What is a health care disparity?

What causes differences in who develops cancer and how they respond to treatment?

Cancer is a complex disease caused by many factors. These differences influence our risk of developing cancer and how well we respond to treatment. For example, the genetics we receive from our parents, including our race and ethnicity, may predispose us to develop certain types of cancer more frequently or have more aggressive forms of cancer.

This combined with our exposure to certain substances that promote cancer, such as tobacco smoke, our general health and nutrition (obesity), infection by certain cancer-causing viruses (HPV human papilloma virus), or others, can further increase our risk of developing cancer and determine how we respond to treatment.

Not all groups of people are affected equally. There are differences (disparities) in how often groups of individuals develop cancer and how they respond to its treatment. It is important to understand these health disparities so we can develop more effective ways to prevent, diagnose, and treat cancer. Investigators at the Gulf South Clinical Trials Network are national leaders in these fields of research and are working closely with patients to improve the outcomes in our region.

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What are the causes of disparities in developing cancer or responding to treatment?

Every individual is genetically unique (except for identical twins). The genetics we inherit from our parents give us our physical characteristics (color of our eyes, type of hair, color of our skin) and also determines whether we may develop certain diseases that may be passed on within families, including diabetes, obesity, cardiovascular disease, and some types of cancer.

For example, melanoma, cancer of the skin, is more frequent in white people than Black or Hispanic people who have darker skin colors that protect them from the damage of the sun. Similarly, young Black women develop an aggressive form of breast cancer (triple negative breast cancer) more often than white or Latina women. Latino men have a higher incidence of liver cancer. Knowing these differences is essential to developing effective strategies and programs to prevent, diagnose, and treat these types of cancer in the right groups of people.

However, not only genetics play an important role. Here are other things that are important to consider.

1. Where we live: geographical location

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

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

2. Income

More than 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

3. Access to health care

Rural areas have fewer doctors who specialize in cancer patients. This is one major reason why working with community health care practices throughout the region can offer advanced clinical studies that can help ease the disparities among people living in different regions of the state.

4. Education

Lower levels of education are associated with high rates of cancer.

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

5. 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:

• 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 health care for all

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

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

The Gulf South Clinical Trials Network is committed to reducing the burden of cancer by increasing access to advanced cancer care, such as screenings and treatment. Clinical trials are a key component because they provide patients with the most advanced, up-to-date treatment available. Clinical trials 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

For more information about the Gulf South Clinical Trials Network, contact us or visit our about us page. You can also search for a clinical trial in the Gulf South region.