Independent Lens . A LION IN THE HOUSE . Cancer Healthcare Disparities

“Disparities are determined and measured by three health statistics—incidence (the number of new cancers), mortality (the number of cancer deaths) and survival rates (length of survival following diagnosis of cancer). Health disparities occur when one group of people has a higher incidence or mortality rate than another, or when survival rates are less for one group than another.”¹

—National Cancer Institute’s Center to Reduce Health Disparities

Many families of children with cancer experience sudden and extreme financial difficulties. In A LION IN THE HOUSE, Justin’s parents are divorced, and both struggle with the burden of missing work and paying the bills. A large portion of their income goes towards travel, motels, meals and other items not covered by insurance. Single parent families like that of Justin’s mom, Debbie, or families that depend on two incomes, are likely to experience financial difficulties if one parent is forced to quit or suspend their job to care for the child.

“I need to get to work. I gotta work. I’ve been going to hospitals.”

––Dale, Justin’s dad

According to the National Cancer Institute, an estimated 564,830 Americans are expected to die of cancer in 2006.² And although the disease affects people of all racial and ethnic groups, a closer look at cancer rates reveals disparities in incidence, prevalence and mortality among those groups.

Research shows that individuals from underserved populations are more likely than the overall U.S. population to:

Die of cancers that are generally curable.
Be diagnosed with late-stage disease for cancers that are detectable at an early stage through screening.
Receive either no treatment or treatment that does not meet currently accepted standards of care.
Suffer from terminal cancers in the absence of adequate pain control and other palliative care.

“It’s hard trying to keep a roof over your head, keep your other kids safe, go to work—it’s hard.”

––Regina, Al’s mother

Many of the differences in cancer incidence and mortality rates among racial and ethnic groups may be due to factors associated with socioeconomic status rather than ethnicity.

Socioeconomic status in particular appears to play a major role in the differences in cancer incidence and mortality rates, risk factors and screening prevalence among children. Moreover, studies have found that socioeconomic status, more than race, predicts the likelihood of a group’s access to education, certain occupations and health insurance, as well as income level and living conditions––all of which are associated with one’s chance of developing and surviving cancer.

Learn about the importance of palliative care and quality of life »

Get tips on caring for kids and families »

Sources

1. National Cancer Institute’s Center to Reduce Health Disparities: What are Cancer Health Disparities?
2. National Cancer Institute, Cancer Facts and Figures, 2006 (PDF)
3. Intercultural Cancer Council (ICC)
4. National Cancer Institute’s Center to Reduce Health Disparities
5. Sloane Kettering Memorial Cancer Center

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Debbie, a Caucasian woman with blonde hair, smiles

Disparities Among Children³

African American, Hispanic, and Asian and Pacific Islander youth age 12 to17 report fewer contacts per year with a physician compared to white youth age 12 to17.

Family poverty and lack of health insurance are often insurmountable barriers to adolescents in need of healthcare services.³ Non-financial barriers, such as living in remote or rural areas, lack of information or education and cultural or racial differences and biases⁴ also interfere with the ability of adolescents to get care and contribute to limited frequency of contact and the lack of relationships with providers. All racial and ethnic groups with cancer are underrepresented in cancer clinical trials.

Approximately 75 percent of children with cancer in the United States will be treated on a clinical trial, also known as a protocol. This number is in sharp contrast to the one to five percent of adults with cancer who are enrolled in clinical trials.⁵

Among children with high risk factors, Hispanic children with acute lymphoblastic leukemia have significantly worse outcomes than white children.

For lymphomas in general (including the Hodgkin's lymphoma and non-Hodgkin's lymphoma subtypes), Hispanic children have higher incidence rates (approximately 30 percent greater) compared to white children.