National Academies Press: OpenBook
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR1
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR2
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR3
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR4
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR5
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR6
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR7
Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR8
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR10
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR11
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR12
Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR13
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR14
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR15
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR16
Page xvii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR17
Page xviii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR18
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR19
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Promoting Health Equity in Cancer Care: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26661.
×
PageR20

Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Promoting Health Equity in Cancer Care Erin Balogh, Francis Amankwah, Theresa Wizemann, and Sharyl Nass, Rapporteurs National Cancer Policy Forum Roundtable on the Promotion of Health Equity Board on Health Care Services Health and Medicine Division Proceedings of a Workshop PREPUBLICATION COPY—Uncorrected Proofs

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW Washington, DC 20001 This activity was supported by Contract No. 200-2011-38807 (Task Order No. 75D30120F00089) and Contract No. HHSN263201800029I (Task Order No. HHSN26300008) with the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health, respectively; American Association for Cancer Research; American Cancer Society; American College of Radiology; American Society of Clinical Oncology; Association of American Cancer Institutes; Association of Community Cancer Centers; Bristol Myers Squibb; Cancer Support Community; Flatiron Health; Merck & Co., Inc.; National Comprehensive Cancer Network; National Patient Advocate Foundation; Novartis Oncology; Oncology Nursing Society; Partners in Health; Pfizer Inc.; Sanofi; and Society for Immunotherapy of Cancer. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26661 This publication is available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2022 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and National Academies Press and the graphical logos for each are all trademarks of the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Promoting health equity in cancer care: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi. org/10.17226/26661. PREPUBLICATION COPY—Uncorrected Proofs

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY—Uncorrected Proofs

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence- based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY—Uncorrected Proofs

WORKSHOP PLANNING COMMITTEE1 GWEN DARIEN (Co-Chair), Executive Vice President, Patient Advocacy and Engagement, National Patient Advocate Foundation REGINALD TUCKER-SEELEY (Co-Chair), Vice President of Health Equity, Zero—The End of Prostate Cancer; and Edward L. Schneider Chair in Gerontology, University of Southern California NICOLE F. DOWLING, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention CHANITA HUGHES-HALBERT, Vice Chair for Research and Professor, Department of Preventive Medicine; and Associate Director for Cancer Equity, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California RANDY A. JONES, Professor and Associate Dean for Partner Development and Engagement, University of Virginia School of Nursing, and Assistant Director, Community Outreach and Engagement, Emily Couric Clinical Cancer Center, University of Virginia CHRISTOPHER LATHAN, Chief Clinical Access and Equity Officer, Dana-Farber Cancer Institute; Associate Medical Director, Dana- Farber Cancer Institute Network; and Assistant Professor of Medicine, Harvard Medical School CLEO A. RYALS, Head of Health Equity and Health Disparities Research, Flatiron Health LAWRENCE N. SHULMAN, Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania SHOBHA SRINIVASAN, Senior Advisor for Health Disparities, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speak- ers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. v PREPUBLICATION COPY—Uncorrected Proofs

ROBERT A. WINN, Director, Massey Cancer Center; and Senior Associate Dean for Cancer Innovation, Professor of Pulmonary Disease and Critical Care Medicine, and Lipman Chair in Oncology, School of Medicine, Virginia Commonwealth University; and President-Elect, Association of American Cancer Institutes ROBIN YABROFF, Scientific Vice President of Health Services Research, American Cancer Society Project Staff FRANCIS AMANKWAH, Program Officer KAT ANDERSON, Senior Program Officer, Roundtable on the Promotion of Health Equity RACHEL AUSTIN, Senior Program Assistant LORI BENJAMIN BRENIG, Research Associate ANNALEE GONZALES, Administrative Assistant ARZOO TAYYEB, Finance Business Partner ERIN BALOGH, Co-Director, National Cancer Policy Forum SHARYL NASS, Co-Director, National Cancer Policy Forum; and Senior Director, Board on Health Care Services vi PREPUBLICATION COPY—Uncorrected Proofs

