Health Disparities Definition
Health disparities are differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These population groups may be characterized by gender, age, ethnicity, education, income, social class, disability, geographic location, or sexual orientation.
Mission
The Division of Cancer Control and Population Sciences (DCCPS) health disparities mission is to monitor the differential burden of cancer among Americans and promote and conduct research that identifies and addresses the economic, social, cultural, psychological, behavioral, and biological mechanisms contributing to these disparities across the cancer control continuum and throughout the human lifespan.
Goals
In response to this challenge, the HDWG will monitor the progress of DCCPS’
efforts to reduce health disparities and will support the following goals:
- Encourage and improve the development of theory and qualitative and quantitative methods to investigate health disparities.
- Assess existing data sources and identify additional data needs to expand health disparities research.
- Describe health disparities in cancer and associated economic, social, cultural, psychological, behavioral, and biological mechanisms over time and across the cancer continuum.
- Develop efficacious, effective, and culturally relevant interventions to reduce health disparities.
- Develop strategies for disseminating research knowledge and evidence-based interventions.
- Disseminate research knowledge and evidence-based interventions.
- Promote intellectual synergy across the Division’s health disparities efforts.
- Integrate health disparities activities across the Division.
- Enhance and strengthen existing networks within the broader cancer control community to support health disparities research.
- Develop a scientific and conceptual basis of the unequal burden of cancer through seminars, discussions, and reviews.
These goals are directed toward achieving the NCI mission to reduce cancer
health disparities.
Major Initiatives
DCCPS has identified a number of critical gaps in research and has worked to focus more research attention to these areas by developing special initiatives. DCCPS also has the responsibility within NCI to monitor the burden of cancer in the United States and to identify health disparities in cancer, and has developed a broad surveillance program to accomplish these goals. Major initiatives and the surveillance program are described in the table. These initiatives are organized by DCCPS Program, and Programs are organized along the cancer control continuum.
Several DCCPS initiatives that focus on health disparities cross cut other NCI priorities. These other priorities are:
- Quality of cancer care
- Cancer communications
- Tobacco
- Genes and the environment
Examples of Current and Planned Major Initiatives That Support Health Disparities Research
|
Description |
Years |
Long Island Breast Cancer Project |
- Examines geographic disparities in breast cancer incidence and mortality through more than 10 studies that include human population studies as well as laboratory research.
- Develops a health-related Geographic Information System (GIS) for Long Island (near completion).This GIS will provide researchers with a new tool to investigate relationships between breast cancer and the environment and to estimate exposures to environmental contamination.
|
1999-2004 |
|
Description |
Years |
Centers for Population Health and Health Disparities |
- Supports 4-5 Centers (P50s) in collaboration with other ICs.
- Encourages innovative research leading to an understanding of and reduction in cancer health disparities.
- Facilitates reciprocal collaboration among biomedical scientists, social scientists, and affected communities.
- Each Center conducts three related research projects (R01) that focus on the complex interactions of the social and physical environment, mediating behavioral factors, and biologic pathways that determine health and disease.
|
2003-2007 |
Digital Divide Pilot Projects |
- Tests strategies to increase cancer communications (particularly computer and Internet-based) in underserved communities.
- Collaborates with the Cancer Information Service (CIS), regional cancer control organizations, and the private sector.
|
1999-2000 |
Health Information National Trends Survey (HINTS) |
- Collects nationally representative data every 2 years about the American public's need for, access to, and use of cancer-related information.
- Oversamples minority populations.
- Tracks national public access to health information and provides data on changing patterns, needs, and opportunities in cancer prevention, screening, treatment, and support.
- Examines preferred information channels, sources, and information needs of diverse audiences and yields data on perceptions about cancer risks related to health hazards.
|
2002 |
|
Description |
Years |
Center for Psycho-Oncology Research Specialized Center (P50) Project |
- Conducts biomedical, behavioral, psychological, and social research on the interrelationships among biological processes, cognition, emotion, and physical health among ethno-culturally diverse survivors of breast, prostate, and AIDS-related cervical cancer.
- Supports 4 R01-level clinical trials to evaluate the efficacy of group-based Cognitive Behavioral Stress Management (CBSM) interventions, and a hormonal treatment to ameliorate adverse consequences of cancer and its treatment among ethno-culturally diverse cancer survivors.
