Cancer Dispari,es in Indiana

Transcription

1 Cancer Dispari,es in Indiana Susan M. Rawl, PhD, RN, FAAHB, FAAN Professor, Indiana University School of Nursing Co- Leader, Cancer PrevenEon & Control Program Indiana University Simon Cancer Center Indiana Cancer ConsorEum Annual MeeEng April 26, 2017

2 Objec,ves Define health equity and dispariees Describe cancer dispariees in Indiana Discuss factors contribueng to cancer dispariees Introduce the Cancer Health Equity Center

3 Health Equity Healthy People 2020 defines health equity as the asainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequaliees, historical and contemporary injuseces, and the eliminaeon of health and health care dispariees. U.S. Department of Health and Human Services, Office of Minority Health. NaEonal Partnership for AcEon to End Health DispariEes. The NaEonal Plan for AcEon DraZ as of February 17, Chapter 1: IntroducEon. Available from h;p://

4 Cancer Health Disparities Adverse differences among specific population groups by age, disability, education, ethnicity, gender, geographic location, income, or race in: Cancer incidence Cancer prevalence Cancer mortality Survivorship

5 Indiana Largest ci,es: Indianapolis Fort Wayne Evansville 46 of 92 Indiana coun,es are considered rural (38 < 30,000 popula,on) Racial Breakdown: White 84% Black 9% Asian 2% Other 5% Indianapolis

6 Cancer Mortality: U.S. vs. Indiana U.S. Mortality Rates Indiana Mortality Rates

7 Percent Above or Below U.S. Rate Indiana Cancer Mortality Rates Compared to US Rates* ( ) Lung and Bronchus Esophagus Kidney and Renal Pelvis Melanoma of the Skin Non-Hodgkin Lymphoma All Sites Combined * Larynx Leukemias Pediatric Cancers Colon and Rectum Breast * Brain and Other Nervous System Urinary Bladder Ovary Myeloma Pancreas Prostate Cervix Uteri Corpus Uteri Gallbladder Thyroid Oral Cavity and Pharynx Liver Stomach -40% -30% -20% -10% 0% 10% 20% 30% -13.0% -22.2% *Age-adjusted Female breast cancers only Urinary Bladder includes invasive and in situ. Note: symbols denote whether Indiana s rate is significantly different than the U.S. rate based on the 95% confidence interval overlap method (see Page 4 for description). = significantly higher; = significantly lower. -4.3% 0.9% 0.9% 0.0% 0.0% 0.0% 0.0% 18.3% 16.3% 13.3% 12.9% 9.1% 9.0% 8.3% 8.0% 7.7% 5.7% 5.4% 4.4% 4.3% 3.6% 2.9% Mortality Rates Indiana vs. US Source: United States Cancer Statistics: Incidence, WONDER Online Database. United States Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute; Accessed at on Jul 14, :56:43 PM

8 Indiana Cancer Sta,s,cs Mortality rates are 9.2% higher than US average Compared to Whites in Indiana, African Americans: o o o Have higher mortality rates for all cancers including breast, colorectal, lung, & prostate Are 70% more likely than whites to not see a doctor during the year because of costs (22.8% vs. 13.4%) Adults were 66% more likely than whites to not have health insurance (28.8% vs 17.3%)

9 African American Dispari,es in Indiana: Cancer Incidence & Mortality % Percent Above Indiana Rates among Whites % % 80.00% 60.00% 40.00% 36.60% 37.60% 45.70% 20.00% 0.00% 20.70% 17.80% 13.20% 8.30% 3.60% 3.40% All Cancers Colon & Rectum Lung & Bronchus Female Breast Prostate Incidence Mortality Indiana Cancer Facts and Figures 2015

10 Geographic Differences in Outcomes Reasons Are Multi-Factorial: Socioeconomic Biological Behavioral Access to care Education Environmental

11 Geographic Dispari,es: Lung Cancer Incidence Mortality

12 Geographic Dispari,es: Colon & Rectum Cancer Incidence Mortality

13 Geographic Dispari,es: Breast Cancer Incidence Mortality

14 Indiana Health Rankings Ranked 43 rd out of 50 in obesity Ranked 44 th out of 50 in smoking Ranked 41 st out of 50 in overall health Prevalence of Self-Reported Obesity Among U.S. Adults by State and Territory, BRFSS, 2014

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18 Social Determinants of Health Economic Stability Poverty Employment Food Security Housing Stability Education High School Graduation Enrollment in Higher Education Language and Literacy Early Childhood Education and Development Social and Community Context Social Cohesion Civic Participation Discrimination Incarceration Health and Health Care Access to Health Care Access to Primary Care Health Literacy Downloaded from hsps:// objeceves/topic/ social- determinants- of- health Neighborhood and Built Environment Access to Healthy Foods Quality of Housing Crime and Violence Environmental Conditions

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20 Indiana University Simon Cancer Center Cancer Health Equity Center (CHEC) Mission Statement To promote health equity, through engagement and collaboration with the community, health care providers, statewide cancer organizations and hospital systems to impact the population of our catchment area through clinical care, education, research and health policy.

21 Goals of the CHEC To enhance relationships with community partners in Indiana towards a common vision to improve health outcomes and equity To identify key areas of cancer and healthcare disparities within our catchment area To establish a vibrant and representative Community Advisory Board To address these disparities through education, training and research To educate the community about prevention, early detection and treatment and supportive care To create educational programs and training opportunities for underrepresentative students and faculty for conducting research, especially in cancer disparities and health equities To increase the enrollment of under-represented and underserved populations onto therapeutic and non-therapeutic trials To disseminate research results to the community at large

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24 hsps://healthequity.globalpolicysolueons.org/about- health- equity/

25 Partners Working Together