Cancer, Culture, and Health Disparities: Time to Chart a New Course?

Abstract

Little progress has been made over the last 40 years to eliminate the racial/ethnic differences in incidence, morbidity, avoidable suffering, and mortality from cancer that result from factors beyond genetic differences. More effective strategies to promote equity in access and quality care are urgently needed because the changing demographics of the United States portend that this disparity will not only persist but significantly increase. Such suffering is avoidable. The authors posit that culture is a prime factor in the persistence of health disparities. However, this concept of culture is still poorly understood, inconsistently defined, and ineffectively used in practice and research. The role of culture in the causal pathway of disparities and the potential impact of culturally competent cancer care on improving cancer outcomes in ethnic minorities has, thus, been underestimated. In this article, the authors provide a comprehensive definition of culture and demonstrate how it can be used at each stage of the cancer care continuum to help reduce the unequal burden of cancer. The authors conclude with suggestions for clinical practice to eliminate the disconnection between evidence-based, quality, cancer care and its delivery to diverse population groups.

Cultural, Economic, and Psychological Predictors of Colonoscopy in a National Sample

“…Recent reports have emphasized the importance of understanding how cultural factors work together with these variables so that providers will have a better understanding of the context within which health care decisions are made. 13 Understanding cultural factors allows physicians to address patients' most salient beliefs and values and other constraints they may be facing when making screening recommendations.…”

Race Differences in Personality and Affect Between Older White and Black Patients: an Exploratory Study

“…Studies identifying various behavioral, social, and biological factors for race differences in cancer incidence, morbidity, and mortality show additional unmeasured individual factors as indicators possibly explaining these differences [3,4]. Behavioral factors that have received little attention are the effect of personality and positive and negative affect on the physical and mental functioning among older cancer patients from diverse race populations.…”

A Pilot Study of a Culturally Targeted Video Intervention to Increase Participation of African American Patients in Cancer Clinical Trials

“…Recognition of the specific attitudes of AA patients and their relationship with intention to enroll is critical to ameliorating disparities in trial participation [34]. Facilitating communication about clinical trials between the patients and their providers is also particularly important.…”