Health Disparities Interest Group
Documenting the extent and understanding the causes of disparities in accessing and
receiving cancer-related health services is a major cross-cutting theme of research
supported by the Health Services and Economics Branch (HSEB). We study health disparities
by race/ethnicity and the socioeconomic status of individuals and by the
socioeconomic characteristics of the community environment.
Studies and Initiatives
for Measuring Cancer Disparities: A Review Using Data Relevant to Healthy
People 2010 Cancer-Related Objectives", was
written under contract by the Applied Research Program and provides
an empirical analysis of methods appropriate for the measurement of
cancer disparities. This report raises some conceptual issues and
reviews different methodological approaches germane to measuring progress
toward the goal of eliminating cancer-related health disparities,
and to assist in monitoring progress toward the Healthy
People 2010 cancer objectives.
- HSEB completed a systematic review of the research
literature on health disparities in cancer treatment by race/ethnicity.
Shavers VL, Brown ML. Racial and ethnic disparities in the receipt of cancer treatment.
J Natl Cancer Inst 2002 Mar 6;94(5):334-57. Review.
- The NCI-sponsored Cancer Care Outcomes Research and Surveillance Consortium (CanCORS)
project, a prospective study of 10,000 patients with newly diagnosed lung or colorectal
cancers, is designed to examine disparities in the receipt of state-of-the-science cancer
care and factors that contribute to disparities in outcomes, and to identify ways to
lessen those disparities.
- The Applied Research Program is using the 2003 California Health Interview Survey (CHIS) to develop a means for assessing the cross-cultural equivalence of survey questions. This project uses a questionnaire evaluation technique called behavior coding, which involves assigning codes to survey questions that appear to present difficulties to either the interviewer (e.g., misreading the item) or the respondent (e.g., asking for clarification or providing uncertain answers). The project will extend the use of this technique to the multi-cultural domain by behavior coding CHIS interviews across three language groups (English, Spanish, and either Chinese or Korean). Investigators will determine which survey questions appear to present problems in particular languages, indicating where the translated version should be reviewed and modified. The project will provide valuable information concerning the means by which this practice should be carried out in other surveys that include multiple languages.
Tools and Data Sources
The California Health Interview
Survey Cancer Control Module, co-sponsored by
NCI, is designed to allow the collection of detailed information on the use of cancer
screening services by racial/ethnic groups not well covered by other surveys, including
Hispanics, Asians, Pacific-Islanders, and African-Americans.
In September 2008, a workshop entitled Methodological and Conceptual Issues in
Conducting Research on Racial/Ethnic Discrimination in Healthcare Delivery,
sponsored by several institutes of the National Institutes of Health, was held
in Bethesda, MD.
Several Funding Opportunities support research in this area. For example, studies
supported by the Cancer Surveillance Using Health Claims-Based Data System program
announcement include studies of disparities in the receipt in cancer care based on
demographic and socio-economic characteristics.
The Program Announcement The Effect of Racial and
Ethnic Discrimination/Bias on Health Care Delivery (PA-07-206 (R01), PA 06-306 (R21), and
PA 06-348 (R03)),
supports research to:
- improve the measurement of racial/ethnic discrimination in health care delivery systems through improved instrumentation, data collection, and statistical/analytical techniques;
- enhance understanding of the influence of racial/ethnic discrimination in health care delivery and its association with disparities in disease incidence, treatment, and outcomes among disadvantaged racial/ethnic minority groups; and
- reduce the prevalence of racial/ethnic health disparities through the development of interventions to reduce the influence of racial/ethnic discrimination in health care delivery systems in the United States.
Publications: Health Disparities includes articles on studies that have examined
cancer-related health disparities by race/ethnicity and socioeconomic status.