Article

Addressing Cancer Health Disparities Using a Global Biopsychosocial Approach

Department of Health Disparities Research, Center for Research on Minority Health, PO Box 301402, Unit 639, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1402, USA.
Cancer (Impact Factor: 4.89). 01/2010; 116(2):264-9. DOI: 10.1002/cncr.24765
Source: PubMed

ABSTRACT

The Center for Research on Minority Health has translated the biopsychosocial framework to address global cancer health disparities through the integration of biological (eg, endogenous steroids, genetic susceptibility, and pesticide levels) and behavioral (eg, dietary interventions) determinants, along with community-based research (eg, comprehensive involvement of community advisory boards) and educational approaches (eg, kindergarten through postgraduate training). Evidence of successful implementation of this framework includes health disparities training for >2000 individuals ranging from elementary to the postgraduate level, and conducting transdisciplinary projects that incorporate traditional and nontraditional health professionals to examine associations between biological and nonbiological determinants of health. Examples and recommendations for implementation of the biopsychosocial approach as it applies to cancer health disparities research are described.

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    • "This is covered within a framework called the Social Determinants of Health, which refers to the economic, social and cultural factors that influence individual and population health directly and indirectly, through their impact on psychosocial and biophysiological responses (Dixon and Welch, 2000). These factors are by definition complex and multifaceted, and it has been recognised that previous approaches to reduce inequalities in cancer outcomes have not adequately addressed the interplay between community-and individual-level factors that can influence our health and health behaviours, and so have failed to have an impact on reducing these inequalities (King et al., 2010). "
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    ABSTRACT: BACKGROUND: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. MATERIALS AND METHODS: A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. RESULTS: 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. CONCLUSIONS: Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.
    Full-text · Article · Mar 2015 · Asian Pacific journal of cancer prevention: APJCP
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    • "This is covered within a framework called the Social Determinants of Health, which refers to the economic, social and cultural factors that influence individual and population health directly and indirectly, through their impact on psychosocial and biophysiological responses (Dixon and Welch, 2000). These factors are by definition complex and multifaceted, and it has been recognised that previous approaches to reduce inequalities in cancer outcomes have not adequately addressed the interplay between community-and individual-level factors that can influence our health and health behaviours, and so have failed to have an impact on reducing these inequalities (King et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study reviewed the published evidence as to how prostate cancer outcomes vary across geographical remoteness and area level disadvantage. A review of the literature published from January 1998 to January 2014 was undertaken: Medline and CINAHL databases were searched in February to May 2014. The search terms included terms of 'Prostate cancer' and 'prostatic neoplasms' coupled with 'rural health', 'urban health', 'geographic inequalities', 'spatial', 'socioeconomic', 'disadvantage', 'health literacy' or 'health service accessibility'. Outcome specific terms were 'incidence', 'mortality', 'prevalence', 'survival', 'disease progression', 'PSA testing' or 'PSA screening', 'treatment', 'treatment complications' and 'recurrence'. A further search through internet search engines was conducted to identify any additional relevant published reports. 91 papers were included in the review. While patterns were sometimes contrasting, the predominate patterns were for PSA testing to be more common in urban (5 studies out of 6) and affluent areas (2 of 2), higher prostate cancer incidence in urban (12 of 22) and affluent (18 of 20), greater risk of advanced stage prostate cancer in rural (7 of 11) and disadvantaged (8 of 9), higher survival in urban (8 of 13) and affluent (16 of 18), greater access or use of definitive treatment services in urban (6 of 9) and affluent (7 of 7), and higher prostate mortality in rural (10 of 20) and disadvantaged (8 of 16) areas. Future studies may need to utilise a mixed methods approach, in which the quantifiable attributes of the individuals living within areas are measured along with the characteristics of the areas themselves, but importantly include a qualitative examination of the lived experience of people within those areas. These studies should be conducted across a range of international countries using consistent measures and incorporate dialogue between clinicians, epidemiologists, policy advocates and disease control specialists.
    Full-text · Article · Mar 2015 · Asian Pacific journal of cancer prevention: APJCP
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    Full-text · Article · Apr 2010 · Journal of Women's Health
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