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Cancer Disparities Among Rural Minority Populations
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Cancer Disparities Among Rural Minority Populations

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 22452

Special Issue Editor

Dr. Whitney Zahnd

E-Mail Website
Guest Editor
Rural & Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
Interests: cancer health disparities; rural health; access to care; spatial epidemiology; social epidemiology

Special Issue Information

Dear Colleagues,

While cancer incidence, mortality, and screening rates have improved over time, these improvements have not been experienced equally by all populations. In the United States, racial and ethnic minority populations living in rural areas, particularly non-Hispanic Black and Native American/Alaska Native populations, have a greater cancer burden than their urban and White counterparts and often have less access to cancer prevention and treatment services. Rural, racial/ethnic minority populations in countries throughout the world experience similar disparities. Continued research is needed to understand the fundamental causes, contextual factors, and individual characteristics that contribute to cancer disparities among racial/ethnic minority populations in rural areas. It is equally important to examine the feasibility and effectiveness of policy-based, clinical, and/or community interventions that aim to reduce disparities among rural, racial, and ethnic minorities. For this Special Issue of the International Journal of Environmental Research and Public Health, we invite research papers, reviews, case reports, methodological papers, brief reports, and commentaries that examine the dynamic of race/ethnicity and rural geography in disparities all along the cancer control continuum (including etiology, primary prevention, screening, treatment, and survivorship). Papers can be submitted from a wide range of disciplines including epidemiology, health services research, health policy, medical geography, health promotion and behaviour, and sociology. Research papers that employ quantitative and qualitative observational methods as well as intervention studies are welcome. International submissions are encouraged.

Dr. Whitney Zahnd
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer health disparities
  • rural health
  • geographic disparities
  • racial/ethnic minorities
  • social determinants of health
  • cancer control continuum
  • access to care
  • racism
  • multilevel studies
  • interventions.

Published Papers (5 papers)

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Research

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13 pages, 367 KiB  
Article
Racial Disparities in Cigarette Smoking Behaviors and Differences Stratified by Metropolitan Area of Residence
by Rony F. Arauz, Margaret Mayer, Carolyn Reyes-Guzman and Bríd M. Ryan
Int. J. Environ. Res. Public Health 2022, 19(5), 2910; https://doi.org/10.3390/ijerph19052910 - 2 Mar 2022
Cited by 2 | Viewed by 2184
Abstract
Background: Black cigarette smokers experience a disproportionate burden of non-small cell lung cancer (NSCLC) compared to other racial and ethnic groups, despite starting to smoke later in life, smoking less frequently, and smoking fewer cigarettes per day compared with White smokers. Research has [...] Read more.
Background: Black cigarette smokers experience a disproportionate burden of non-small cell lung cancer (NSCLC) compared to other racial and ethnic groups, despite starting to smoke later in life, smoking less frequently, and smoking fewer cigarettes per day compared with White smokers. Research has shown that these disparities in NSCLC are wider in rural areas. Objective: To examine differences in smoking behaviors between Black and White individuals living in non-metropolitan areas and metropolitan areas. Methods: Using harmonized data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) years 2010–2011, 2014–2015, and 2018–2019, we compared smoking behaviors between Black and White current and former smokers by metropolitan status (i.e., whether an individual lives in a densely populated area or not) and by both metropolitan status and sex. Results: Smoking prevalence was higher among White participants living in non-metropolitan versus Black participants. Further, in non-metropolitan areas, Black individuals reported smoking fewer cigarettes per day, fewer years of smoking, and a later age of initiation compared to White individuals. Additionally, Black individuals, especially men, were more likely than White individuals to be current non-daily smokers. Conclusions: Our findings show that Black individuals living in non-metropolitan areas do not, in aggregate, have more cigarette smoking exposure relative to White individuals. Additional research is needed to further understand smoking-related exposures and other factors that may contribute to lung cancer disparities, especially in non-metropolitan areas. Full article
(This article belongs to the Special Issue Cancer Disparities Among Rural Minority Populations)
10 pages, 302 KiB  
Article
The Rural Household Production of Health Approach: Applying Lessons from Zambia to Rural Cancer Disparities in the U.S.
by Mutale Chileshe, Emma Nelson Bunkley and Jean Hunleth
Int. J. Environ. Res. Public Health 2022, 19(2), 974; https://doi.org/10.3390/ijerph19020974 - 15 Jan 2022
Cited by 2 | Viewed by 2647
Abstract
The recent focus on rural–urban cancer disparities in the United States (U.S.) requires a comprehensive understanding of the processes and relations that influence cancer care seeking and decision making. This is of particular importance for Black, Latino, and Native populations living in rural [...] Read more.
The recent focus on rural–urban cancer disparities in the United States (U.S.) requires a comprehensive understanding of the processes and relations that influence cancer care seeking and decision making. This is of particular importance for Black, Latino, and Native populations living in rural areas in the U.S., who remain marginalized in health care spaces. In this article, we describe the household production of health approach (HHPH) as a contextually-sensitive approach to examining health care seeking and treatment decisions and actions. The HHPH approach is based on several decades of research and grounded in anthropological theory on the household, gender, and therapy management. This approach directs analytical attention to how time, money, and social resources are secured and allocated within the household, sometimes in highly unequal ways that reflect and refract broader social structures. To demonstrate the benefits of such an approach to the study of cancer in rural populations in the U.S., we take lessons from our extensive HHPH research in Zambia. Using a case study of a rural household, in which household members had to seek care in a distant urban hospital, we map out what we call a rural HHPH approach to bring into focus the relations, negotiations, and interactions that are central to individual and familial health care seeking behaviors and clinical treatment particular to rural regions. Our aim is to show how such an approach might offer alternative interpretations of existing rural cancer research in the U.S. and also present new avenues for questions and for developing interventions that are more sensitive to people’s realities. Full article
(This article belongs to the Special Issue Cancer Disparities Among Rural Minority Populations)
16 pages, 361 KiB  
Article
Perceptions of Behavioral Awareness, Intention, and Readiness for Advance Care Planning: A Mixed-Method Study among Older Indigenous Patients with Late-Stage Cancers in Remote Areas of Eastern Taiwan
by In-Fun Li, Sheng-Miauh Huang, Ching-Fang Lee, Yi-Heng Chen and Yvonne Hsiung
Int. J. Environ. Res. Public Health 2021, 18(16), 8665; https://doi.org/10.3390/ijerph18168665 - 17 Aug 2021
Cited by 6 | Viewed by 2347
Abstract
The first Patient Right to Autonomy Act enacted in Asia in 2019 has enabled every Taiwanese citizen to plan for his/her end-of-life (EOL) in case of incompetency. Advance care planning (ACP) has been highly promoted for individuals with terminal, life-threatening illnesses, particularly in [...] Read more.
The first Patient Right to Autonomy Act enacted in Asia in 2019 has enabled every Taiwanese citizen to plan for his/her end-of-life (EOL) in case of incompetency. Advance care planning (ACP) has been highly promoted for individuals with terminal, life-threatening illnesses, particularly in the mainstream society, and efforts have been made by the Taiwanese government to train health care providers in order to optimize patients’ quality of dying. However, such advanced decisions and discussions regarding life-sustaining treatment and EOL care remain scarce among older ethnically minority patients. A multiple-case study employing a mixed-method (n = 9) was undertaken to explore indigenous patients’ ACP perceptions. Both quantitative and qualitative information was obtained from indigenous patients, a minority group whose socio-economic and educational status are different from the general Taiwanese population. An initiative was made to describe ACP behavioral awareness, intention, and readiness of older terminal patients from four tribes with seven late-stage cancers in remote, mountainous areas of eastern Taiwan. Our findings showed that according to the Transtheoretical Model, terminal indigenous patients’ ACP readiness was at a precontemplation stage. Their lack of fundamental ACP awareness, insufficient healthcare resources, life-sustaining value in a Christian faith context, and the prevalent health disparity in the remote communities have negatively affected indigenous patients’ intention to participate in ACP. We provide suggestions to further promote ACP in this group and suggest that health information should be tailored at various readiness stages in order to overcome barriers and decrease ACP literacy discrepancies. This study calls attention to an understudied area of ACP behaviors, an overlooked need in EOL care for older cancer patients of unique cultural backgrounds, and the imperativeness to ensure cultural minority group’s EOL care is consistent with patients’ preferences. Full article
(This article belongs to the Special Issue Cancer Disparities Among Rural Minority Populations)

