What is a health care disparity?

Across the country, not everyone has the same opportunities in achieving their best possible health. Health disparities – which are preventable health differences among certain groups of people – persist from coast to coast, including right here in the Gulf South region. 

When it comes to cancer, disparities exist related to screening rates, new and existing cases, stage at diagnosis, financial burden, survival rates (length of survival after diagnosis), and death rates. 

Understanding cancer disparities is the first step to eliminating them. Programs like the Gulf South Clinical Trials Network build upon this knowledge to create change by providing access to advanced cancer screenings and treatment for everyone who needs them in the Gulf South region.

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Types of cancer disparities

Health disparities exist based on many factors. Being a part of one or more at-risk populations does not necessarily mean a person will develop cancer, but it increases their risk of developing and dying from the disease.

Race and ethnicity

Race and ethnicity are significant factors in cancer disparities. Examples of these inequities include:

• Black people have higher rates of deaths for many types of cancer compared to all other racial/ethnic groups.

• Black women are more likely than white women to die from breast cancer.

• Black men are more likely than all other racial/ethnic groups to die of prostate cancer.

• Black, Hispanic/Latino, and American Indian/Alaska Native women are more likely to develop cervical cancer compared to every other racial/ethnic group, and Black women are most likely to die from the disease.

• American Indians/Alaska Natives are more likely to develop kidney cancer than any other racial/ethnic group.


These disparities exist in part due to other cancer risk factors. For instance, Black Americans are more likely to experience barriers to getting care, such as financial constraints and lack of health insurance. Nonelderly American Indian/Alaska Native and Hispanic people are also more likely to be uninsured compared to white people. Some populations face additional hurdles, such as being treated unfairly because of their race while seeking care. 

There may also be a genetic component to some disparities. For example, there may be biological differences that affect breast, colorectal, and prostate cancers in Black Americans differently than people of other racial/ethnic groups.

Finally, cancer disparities are increased due to a lack of diversity in clinical trials, making research less applicable to people of all races.

Geographical location

Roughly 15% of the US population lives in a rural area. In Louisiana, this number jumps to over 26% of the state’s population residing in a rural area. 

While rural counties tend to have lower rates of all kinds of cancer compared to nonmetropolitan urban and metropolitan counties, they experience higher death rates. This disparity is getting worse over time.

Many rural residents face obstacles such as:

• Low income

• Low rates of preventative care, including cancer screening

• High rates of risky behaviors, such as tobacco use and unhealthy eating

• Lower access to health care, particularly cancer care, as only 3% of medical oncologists practice in rural areas and more than 70% of US counties don’t have this kind of care

Income

Over 11% of people in the US are living in poverty. In Louisiana, nearly 20% of the population lives below the federal poverty level, making it the second-highest rate of poverty in the country.

People who live in low- or middle-income counties have a higher chance of dying from cancer compared to those in high-income counties. This may be due to other risk factors, such as:

• Low rates of cancer screenings

• Lack of high-quality cancer care

• Food insecurity

• Obesity

• Smoking

Sexual orientation

The lesbian, gay, bisexual, transgender, and queer (LGBTQ) community – which makes up nearly 8% of the US population – faces a higher risk of developing cancer compared to those who identify as heterosexual or cisgender. This disparity exists due to an increased likelihood of facing additional factors, such as:

• Unemployment

• Not having health insurance or access to health care

• Delays in care

• Negative experiences with health care providers, including discrimination and dismissing concerns

Lesbian, gay, and bisexual youths are also more likely to engage in risky behaviors, like smoking and drinking, compared to heterosexual youths

Education level

Lower levels of education are associated with high rates of cancer. For instance, among Black and white men and women, the cancer death rates among people with 12 years or less of education are 60% to 180% higher compared to those with 16 years or more of education. 

This may be due to lower screening rates, leading to diagnoses that are more advanced and harder to treat.

Disability

In the US, over 60 million people are living with a disability. People with disabilities often face risk factors that make them more likely to develop cancer, such as:

• Chronic inflammation

• Functional limitations, such as inability to perform self-exams or travel to screening facilities

• Problems with patient-provider communication

• Lower cancer screening rates

• Risky behaviors, like smoking and substance misuse

• Lack of health insurance

Making progress toward equitable health care for everyone

There are a range of components that contribute to cancer disparities in the US, and many people face multiple risk factors that increase their chances of developing and dying from cancer.

Addressing these disparities is not straightforward, and it won’t happen overnight. In addition to policy changes and systemic movements, everyone needs quality health care, including preventative care and cancer care. 

The Gulf South Clinical Trials Network is committed to reducing disparities by increasing access to advanced cancer care, such as screenings and treatment. Clinical trials are a key component in this, as they provide patients with the most advanced, up-to-date treatment available. They also further critical research that ensures all patients get the care they need now and in the future.

Through community outreach, education, and clinical trials that are close to home, we can begin to address cancer disparities in the Gulf South region and around the country.

Learn more about clinical trials