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Defining, Investigating, and Addressing Cancer Inequities: Critical Issues

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Toward the Elimination of Cancer Disparities

Abstract

Research and action to address social disparities in cancer require clarity about what constitutes and causes these persistent and onerous inequities in health. Currently, both scientific literature and government documents exhibit important disagreements, confused terminology, and considerable, if not deliberate, vagueness about the meaning of the phrase “cancer disparities.” To help clarify what is meant by social disparities in cancer and what this means for efforts to investigate their causes and act to rectify them, this chapter offers a definition of cancer inequities that is premised on the causal contention that health inequities, by definition, arise from social inequity and considers its implications for developing a multidisciplinary research agenda for investigating and addressing social inequalities in cancer. Tackling this issue will require rigorous and critical frameworks, questions, and methods derived from multiple disciplines and will necessarily involve epidemiologic, clinical, and intervention research, both quantitative and qualitative. At issue is making conscious research choices about which types of disparities we study, in relation to which aspect of cancer, so as to improve the likelihood our research will help inform a society-wide discourse about the extent of, origins of, and remedies for social injustices in cancer, thereby aiding efforts to eliminate health inequities.

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Notes

  1. 1.

    This chapter is in part based on an article by Nancy Krieger previously published in Cancer Causes and Control (vol 16, pp, 5–14, 2005), © 2005 Springer; the publisher (Springer) has given permission for text to be included from this prior article.

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Acknowledgments

The first author wrote the original article upon which this chapter is based (see Krieger 2005a). Preparation of the original article was in part supported by the Dana Farber/Harvard Cancer Center (DF/HCC) Cancer Disparities “program-in-development.” Preliminary versions were presented at the DF/HCC workshop on “Social Disparities in Cancer: Developing a Multidisciplinary Research Agenda” (DF/HCC, Boston, MA, January 23, 2004) and as part of an invited symposium on “In the Era of Genomics and Persistent Social Inequities in Cancer,” held at the American Society of Preventive Oncology, 28th annual meeting, Washington, DC, March 16, 2004. Helpful comments on both the content of the grid and the wording of the definition of cancer inequities, initially conceived and developed by the first author, were provided by members of the Executive Committee of the DF/HCC Cancer Disparities program-in-development. Additional support was provided by NIH grants: 1K05CA124415-01A1 and 5P01CA7308.

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Authors and Affiliations

  1. Department of Society, Human Development, and Health, Harvard School of Public Health, Kresge 717, 677 Huntington Avenue, Boston, MA 02115, USA

    Nancy Krieger

  2. Department of Society, Human Development, and Health, Dana-Farber Cancer Institute, Harvard School of Public Health, Boston, MA

    Karen M. Emmons

  3. Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA

    David Williams

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  1. Nancy Krieger
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  2. Karen M. Emmons
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  3. David Williams
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Correspondence to Nancy Krieger .

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    Krieger, N., Emmons, K.M., Williams, D. (2009). Defining, Investigating, and Addressing Cancer Inequities: Critical Issues. In: Koh, H. (eds) Toward the Elimination of Cancer Disparities. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89443-0_1

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