Review

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26 pages, 1491 KiB  
Review
The Intersection of Rural Residence and Minority Race/Ethnicity in Cancer Disparities in the United States
by Whitney E. Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt and Jan M. Eberth
Int. J. Environ. Res. Public Health 2021, 18(4), 1384; https://doi.org/10.3390/ijerph18041384 - 3 Feb 2021
Cited by 54 | Viewed by 11963
Abstract
One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer [...] Read more.
One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There is a critical need for additional research to understand the disparities experienced by all rural racial/ethnic minority populations. We propose that policies aim to increase access to care and healthcare resources for these communities. Further, that observational and interventional research should more effectively address the intersections of rurality and race/ethnicity through reduced structural and interpersonal biases in cancer care, increased data access, more research on newer cancer screening and treatment modalities, and continued intervention and implementation research to understand how evidence-based practices can most effectively reduce disparities among these populations. Full article
(This article belongs to the Special Issue Cancer Disparities Among Rural Minority Populations)
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5 pages, 294 KiB  
Perspective
Challenges to Bringing Personalized Medicine to a Low-Resource Setting in Peru
by Nelly Solis, Elizabeth Zavaleta, Patrik Wernhoff, Constantino Dominguez-Barrera and Mev Dominguez-Valentin
Int. J. Environ. Res. Public Health 2021, 18(4), 1470; https://doi.org/10.3390/ijerph18041470 - 4 Feb 2021
Cited by 2 | Viewed by 2128
Abstract
We provide an overview of the challenges that low-resource setting cities are facing, including a lack of global implementation of cancer screening programs, accurate data and statistics that may aid the health authorities and guide future public health activities, as well as reorient [...] Read more.
We provide an overview of the challenges that low-resource setting cities are facing, including a lack of global implementation of cancer screening programs, accurate data and statistics that may aid the health authorities and guide future public health activities, as well as reorient strategies, interventions and budgets to promote lifestyles that help prevent disease. Current cancer care does not fully reflect ethnic, cultural, environmental and resource differences. Herein, we described a snapshot of the cancer mortality and morbidity from a hospital that cares a rural and low-income population from Peru, called Chimbote (316,966 inhabitants) and showed the limitation of access to oncological care and genetic services. The city is located in the region of Ancash, which is a department of Northern Peru. Of note, we identified a greater proportion of cancer cases than previously described, with a young age of onset and differential profile of the most frequent cancers. With the emergence of increasingly effective interventions, it becomes paramount that populations living in resource-limited settings have access to cancer services and participate in genetics and genomic research. Full article
(This article belongs to the Special Issue Cancer Disparities Among Rural Minority Populations)
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