Monday, July 28, 2014
Women’s Hospice, Cancer Healthcare Disparities (Research, Video 1:37)
Healthcare disparities are inequalities that exist when members of certain populations do not benefit from the same healthcare status as other groups. These disparities can be related to racial-ethnicity, socioeconomics, gender, age, geography, and more. They are recognized by the Centers for Disease Control and Prevention, the American Medical Association, and other reputable major healthcare organizations. Being proactive in efforts to eliminate them is not only a healthcare issue, but a moral one.
Quality of end-of life care depends a lot on timely referral to hospice care. Lack of hospice services often translates into less pain management. A growing body of research indicates that several types of cancer are referred to hospice very late. These late referrals indicate racial-ethnic, sociodemographic, socioeconomic, and age disparities. In a study of patients over 65 with ovarian cancer, a higher proportion of black women, women in the lowest income groups, and women receiving fee for service Medicare were never referred to hospice care. A substantial proportion of older women with ovarian cancer were referred to hospice care only when they were very near death.
The New York Times recently reported research on breast cancer mortality trends in 41 of the largest cities in the United States. Results indicate that the mortality gap between black and white women has increased in the past twenty years. The chance of surviving breast cancer correlates strongly with the color of a woman’s skin. Black women with breast cancer are about 40 percent more likely to die of the disease than white women with breast cancer. Dr. Steve Whitman, director of Sinai Urban Health Institute and the study’s senior author emphasized that this had nothing to do with genetics. He stated further, “It’s undeniable that this is systemic racism,” and that the system is arranged in such a way that it’s allowing white women access to the important gains we’ve made since 1990 in terms of breast health, and black women have not been able to gain access to these advances.”
In this video, Dr. Karen L. Kruper, co-director of City of Hope's breast cancer program, discusses her research in healthcare disparities and quality of life outcomes.
Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.