Social Science Series #11: The impact of poverty on cancer prevention and access to care

Link between poverty and cancer

Living in a low-resource context can have a significant negative impact on health outcomes, according to recent research. Individuals living in areas with lower income, education, employment, and housing quality have been found to have lower survival rates when diagnosed with nonmetastatic breast, prostate, lung, and colorectal cancer.

Moreover, persistent poverty exacerbates the situation even further. In a study on cancer outcomes and persistent poverty, National Cancer Institute (NCI)-funded researchers from the Pennsylvania State University and NCI discovered that black residents living in rural counties withthis condition had the highest rates of cancer death in the United States. This finding underscores the joint contributions of persistent poverty, rural environment, and race on cancer mortality.

Source: National Cancer Institute, 2023.

Poverty as a barrier to cancer screening and prevention

Cancer screenings are an essential part of cancer prevention and early detection. However, the costs associated with these screenings can be prohibitively high for some individuals, especially those without health insurance. Without access to affordable healthcare services, many people may delay cancer screenings, which can have serious consequences for their health.

One of the most significant barriers to cancer screening and prevention is a lack of access to healthcare services. Many people cannot afford health insurance or do not have access to healthcare facilities in their communities. Even if someone has access to healthcare services, they may not be able to afford the cost of screenings or treatment. This can make it difficult for them to receive regular check-ups or screenings that could detect cancer early on. Additionally, those who live in remote areas may not have access to specialized cancer care or the transportation to reach such services, making it even more challenging to receive treatment.

For those without health insurance, the costs of cancer screenings can vary widely depending on the procedure or location and can cost up to hundreds of dollars out of pocket. This can make it difficult for some people to afford the care they need.

Source: Moss, J. et al, 2022; Correll, R, 2022.

Social determinants of health and cancer

While cancer screenings are an essential tool for cancer prevention and early detection, they are just one part of a larger picture of health. Social determinants of health, such as income, education, and access to healthcare, can have a significant impact on an individual’s risk of developing cancer and their ability to receive timely and effective care.

Social determinants of health are the conditions in which people are born, grow, live, work, and age. These factors have a direct effect on a person’s health and well-being. When it comes to cancer prevention and access to care, social determinants of health play a crucial role in determining the outcome of the disease. For instance, where a person with cancer lives and whether they have access to food and healthcare can significantly affect their care and survival. Other factors such as financial challenges, access to education, and community can also impact a person’s cancer experience. Addressing these social determinants of health can help improve cancer outcomes

Research shows that these factors are more important than healthcare or lifestyle choices in influencing health. For example, numerous studies suggest that social determinants account for between 30-55% of health outcomes.  Addressing social determinants appropriately is fundamental for reducing longstanding inequities in health, which requires action by all sectors of society.

Studies have shown that individuals with lower incomes and less education are more likely to develop certain types of cancer and have worse outcomes. This may be due to a variety of factors, including limited access to healthy food options, increased exposure to environmental toxins, and lack of access to quality healthcare.

Source: Center for Disease Control and Prevention, 2021; Pinheiro, L et al, 2022; Collins, B, 2021; Snow, S, 2020.

Financial burden of cancer treatment

Treatments for cancer can be financially burdensome for patients and their families. According to a review of risk factors and outcomes in the Journal of the National Comprehensive Cancer Network, 40% to 50% of U.S. patients experienced material or psychological stress as a result of the financial burdens of treatment. The frequency of these burdens among patients with cancer could also increase, especially for those facing escalating cancer therapy costs and barriers to insurance coverage.

The financial burden of cancer treatment can be attributed to several factors. For instance, direct costs such as medical bills, hospital stays, and medication expenses can be significant. Indirect costs such as transportation expenses and lost wages due to time off work can also add up quickly. Moreover, some treatments may require additional support services such as home healthcare or counseling which can further increase the financial burden.

Addressing these burdens requires a multi-faceted approach. This includes increasing access to affordable healthcare services, expanding insurance coverage, and providing financial assistance programs for those in need. It also involves addressing the root causes of poverty, such as income inequality and lack of access to education and employment opportunities.

Source: National Cancer Institute, 2021; American Cancer Society, 2020; Centers for Disease Control and Prevention, 2021.

Health disparities in cancer research and clinical trials

Health disparities in cancer research and clinical trials have been a longstanding issue, particularly for individuals living in poverty. These disparities can lead to unequal access to cutting-edge treatments and potential cures, as well as a lack of representation in research studies.

One reason for these disparities is the underrepresentation of minority and low-income populations in clinical trials. This can be due to a variety of factors, such as a lack of access to healthcare services, mistrust of the medical system, and language barriers. Additionally, clinical trials often have strict eligibility criteria that may exclude individuals with certain health conditions or socioeconomic backgrounds.

The lack of representation in clinical trials can have significant consequences for cancer prevention and treatment. For example, certain genetic mutations that are more common in minority populations may go undetected, leading to missed opportunities for targeted therapies. Additionally, clinical trials can provide valuable information about the effectiveness of new treatments and potential side effects, which can inform future cancer care.

Addressing health disparities in cancer research and clinical trials requires increasing access to healthcare services and preventative care, addressing mistrust of the medical system through community engagement and education, and increasing diversity in clinical trial recruitment.

Efforts to increase diversity in clinical trial recruitment include working with community organizations and patient advocacy groups to raise awareness about clinical trials and their potential benefits.

Source: National Cancer Institute, 2021; Centers for Disease Control and Prevention, 2023.

Education and awareness for cancer prevention

Education and awareness are crucial components of cancer prevention and early detection. However, individuals living in poverty often lack access to information and resources that can help them reduce their risk of developing cancer or detect it early when it is most treatable.

One of the most effective ways to increase cancer education and awareness in poor developing communities is through community-based programs. These programs can provide information on cancer prevention, screening, and treatment options in an appropriate manner. They can also help address mistrust of the medical system by building relationships between healthcare providers and community members.

Another important component of cancer education and awareness is the existence of patient navigators. Considering their critical role as trained professionals who assist patients in accessing healthcare services, including cancer screenings and treatment, their duties include helping patients overcome barriers to care such as transportation or language barriers, and provide emotional support throughout the cancer journey.

Individuals living in poverty may be unable to afford cancer screenings or treatment, which can lead to delayed diagnosis and poorer outcomes. Programs that provide free or low-cost cancer screenings and treatment options can help address these barriers.

Source: American Cancer Society, 2022; Centers for Disease Control and Prevention.

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