NATIONAL CANCER POLICY FORUM1 EDWARD J. BENZ, JR. (Chair), President and Chief Executive Officer, Emeritus, Dana-Farber Cancer Institute; and Richard and Susan Smith Distinguished Professor of Medicine, Genetics and Pediatrics, Harvard Medical School PETER C. ADAMSON, Global Head, Oncology Development and Pediatric Innovation, Sanofi GARNET L. ANDERSON, Senior Vice President and Director, Public Health Sciences Division, Fred Hutchinson Cancer Center; Affiliate Professor, Department of Biostatistics, University of Washington; and Principal Investigator, Women’s Health Initiative Clinical Coordinating Center KAREN BASEN-ENGQUIST, Annie Laurie Howard Research Distinguished Professor; Professor of Behavioral Science; and Director, Center for Energy Balance in Cancer Prevention and Survivorship, The University of Texas MD Anderson Cancer Center SMITA BHATIA, Professor and Vice Chair of Outcomes for Pediatrics; Gay and Bew White Endowed Chair in Pediatric Oncology; Director, Institute for Cancer Outcomes and Survivorship; and Associate Director for Outcomes Research, Comprehensive Cancer Center, The University of Alabama at Birmingham CHRIS BOSHOFF, Chief Development Officer, Oncology, Global Product Development, Pfizer Inc. CATHY J. BRADLEY, David F. and Margaret Turley Grohne Endowed Chair for Cancer Prevention and Control Research; Professor and Associate Dean for Research, Colorado School of Public Health; Bunn Chair of Cancer Research and Deputy Director, University of Colorado Comprehensive Cancer Center OTIS W. BRAWLEY, Bloomberg Distinguished Professor, Department of Epidemiology and Oncology, Bloomberg School of Public Health and Department of Oncology, School of Medicine, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University 1 The National Academies of Sciences, Engineering, and Medicine’s forums and round- tables do not issue, review, or approve individual documents. The responsibility for the pub- lished Proceedings of a Workshop rests with the workshop rapporteurs and the institution. vii PREPUBLICATION COPY—Uncorrected Proofs

ROBERT W. CARLSON, Chief Executive Officer, National Comprehensive Cancer Network CHRISTINA CHAPMAN, Assistant Professor of Radiation Oncology, Baylor College of Medicine GWEN DARIEN, Executive Vice President, Patient Advocacy and Engagement, National Patient Advocate Foundation NANCY E. DAVIDSON, Executive Vice President for Clinical Affairs, Senior Vice President, and Professor, Clinical Research Division, Fred Hutchinson Cancer Center; Professor and Head, Division of Medical Oncology, Department of Medicine, University of Washington, and Raisbeck Endowed Chair for Collaborative Cancer Research JAMES H. DOROSHOW, Director, Division of Cancer Treatment and Diagnosis; Deputy Director for Clinical and Translational Research; and Head, Oxidative Signaling and Molecular Therapeutics Group, National Cancer Institute of the National Institutes of Health NICOLE F. DOWLING, Associate Director for Science, Division of Cancer Prevention and Control, National Center for Chronic Disease Control and Prevention, Centers for Disease Control and Prevention SCOT W. EBBINGHAUS, Vice President and Therapeutic Area Head, Oncology Clinical Research, Merck Research Laboratories KOJO S. J. ELENITOBA-JOHNSON, Director, Center for Personalized Diagnostics and Division of Precision and Computational Diagnostics; and Professor, Perelman School of Medicine, University of Pennsylvania STANTON L. GERSON, Dean and Senior Vice President, Medical Affairs, Case Western Reserve University School of Medicine; Acting Director, Case Comprehensive Cancer Center; Asa & Patricia Shiverick—Jane B. Shiverick (Tripp) Professor of Hematological Oncology and Distinguished University Professor, and Director, National Center for Regenerative Medicine, Case Western Reserve University JULIE R. GRALOW, Chief Medical Officer and Executive Vice Present, American Society of Clinical Oncology ROY S. HERBST, Ensign Professor of Medicine and Professor of Pharmacology; Chief of Medical Oncology, Associate Director for Translational Research, Yale Comprehensive Cancer Center and Yale School of Medicine HEDVIG HRICAK, Chair, Department of Radiology, Memorial Sloan Kettering Cancer Center viii PREPUBLICATION COPY—Uncorrected Proofs

