Poverty as Carcinogen?

The American Cancer Society released a report earlier this month that covers, among other things, the role of socioeconomic disparities in cancer mortality rates. It's a companion to their annual report called Cancer Facts & Figures 2011. It names the well-documented contributors to individual cancer risk like smoking and obesity that we've all heard about, but it also outlines the link between socioeconomic status and cancer deaths.

The good news is that the report shows a decrease in the rate of cancer deaths between 1990 and 2007; 22% in men and 14% in women. This means that over that 17 year span 898,000 people didn't die of cancer that would have in years prior.

The bad news, however, is how that survival is spread across the population. Or, more accurately, how it is not. According to the report, death rates in persons with lower socioeconomic status (defined by education, occupation or residence) showed little or no decrease. In fact, there were increases in their cancer deaths in some instances. The evidence shows a continually widening gap in mortality rates between advantaged and disadvantaged segments of the US population. For example: in 1993, in men aged 25-64 (both black and white populations), the cancer death rate was twice as high as the least educated compared to the most educated. By 2007, this disparity had increased to a nearly three-fold difference.

So, what does this mean?? The good news of lower rates of cancer deaths overall shows that research being done every day to find better treatment options is proving successful in the fight against the disease. There is also a direct link to the community education being provided across the country by organizations like Hope Cancer Resources. More screenings are being done, more preventative measures are being taken, and more cancers are being caught in earlier stages. But, the numbers show (on page 25 of the report) that those preventative measures and screenings are being utilized primarily among the educated and those residing in the higher levels of economic comfort.

According to the US Census Bureau, more than 50.7 million Americans were uninsured in 2009. Those people have limited access to health care, and that limited access affects every part of the cancer contiuum: prevention, early diagnosis, treatment, and palliative care. If there is a cancer diagnosis, it is more likely to be made in an advanced stage of the disease and the patient is less likely to have been partaking of healthy lifestyle habits prior to their diagnosis. Consider the observation that there are usually more fast-food restaurants and fewer safe public parks and walking trails in communities that are economically challenged than in those with higher per-capita incomes.

To bear this point out, a study done by the American Cancer Society showed that uninsured or Medicaid-insured patients diagnosed with early state colorectal cancer were less likely to survive five years than privately insured patients diagnosed with a more advanced stage of the disease. This disparity likely reflects the unequal treatment that results from living with limited healthcare access, generally poorer underlying health (also associated with lack of preventative care and absence of healthy activity and food choices), and physical barriers to care, such as transportation to health facilities, that are commonly experienced by non-privately insured patients.

Over the past 30 years, the American Cancer Society has issued a number of special reports on cancer disparities which concluded that poverty is the primary contributing factor to cancer disparities between racial and ethnic groups... and that people living in poverty lack access to health care and endure greater pain and suffering from cancer.

At Hope Cancer Resources we are not able to affect a cure for cancer, nor do we lobby for better healthcare coverage for Americans. But we do provide the community education and free screenings that are so desperately needed if we are to keep seeing a reduction of mortality rates. We provide financial assistance through our Save-A-Life program to people needing tests and procedures they can't afford and we don't offer. We also help reduce obstacles encountered by many of our neighbors by providing financial assistance when a household income is severely affected by a cancer diagnosis, or when transportation to and from treatments is needed. Our mission, to provide compassionate, professional cancer support and education in the Northwest Arkansas region today and tomorrow holds true for everyone in our community, regardless of their socioeconomic status.

We are on the front lines of the battle against cancer in Northwest Arkansas, and we always welcome the support of additional warriors! Join us as a volunteer, or make a donation today.

Your support makes a difference, and we can't do it without you.