- Assesses whether CBSM interventions can modulate the output of the sympathetic nervous system, the Hypothalamo-Pituitary-Adrenal axis, and Hypothalamic Pituitary Gonadal hormones; and normalize immunologic status in different populations.
- Supports pilot studies of CBSM intervention effects in individuals with other cancers, such as malignant melanoma.
- Develops and tests Spanish translations of interventions for breast and prostate cancer patients.
|
1999-2003 |
Minority and Underserved Cancer Survivors Supplement |
- Supports 6 pilot projects (1-year duration each) that examine survivorship issues among minority and underserved patients who have returned to their communities after completion of initial treatment, and/or their family members.
- Fosters collaborations between cancer centers and community organizations.
|
2001 |
Overcoming Barriers to Treatment Adherence In Minorities and Persons Living in Poverty |
- Supports 2 projects that examine issues related to adherence to prescribed medical and healthy-lifestyle regimens among diverse ethnic and/or low-income populations.
|
2001-2005 |
Long Term Cancer Survivors Research Initiative |
- Supports 15 research grants examining questions related to physiological or psychosocial outcomes, and/or interventions that may promote positive outcomes, among long-term (5 years posttreatment) cancer survivors.
- Examines the relationship between treatment and late effects among ethno-culturally diverse long-term cancer survivors (8 of 15 projects funded under this initiative).
|
1998-2003 |
|
Description |
Years |
Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) |
- Establishes a national consortium of competitively selected research teams focusing on colorectal and lung cancers to collaborate on large observational cohort studies of newly diagnosed cancer patients.
- Analyzes disparities in the delivery of quality cancer care.
- Examines factors such as the clinical or nonclinical characteristics of patients; provider knowledge, attitudes, and practices; and health system factors that also may be related to quality of cancer care.
|
2001-2005 |
Breast Cancer Surveillance Consortium |
- Evaluates performance of mammography services in community settings with diverse populations by linking data on mammography practice to data on cancer outcomes in either cancer registries or pathology laboratories.
- Expands monitoring of disparities in mammography-related outcomes through a large sample drawn from diverse geographic and practice settings.
- Identifies health disparities as a special focus of investigation.
- Assesses the understanding of breast cancer screening practices in the United States through an assessment of the accuracy, cost, and quality of screening programs and estimates the quantitative population effect of mammography screening on various outcomes.
|
1994-2001 |
HMO Cancer Research Network (CRN) |
- Develops a population laboratory, blending diverse populations and research expertise of various HMO plans.
- Encourages the expansion of collaborative cancer research among health care provider organizations that are oriented to community care and have access to large, stable, and diverse patient populations.
- Takes advantage of existing integrated databases that can provide patient-level information.
- Six plans have 20% or more non-white racial/ethnic enrollees and four of these have SEER cancer registries with rapid ascertainment systems.
- Studies late-stage breast and invasive cervical cancer patients to identify factors that affect advanced disease.
|
1999-2002 |
|
Description |
Years |
Surveillance Epidemiology and End Results (SEER) Program |
- Maintains 18 cancer registries, covering 26% of the U.S. population (23% of the African-American, 40% of the Hispanic, 45% of the American Indian/Alaska Native [AI/AN], and 53% of the Asian/Pacific Islander populations in the U.S.).
- Supports new registries to increase the oversampling of minority/ethnic groups, rural populations, and states with high cancer mortality.
- Enhances data systems to improve racial/ethnic classification and to measure cancer disparities by socioeconomic factors through linkage with other databases.
- Collaborates with other registries and organizations to set standards; improve coding systems; and interpret, report, and disseminate data.
- Provides access to SEER data and common statistical analyses through a public Web site(http://seer.cancer.gov).
- Supports efforts to improve the methods for derivation of statistics, such as cancer prevalence and survival, to increase their usability and meaningfulness.
|
Annual |
The Network for Cancer Control Research Among American Indian/Alaska Native Populations |
- Exchanges information on cancer control research; improves community links to the NCI, CIS, and ACS.
- Increases the number of AI/AN researchers, scientists, and medical students involved in cancer control activities in AI/AN communities.
- Develops curricula and mentors students in the Native Researchers' Cancer Control Training Program, increasing the research skills of young Native investigators.
- Convenes national conferences on "Cancer in Indian Country."
- Established the Native CIRCLE:Cancer Information Resource Center and Learning Exchange for individuals involved in the education, care, and treatment of AI/AN.
|
Annual |
|