CHANITA HUGHES-HALBERT, Vice Chair for Research and Professor, Department of Preventive Medicine; and Associate Director for Cancer Equity, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California ROY A. JENSEN, Professor of Pathology and Laboratory Medicine, William R. Jewell, MD Distinguished Masonic Professor of Cancer Research, and Director, The University of Kansas Cancer Center; Director, Kansas Masonic Cancer Research Institute; and Past President, Association of American Cancer Institutes RANDY A. JONES, Professor and Associate Dean for Partner Development and Engagement, University of Virginia School of Nursing, and the Assistant Director, Community Outreach and Engagement, Emily Couric Clinical Cancer Center, University of Virginia BETH Y. KARLAN, Vice Chair, Women’s Health Research; Professor, Department of Obstetrics and Gynecology, David Geffen School of Medicine; and Director, Cancer Population Genetics, Jonsson Comprehensive Cancer Center, University of California, Los Angeles SAMIR N. KHLEIF, Director, Jeannie and Tony Loop Immuno- Oncology Lab; Biomedical Scholar and Professor of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center; and Member, Society for Immunotherapy of Cancer MIA LEVY, Chief Medical Officer, Foundation Medicine SCOTT M. LIPPMAN, Director, Moores Cancer Center; Distinguished Professor of Medicine, Senior Associate Dean, and Associate Vice Chancellor for Cancer Research and Care; and Chugai Pharmaceutical Chair in Cancer, University of California, San Diego LARISSA NEKHLYUDOV, Professor of Medicine, Harvard Medical School; Internist, Brigham and Women’s Hospital; and Clinical Director, Internal Medicine for Cancer Survivors, Dana-Farber Cancer Institute RANDALL A. OYER, Clinical Professor of Medicine, Perelman School of Medicine; and Executive Medical Director, Ann B. Barshinger Cancer Institute; Penn Medicine Lancaster General Health; and Past President, Association of Community Cancer Centers CLEO A. RYALS, Head of Health Equity and Health Disparities Research, Flatiron Health RICHARD L. SCHILSKY, Principal Investigator, ASCO TAPUR Study; and Professor Emeritus, University of Chicago ix PREPUBLICATION COPY—Uncorrected Proofs

JULIE SCHNEIDER, Associate Director, Research Strategy and Partnership, Oncology Center of Excellence, Food and Drug Administration SUSAN M. SCHNEIDER, Associate Professor Emerita, School of Nursing, Duke University LAWRENCE N. SHULMAN, Professor of Medicine, Deputy Director for Clinical Services, and Director, Center for Global Cancer Medicine, Abramson Cancer Center, University of Pennsylvania HEIDI SMITH, Vice President, Center of Operations and Research Excellence, US Clinical Development and Medical Affairs, Oncology, Novartis Pharmaceuticals LARA STRAWBRIDGE, Director, Division of Ambulatory Payment Models, Patient Care Models Group, Center for Medicare & Medicaid Innovation, Centers for Medicare & Medicaid Services GEORGE J. WEINER, C. E. Block Chair of Cancer Research, Professor of Internal Medicine and Pharmaceutical Science; and Director, Holden Comprehensive Cancer Center, University of Iowa ROBERT A. WINN, Director, Massey Cancer Center; and Senior Associate Dean for Cancer Innovation, Professor of Pulmonary Disease and Critical Care Medicine, and Lipman Chair in Oncology, School of Medicine, Virginia Commonwealth University; and President-Elect, Association of American Cancer Institutes ROBIN YABROFF, Scientific Vice President, Health Services Research, American Cancer Society National Cancer Policy Forum Staff FRANCIS AMANKWAH, Program Officer RACHEL AUSTIN, Senior Program Assistant LORI BENJAMIN BRENIG, Research Associate ANNALEE GONZALES, Administrative Assistant ARZOO TAYYEB, Finance Business Partner ERIN BALOGH, Co-Director, National Cancer Policy Forum SHARYL J. NASS, Co-Director, National Cancer Policy Forum; and Senior Director, Board on Health Care Services x PREPUBLICATION COPY—Uncorrected Proofs

