Racial Gap in Treatment, Incidence of Cancer
President’s Cancer Panel Finds Differences Between Minorities and Whites in Treatment and Survival
To better address health disparities, the panel made 10 recommendations:
- Address serious data deficiencies. The report asks the president to convene an ongoing, multidisciplinary working group to develop more accurate and useful ways of characterizing the population. Until better categorizations are available, the report says, researchers should be explicit about the definitions they use for race and ethnicity and be clear about underlying weaknesses in their information.
- Improve data sharing among government agencies.
- Support better outreach and training to students so they have educational foundations that support careers in science and health care.
- Include cultural competency as an integral part of medical school and continuing medical education.
- Increase research on health disparities with a focus on sociocultural and biologic factors underlying the disproportionate burden of cancer borne by medically underserved, socially disenfranchised populations.
- Explore and evaluate the benefits of patient navigators and patient-centered medical homes to help people access health care.
- Re-evaluate current cancer-screening guidelines to determine their accuracy in assessing disease burden in different populations.
- Change patient-reimbursement policies to allow doctors enough time to gather relevant sociocultural information on their patients.
- Encourage greater use of medically trained language translators by hospitals and other health care providers.
- Continue funding American Indian health services.
Role of Health Care Reform
Many of the 10 recommendations in the 150-page report, which was developed before the Patient Protection and Affordable Care Act (PPACA) was passed last year, have already been addressed by health reform, the panel notes.
The panel says its report underscores the importance of the legislation, and in some cases, shows where federal agencies need to go beyond the minimum requirements of the law.
Title IV of the PPACA, for example, mandates that all federally funded health programs collect and report data on race, ethnicity, sex, primary language, and disability status by 2012.
The Department of Health and Human Services has to develop standards for that data, which, at minimum must adhere to criteria for race developed by the Office of Management and Budget (OMB).
Health reform also addressed many problems with access to health care faced by minorities. It authorizes patient navigation demonstration programs, for example, and mandates that the government establish comprehensive methodology and criteria for “medically underserved populations,” a designation that delivers federal funding for health care to places that don’t have enough facilities or medical providers.
The act also mandates better data sharing across agencies.
There are recommendations in the report that are not addressed by the PPACA, such as the need for standardized definitions of race and ethnicity, the need to expand research and improve understanding of the factors that influence cancer risk and outcomes among diverse populations, and the need for higher standards of cultural competency among health care professionals.