Barriers to Prostate Cancer Care

Abstract

Low-income, uninsured Latino men face a myriad of barriers when accessing health care to detect, diagnose, treat, and manage their prostate cancer. In this study, we utilized grounded theory techniques to analyze transcripts of semistructured interviews with 60 Latino men enrolled in a state-funded public assistance program. We developed a descriptive framework to understand barriers to health care access among these men. Findings demonstrate that societal, systemic, and individual barriers function independently and together to bar access to prostate cancer care for Latino men. Participant perceptions illustrate the individual, interpersonal, and macro-level structures that impede access, stressing the need for expanded medical coverage coupled with measures to improve quality care. The health care system needs a multifaceted approach, including alleviation of financial burdens for underserved prostate cancer patients, empowerment of patients with navigational skills, access to culturally competent providers, and consistent monitoring of access to quality health care.

Exploratory Research Focusing on Oral Cancer Prevention: Challenges of Dealing With Informational and Cognitive Barriers

“…However, they did not react on these challenges by acquisition of information that may help to gain a better understanding of the problem and coping-oriented behaviors. These results correspond to research on cancer-related information seeking, particularly, among people from high-risk groups with low educational levels (e.g., Goldman et al, 2009; Lee, Ramírez, Lewis, Gray, & Hornik, 2012; Oduro et al, 2012). It can be assumed that people rather feel at risk of even increasing their perceptions of uncertainty, fear, and helplessness by additional information instead of deriving benefits from them.…”

“…This problem is multifaceted and complex (Papas, Logan, & Tomar, 2004), and health communication efforts require addressing sociodemographic and socioeconomic factors as well as the individuals’ informational needs and behaviors. There is profound empirical evidence that inequalities in education, income, and occupation—that is, a low socioeconomic status—are closely linked to health and risk-related psychosocial and behavioral factors, to disparities in health status and health care (Adler & Newman, 2002; Goldman, Diaz, & Kim, 2009; Mackenbach et al, 2008; Oduro, Connor, Litwin, & Maliski, 2012; van Lenthe et al, 2004). This can also be observed for oral cancer which is particularly prevalent among elderly people and among men (Andersen, Lassen, & Clemmensen, 2008; Conway et al, 2008): A low socioeconomic status, regular smoking, and alcohol consumption are described as main risk factors of developing oral cancer.…”

Undertreatment of High-Risk Localized Prostate Cancer in the California Latino Population

“…18,19 Yet effective patient-provider communication may be hampered by language barriers and low health literacy in the Latino population. 20,21 Ineffective communication of, or differences in perception of, risk of disease progression may play a role in the relative under-treatment of younger Latino men and those with intermediate grade disease. Physician treatment recommendations for Latino patients may also be influenced by implicit bias, which operates unconsciously and is frequently contrary to an individual’s explicit beliefs and values.…”

“…12 The nature of this work may make it difficult to take sufficient time off for treatment, and treatment-related side effects may make continued employment in these industries difficult. 21 Even with insurance to cover medical expenses, some Latinos, especially younger men, who are more likely to be primary wage earners, may be less able to withstand the income disruption that accompanies treatment, leading them to forego definitive management of their disease.…”

Barriers to cancer treatment for people experiencing socioeconomic disadvantage in high-income countries: a scoping review

“…Insurance coverage for cancer treatment was largely driven by the conditions set forth by political environments, and was identified as a fundamental barrier to accessing care [ 64 ]. Within the context of the mixed healthcare (i.e., public and private) system in the United States, for example, inadequate or no insurance coverage to cover medical costs resulted in poor access to treatment [ 65 ], poor adherence [ 66 ], greater delays in receiving treatment [ 38 , 64 , 67 , 68 ], having to receive substandard treatment options based on cost, [ 69 , 70 ] or foregoing treatment altogether [ 37 ]. Many people who experience socioeconomic disadvantage are also faced with precarious working environments.…”