically
appropriate for the diversity of communities we serve.
African American Breast Cancer
Mortality Rates in the US by County
African American Breast Cancer
Mortality Rates by Region and County
African American Female Population and
Breast Cancer Mortality Rates by County
Edgefield
County
Mortality Rate for Breast Cancer by County - Black Female (2002-2006)
Edgefield
County
Edgefield County
County FIPS
45037
County Name
Edgefield County
Black Female Mortality Rate, Breast Cancer
52.9
Black Female Mortalities, Breast Cancer
12
Black Female Population
Web Portals
Working on the development of culturally and
linguistically adapted web portals for each
community, that will help promote community
cancer awareness, increase positive imaging of
the Society among diverse groups and motivate
this segment of the population to become involved
by volunteering and supporting the organization.
Not just a web-site, but rather an experience
that is tailored to the needs of the community
So What?
The intent is to strategically
increase trust and credibility
among communities and
encourage civic engagement and
corporate social responsibility
around cancer health promotion.
We are intently looking at more efficient ways to utilize resources at all levels of
service by defining the issues, identifying feasible projects and aligning activities.
THANK YOU
©2010 American Cancer Society, Inc. No.0052.19