How Can We Promote Preventative Care to The Underserved?

Illustrated by Clair Huang

With cancer as the second leading cause of death, bureaucratic and financial support for preventative care is needed now, more than ever. Indeed, an estimated 42% of cancers are preventable; however, underserved communities are characterized by “inadequate access to, or reduced utilization of, high quality cancer prevention, screening and early detection, treatment, and/or rehabilitation services[1]. Furthermore, studies demonstrate inequities across ethnic and racial groups propagated by fewer opportunities for medical screenings, provider counseling and clinician recommendations. Sociocultural factors, including differential environmental exposures, psychological stressors, poor diet and lacking health risk education contribute to disparities across socioeconomic statuses. Insufficient job security, child care opportunities and transportation availability present significant difficulties for underserved populations.

Reducing these disparities first requires a frameshift for disseminating prevention strategies through educational materials. A 2013 study conducted by the Center for Disease Control investigated how patient knowledge and beliefs impacts the prevalence of pap smear testing for cervical cancer prevention. Results revealed that 57% of low income women participants would get more frequently if instructed to do so by their physician [2]. Furthermore, between 58%–72% of study participants believed false information about the purpose of the exam itself [2]. Providing tailored educational resources for underserved communities would help increase awareness and decrease misinformation even when primary care facilities fail to provide adequate assistance on this front. Primary care is indeed lacking for many underserved communities, where about 6700 primary care Health Professional Shortage Areas (HPSAs) were identified across the country as of July 2017 [3]. Increasing access to information about screening health benefits, warning signs and symptoms of contributory disorders, institutional resources for underserved persons and lifestyle wellness habit development are only part of the first steps towards acknowledging existing health barriers and seeking alternative solutions to increase promotion of preventative measures. Connecting underserved individuals with counseling services and positive networks would also ensure the often lacking continuity in follow-up care.

Measures for reducing prevalent risk factors are also key pillars in the promotion of preventative health. An estimated 13% of global cancer incidence was attributed to infection in 2018, a statistic particularly concerning for underserved communities experiencing higher risks of developing cancer linked infections due to reduced availability for medical care and prevalent environmental exposures [4]. Thus, vaccine promotion is a critical step in reducing cancer rates. Encouraging more regular testing for environmental toxins is another measure that would have significant impacts on reducing cancer risks. Studies have shown that a major source of  exposure to ionizing radiation is the naturally occurring radon gas in the basement of homes; however, the “significant and negative correlation between income and radon levels” demonstrates how dangerous environmental exposure for radon disproportionately affects the underserved [5]. Additional opportunities for reducing prevalent cancer risks are associated with facilitating greater distribution of fruits and non-starchy vegetables, as concluded to be associated with decreased cancers of the mouth, esophagus and stomach by the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) [5]. Promoting good health overall as a preventative measure also assists in reducing an array of cancer comorbidities, which lead to worse health outcomes.

Expediting progress on preventative care promotion through education reform on these topics and opening pathways for connecting individuals to resources they need is critical. As new opportunities for revitalizing healthcare open in 2021, cancer prevention care in underserved communities warrants greater attention and action than ever before.

Edited by: Neha Adari
Illustrated by: Clair Huang

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