Disparities in African American oncology care in the US: A socioeconomic and geographic outlook.

Authors

null

Ranjit Jasaraj

Mount Sinai Hospital, Chicago, IL

Ranjit Jasaraj , Suman Gaire , Ekaterina Proskuriakova , Mohammed Azher Kassem , Paramjeet Grewal Khosla , Larissa Verda , Nabin R Karki

Organizations

Mount Sinai Hospital, Chicago, IL, Mitchell Cancer Institute, Mobile, AL

Research Funding

No funding received
None.

Background: Mortality from cancer has been decreasing for all races and ethnicities. However, African Americans (AA) continue to have the highest mortality. Healthcare disparity contributes to poor outcomes. Here, we evaluate the differences in access to health care and socioeconomic status between different races and ethnicities in the US. Methods: We extracted data on demographic and healthcare coverage variables of patients diagnosed with cancer from the 2021 Behavioural Risk Factor Surveillance System (BRFSS), a national health-related telephone survey. We analyzed the effect of racial disparities in relation to socioeconomic factors and Census Bureau regions. R version 2.2.2 was used for all data extraction and analysis. Results: Out of 4,31,639 responders of BRFSS from the mainland US territory, 41,933 (9.71%) had been diagnosed with cancer other than skin cancer. Of these, 9,746 (9.74%) were from North East, 8,827 (9.11%) were from West, 10,806 (9.98%) were from South, and 12,554 (9.92%) were from Mid-West. In our sample, 35,137 (83.8%) were White, 2,356 (5.6%) were AA, 1,383 (3.3%) were Hispanic, and 3,047 (7.3%) were from others (Asian, American Indian/Alaskan Native, other race). More than 95% of oncology patients had health care coverage. However, the proportion of AA without healthcare coverage was higher than the White population (2.1% vs 1.2%, p < 0.005). 5.3% of cancer patients did not see physicians due to cost. This percentage was significantly higher among AA compared to White (8.2% vs 4.3%, p < 0.001). The rates of health care coverage and being unable to see a physician due to cost between AA and White were also statistically significant in each census region (not shown in table). Compared to White, AA patients with cancer were found to have statistically significantly lower education and income levels. This difference was present in all census regions of the US (not shown in table). Conclusions: Among cancer patients, AA are more likely not to have health care coverage, unable to see a physician due to cost, and have lower education and income level than White. These disparities impacting care of cancer patients exists in all major US regions, which likely promotes poor health outcomes. In addition, AA patients are underrepresented in this survey.

Healthcare care coverage and socioeconomic status of African American (AA) and White patients diagnosed with cancer.

White (%)AA (%)P-value
Health care coverageNo414 (1.2)49 (2.1)0.00175
Not seen physician due to costYes1,503 (4.3)192 (8.2)< 0.001
Education levelLess than high school1,471 (4.2)232 (9.9)< 0.001
High school graduate8,754 (25)665 (28.3)
College graduate24,824 (70.8)1,450 (61.8)
Annual income (US$)Less than 25,0004,858 (14)581 (25.2)< 0.001
25,000 – 50,0008,286 (23.9)578 (25.1)
More than 50,00014,090 (40.7)687 (29.9)
Refused/don’t know7,426 (21.4)455 (19.8)

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Health Services Research and Quality Improvement

Track

Quality Care/Health Services Research

Sub Track

Access to Care

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e18590)

DOI

10.1200/JCO.2023.41.16_suppl.e18590

Abstract #

e18590

Abstract Disclosures

Similar Abstracts

First Author: Larissa H Mattei

First Author: Sujith Baliga

Abstract

2024 ASCO Gastrointestinal Cancers Symposium

Assessing disparities in pancreatic cancer outcomes in African Americans.

First Author: Shiva Shrotriya