Reviewers This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in mak- ing each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsive- ness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: REBECAH ANGOVE, Patient Advocate Foundation MONICA BASKIN, University of Pittsburgh, UPMC, Hillman Cancer Center EVAN M. GRABOYES, Medical University of South Carolina Although the reviewers listed above provided many constructive com- ments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by VIVIAN W. PINN, University of South Florida. She was responsible for making certain that an independent examination of this proceedings was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. xi PREPUBLICATION COPY—Uncorrected Proofs

PREPUBLICATION COPY—Uncorrected Proofs

Acknowledgments Support from the many annual sponsors of the National Academies of Sciences, Engineering, and Medicine’s National Cancer Policy Forum is crucial to the work of the forum. Federal sponsors include the Centers for Disease Control and Prevention and the National Cancer Institute/National Institutes of Health. Non-federal sponsors include the American Association for Cancer Research; American Cancer Society; American College of Radiology; Ameri- can Society of Clinical Oncology; Association of American Cancer Institutes; Association of Community Cancer Centers; Bristol Myers Squibb; Cancer Support Community; Flatiron Health; Merck & Co., Inc.; National Com- prehensive Cancer Network; National Patient Advocate Foundation; Novartis Oncology; Oncology Nursing Society; Partners in Health; Pfizer Inc.; Sanofi; and Society for Immunotherapy of Cancer. The forum wishes to express its gratitude to the expert speakers whose presentations and discussions helped inform efforts to advance progress in promoting health equity in the delivery of high-quality cancer care. The forum also wishes to thank the members of the planning committee for their work in developing an excellent workshop agenda. xiii PREPUBLICATION COPY—Uncorrected Proofs

PREPUBLICATION COPY—Uncorrected Proofs

Contents ACRONYMS AND ABBREVIATIONS xix PROCEEDINGS OF A WORKSHOP 1 WORKSHOP OVERVIEW 1 SOCIAL DETERMINANTS OF HEALTH AND STRUCTURAL RACISM IN CANCER CARE 5 Elements of an Equitable Cancer Care Delivery System, 10 Incorporating Key Voices in Cancer Care, 12 Countering Resistance to Change, 14 APPROACHES TO OPERATIONALIZING EQUITY 14 Undoing Racism: Five Focus Areas for Operationalizing Equity, 15 Social Risk Screening and Social Needs Navigation, 17 Building Trust as the Foundation for Operationalizing Equity, 18 Creating the Infrastructure to Operationalize Equity in Health Insurance Plans, 20 IMPROVING EQUITABLE DELIVERY OF HIGH-QUALITY CANCER CARE 22 The Role of Payers and Health Care Systems in Supporting Access to Equitable Cancer Care, 22 Reimagining the Current Health Care Financing and Delivery System for Health Equity, 26 xv PREPUBLICATION COPY—Uncorrected Proofs

xvi CONTENTS IMPACT OF GEOGRAPHY AND SETTINGS OF CARE ON ACCESS TO HIGH-QUALITY CANCER CARE 29 The Intersection of Race, Place, and Cancer Mortality, 29 High-Quality Cancer Care for Rural Communities, 31 High-Quality Cancer Care for Indigenous Communities, 32 High-Quality Cancer Care at Safety Net Hospitals, 33 Reducing Disparities in Cancer Screening and Follow-Up Care, 34 OPPORTUNITIES TO SPUR PROGRESS TOWARD EQUITY IN CANCER CARE 36 Building on the Momentum of NIH’s “Great Awakening,” 36 Opportunities to Improve Equity in Cancer Care for Rural and Indigenous Communities, 38 Opportunities for Nurses to Improve Equity in Cancer Care, 39 Using Accreditation to Spur Progress in Health Equity in Cancer Care, 40 Public Health Opportunities to Accelerate Health Equity in Cancer Care, 41 Opportunities to Advance Health Equity Through Oncology Value-Based Care Models, 42 Opportunities to Address the Impact of Intersectionality on Equitable Cancer Care, 43 Primary Care Opportunities to Advance Cancer Care Equity, 44 Leveraging Partnerships to Advance Equity in Cancer Care, 45 Prioritizing Initiatives, 45 FROM ASPIRATION TO IMPLEMENTATION: THE ROLE OF ACADEMIC CANCER CENTERS IN PROMOTING HEALTH EQUITY 46 Cancer Centers Expanding the Scope of Cancer Research to Expand Who Benefits, 47 Innovative Models of Partnership and Engagement at Cancer Centers, 48 The Role of ACS in Supporting Cancer Centers, 52 Building the Table: Community Engagement in Cancer Care and Cancer Research, 53 Demonstrating an Impact on Health Equity, 54 The Role of Leadership, 55 REFLECTIONS 56 REFERENCES 57 APPENDIX A: STATEMENT OF TASK 61 APPENDIX B: WORKSHOP AGENDA 63 PREPUBLICATION COPY—Uncorrected Proofs

