Interventions, Policy, and Advocacy
In the broadest sense, health disparities are inequities or inequalities in environment, access and utilization of care, health status, and health outcomes (Carter-Pokras and Baquet 2002). These inequalities can occur at any stage of the cancer continuum (prevention, incidence, etiology, screening, diagnosis, access to clinical trials, treatment, survival, morbidity, and mortality) (Krieger 2005). Another chapter in this monograph (Chapter 14) addresses community-based approaches for cancer disparities. This chapter reviews current knowledge about effective interventions to reduce cancer disparities, particularly with respect to policy and advocacy, and recommends strategies for implementing and sustaining these interventions. While there may be some necessary overlap in the approaches described in the two chapters, they complement one another to provide an array of possible interventions.
KeywordsCervical Cancer Screening Public Health Approach Cancer Disparity Comprehensive Cancer Control Tobacco Control Program
- Agency for Healthcare Research and Quality. National Healthcare Disparities Report. Rockville, MD: AHRQ, DHHS, 2006.Google Scholar
- American Cancer Society. Cancer Facts and Figures. Atlanta: American Cancer Society, 2008.Google Scholar
- Applied Research Center and Northwest Federation of Community Organizations. Closing the Gap: Solutions to Race-based Health Disparities. Seattle, WA: Northwest Federation of Community Organizations, 2005.Google Scholar
- Center for Disease Prevention and Control. Health Disparities in Cancer. 2007. Available at: http://www.cdc.gov/cancer/healthdisparities/ and http://www.cdc.gov/cancer/healthdisparities/basic_info/disparities.htm. Accessed May 1, 2008.
- Chin, M.H., Walters, A.E., Cook, S.C., and Huanges. Interventions to reduce racial and ethnic disparities in healthcare. Medical Care Research and Review. 2007;64(5 suppl):7s–28s.Google Scholar
- Dahlgren, G., and Whitehead, M. Policies and Strategies to Promote Social Equity in Health. Stockholm, Sweden: Institute for Futures Studies, 1991.Google Scholar
- Horowitz, C. and Lawlor, E.F. Community approaches to addressing health disparities. In Challenges and successes in reducing health disparities: Workshop summary. Washington, DC: The National Academies Press, 2008, pp. 161–192.Google Scholar
- Institute of Medicine. The Future of Public Health. Washington, DC: National Academies Press, 1988.Google Scholar
- Institute of Medicine. Improving Health in the Community: A Role for Performance Monitoring. Washington, DC: National Academy Press, 1997.Google Scholar
- Institute of Medicine. The Unequal Burden of Cancer. Washington, DC: National Academies Press, 1999.Google Scholar
- Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press, 2002.Google Scholar
- Institute of Medicine. The Future of the Public’s Health in the 21st Century. Washington, DC: National Academies Press, 2003.Google Scholar
- Institute of Medicine. Challenges and Successes in Reducing Health Disparities: Workshop Summary. Washington, DC: The National Academies Press, 2008.Google Scholar
- Israel, B.A., Schulz, A.J., Parker, E.A., Becker, A.B., et al. Critical issues in developing and following community-based participatory research principles. In M. Minkler and N. Wallerstain (eds.). Community-based Participatory Research for Health. San Francisco, CA: Jossey-Bass, 2003, pp. 53–76.Google Scholar
- Koutoujian, P.J. and Wilkerson, D. (eds.). Commission to End Racial and Ethnic Health Disparities: Final Report. 2007. Available at: http://www.hcfama.org/_data/global/resources/live/Disparities%20Comission%20Full%20Report.pdf. Accessed January 15, 2008.
- Martin, M.Y. Community health advisors effectively promote cancer screening. Ethnicity and Disease. 2005;15(Suppl 2):14s–16s.Google Scholar
- National Cancer Institute. Cancer health disparities. 2007. Available at: http://www.cancer.gov/cancertopics/types/disparities and http://crchd.cancer.gov/. Accessed February 12, 2008.
- National Institutes of Health. NIH State-of-the-Science conference on tobacco use: prevention, cessation, and control. Annals of Internal Medicine. 2006;145:839–844.Google Scholar
- Powe, B.D. Eliminating cancer disparities. Cancer. 2006;109 Suppl:345–347.Google Scholar
- Richmond, J.B. and Kotelchuck, M. The effect of the political process on the delivery of health services. In C.H. McGuire, R. Foley, A. Gorr and R.W. Richards (eds.). Handbook of Health Professions Education. San Francisco, CA: Jossey-Bass, 1983, pp. 386–404.Google Scholar
- Singh, G.K., Miller, B.A., Hankey, B.F., and Edwards, B.K. Area Socioeconomic Variations in U.S. Cancer Incidence, Mortality, Stage, Treatment, and Survival, 1975–1999. Bethesda, MD: National Cancer Institute, 2003.Google Scholar
- Underwood, S.M., Buseh, A.G., Canales, M.K., Powe, B., Dockery, B., Kather, T., and Kent, N. Nursing contributions to the elimination of health disparities among African-Americans: review and critique of a decade of research. Journal of National Black Nurses' Association. 2004;12:48–62.Google Scholar
- U.S. Department of Health and Human Services. Healthy People 2010. Washington, DC, DHHS, 2000.Google Scholar
- U.S. Department of Health and Human Services. Making Health Disparities History: Report of the Trans-HHS Cancer Disparities Progress. Washington, DC: DHHS, 2004.Google Scholar
- U.S. Department of Health and Human Services. Healthy People 2010 Mid-Course Review. 2003. Available at: http://www.healthypeople.gov/data/midcourse/default.htm#pubs Accessed May 1, 2008.
- Viswanathan, M.A.A., Eng, E., Gartlehner, G., Lohr, K.N., et al. Community-based Participatory Research: Assessing the Evidence: Summary. Evidence Report/Technology Assessment, No. 99. Rockville, MD: Agency for Healthcare Research and Quality, 2004.Google Scholar
- Yabroff, K.R., Lawrence, W.F., King, J.C., Mangan, P., Washington, K.S., Yi, B., Kerner, J.F., and Mandelblatt, J.W. Geographic disparities in cervical cancer mortality: what are the roles of risk factor prevalence, screening, and use of recommended treatment? The Journal of Rural Health. 2005;21:149–157.PubMedCrossRefGoogle Scholar