According to a March 1st study authored by Rebecca Siegel, MPH, Nikita Wagle, MBBA, MHA, Ph.D, Andrea Cereck, M.D., Robert Smith, Ph.D, and Ahmedin Jemal, M.D., Ph.D., approximately 153,000 Americans will be diagnosed with colorectal cancer (CRC) in 2023. Additionally 52,550 individuals were predicted to die from the disease, including 19,550 cases and 3,750 deaths in patients under the age of 50. Of this group, minorities, especially Black Americans, see increased risk potential due to possibilities of genetic mutation, environmental and socioeconomic factors, experiences learned through past interactions and more.
Polling and studies have shown that, compared to white Americans, minorities see increased rates of later-stage diagnoses, lower screening rates, and increased mortality from colorectal cancer. A poll conducted by the Harris Poll on behalf of Olympus and posted to Becker’s on September 13th outlines some startling facts surrounding the effects of CRC on minority communities.
“Black Americans are 20% more likely to get colorectal cancer and 40% more likely to die from it than other groups,” the post says.
Factors relating to this increased rate have included diet, higher rates of tobacco usage and obesity, education levels surrounding the disease, and genetic factors such as mutations in the KRAS gene according to Colorectal Surgical Associates.
Mistrust of Care Providers
An April 2022 report by the Pew Research Center highlighted one major reasoning behind the increased occurance behind CRC in Black Americans as a lack of trust in some providers.
“Asked about their own experiences, most Black Americans have positive assessments of the care they’ve recently received,’ the study reads. “However, a majority (56%), say they have experienced at least one several negative experiences (in the past) including having the speak up to get proper care and being treated with less respect than other patients.”
A deeper look into these numbers shows that Black women reported higher rates of having at least one of many outlined negative experiences. According to Pew, 71% of younger Black women (recognized as aged 18-49) reported having at least one negative experience. Additionally, 54% of older Black women (aged 50 and above) reported the same.
These experiences can build upon one another, and create a negative perception of care providers. As a result, these patients are more hesitant to set appointments or call to schedule vital screenings. When not addressed, this hesitation can potentially pass to younger generations, creating a lack of education and increased risks.
A 2020 study from Front Public Health recognizes that, “In a variety of contexts, lower SES (socioeconomic standing) is associated with reduced access to care, poorer health outcomes, and increased mortality and morbidity as individuals age.”
These inequities lead to increased difficulties in accessing affordable healthcare. When quality care is neither local or accessible patients have a higher chance of opting to skip screenings or routine health appointments, only increasing their chances of fighting CRC and other health issues.
Front Public Health also calls out the “Wealth-Health Divide” in lower income communities. This divide showcases how the accumulation of wealth in younger years directly correlates to improved health and health outcomes as one ages. In lower-income communities with heavy minority populations, this divide leads to increased rates of negative health outcomes, providing an unlevel playing field and ability to receive proper care.
While there is no one answer to solving this complex issue, providing affordable, accessible care in lower-income communities and neighborhoods should be the first step toward righting inequities faced by minority communities.
A Lack of Understanding and Education
In combination with the above, a lack of proper healthcare education surrounding topics such as CRC and screenings adds to this multifaceted issue. This lack of comprehension surrounding risk factors, potential health issues surrounding CRC, and the science behind screenings builds upon current inequities, failing the signify the importance of receiving routine colonoscopies or other screening methods.
While a poor perception of providers may be rooted in the experiences of past generations, providing a proper understanding of healthcare topics can be a big step in reversing previous poor experiences and helping educate eligble patients on why screenings are vital for a healthy life.
The impact of this lack of education is shown by the Harris Poll. 31% of surveyed Black- and Latino-Americans believed that only high-risk individuals should receive screenings for CRC. Additionally, over half (53%) of surveyed Black Americans belived that at-home screening alternatives provided the same quality of results in comparison to a colonoscopy.
The colonoscopy is commonly referred to as “The Gold Standard” of colorectal screening and prevention for its high rate of accuracy and ability to remove precancerous polyps in one procedure. The colonoscopy is also identified as a “preventative procedure” providing little to no costs for patients.
What can we do?
While no answer currently exists to address every factor in this complicated issue, a combination of improved education, better provider-patient experiences, and increased access to affordable care can act as a step toward righting healthcare inequities in minority communities.
As an organization, SCA Health remains committed to providing valuable patient education on complex medical topics in a cost-effective location. We aim to ensure all of our patients leave our practices and centers informed and aware of their health and how to best maintain a healthy lifestyle.