Boxes and Figures BOXES 1 Examples of Key Terms Shared by Individual Speakers, 2 2 Observations from Individual Workshop Participants Regarding Inequities in Cancer Care and Patient Outcomes, 6 3 Suggestions from Individual Workshop Participants to Promote Health Equity in Cancer Care, 8 4 The Greensboro Health Disparities Collaborative, 13 5 Messengers for Health: Improving Cancer Awareness and Screening by Building Trust, 19 6 The Critical Value of Time, 24 7 Events Leading to the “Great Awakening” at the National Institutes of Health, 36 FIGURES 1 Mutually reinforcing pathways from structural racism to inequities, 10 2 Age-adjusted annual cancer death rates by state, 2015–2019 (for all cancers, races, sexes, and ages), 30 3 The role of primary care across the cancer control continuum, 35 xvii PREPUBLICATION COPY—Uncorrected Proofs

PREPUBLICATION COPY—Uncorrected Proofs

Acronyms and Abbreviations ACA Patient Protection and Affordable Care Act ACS American Cancer Society BSPAN Breast Screening and Patient Navigation CDC Centers for Disease Control and Prevention CHA/P Community Health Aide/Practitioner CMMI Center for Medicare & Medicaid Innovation CMS Centers for Medicare & Medicaid Services CoC Commission on Cancer CPRIT Cancer Prevention and Research Institute of Texas ECANA Endometrial Cancer Action Network for African Americans EHR electronic health record GHDC Greensboro Health Disparities Collaborative HCI Huntsman Cancer Institute HOPE Center for Health Outcomes and Population Equity IHS Indian Health Service JMH Jackson Memorial Hospital xix PREPUBLICATION COPY—Uncorrected Proofs

xx ACRONYMS AND ABBREVIATIONS MCCAN Markey Cancer Center Affiliate Network NCI National Cancer Institute NIH National Institutes of Health NIMHD National Institute on Minority Health and Health Disparities SDOH social determinants of health SIREN Social Interventions Research & Evaluation Network SKCC Sidney Kimmel Cancer Center USP U.S. Pharmacopeia UT University of Texas VA U.S. Department of Veterans Affairs VCU Virginia Commonwealth University PREPUBLICATION COPY—Uncorrected Proofs

Next: Proceedings of a Workshop »
Promoting Health Equity in Cancer Care: Proceedings of a Workshop Get This Book
×
Buy Paperback | $22.00
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Despite advances in the delivery of high-quality cancer care and improvements in patient outcomes in recent years, disparities in cancer incidence, care, and patient outcomes persist. To examine opportunities to improve health equity across the cancer care continuum, the National Cancer Policy Forum and the Roundtable on the Promotion of Health Equity hosted a public workshop, Promoting Health Equity in Cancer Care, on October 25 and October 26, 2021.

This virtual workshop featured presentations and panel discussions on topics that included: opportunities to improve equitable access to affordable, high-quality cancer care; strategies to identify and address the intersectionality of structural racism and implicit bias in cancer care delivery; the potential for quality measurement and payment mechanisms to incentivize health equity in cancer care delivery; and clinical practice data collection efforts to better assess and care for people living with and beyond cancer. This publication summarizes the presentation and discussion of the workshop.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  6. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  7. ×

    View our suggested citation for this chapter.

    « Back Next »
  8. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!