In both industrialized and lessdeveloped societies, cancer incidence and survival are related to socioeconomic factors. This fascinating volume, the first to examine the magnitude of these socioeconomic differences in relation to cancer, provides vital information for all those interested in public health. Cancer incidence and survival are related to socioeconomic status in both industrialized and less developed countries. These differences can be explained, in part, by known risk factors, particularly tobacco smoke, occupational exposures, reproductive behaviour, diet and biological agents. T.
This volume summarizes the current scientific evidence and identifies research priorities needed to decrease social inequalities in cancer. The publication, based on the expert knowledge of more than 70 international scientists from multiple disciplines, undertakes a populations-within-populations approach, highlighting the large variations in cancer incidence, survival, and mortality that exist between countries and, within countries, between social groups. Several factors may lead individuals with low social status to adopt unhealthy behaviors, to be exposed to a wider range and a higher intensity of cancer risk factors, and to have reduced access to health-care services, compared with their fellow citizens. A special focus is given to how the phenomenon of inequalities in cancer evolves and is reshaped over time, driven by economic, social, political, legislative, and technological forces; it affects everyone, but the most disadvantaged individuals are particularly hard hit. This IARC Scientific Publication was developed to serve as a reference for policy-makers and public health officials, linking to specific examples of interventions that may reduce future inequalities in cancer.The vignette is attached.
The Cancer in Sub-Saharan Africa volume brings together population-based cancer incidence data from 25 cancer registries in 20 sub-Saharan African countries that are part of the African Cancer Registry Network. The compiled data in this volume, presented and commented upon by covered population and by anatomical site, are of tremendous value to the assessment of the pattern and evolution of cancer in Africa, as a means of elucidating, confirming, and evaluating causes of the disease.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
This contributed volume addresses the link between the social environment and cancer in Europe. The authors document the wide range and diverse trends in cancer incidence and patient survival in Europe, and they identify the main mechanisms and key influences that underlie these inequalities. They suggest a series of actions and programmes to tackle these inequalities in Europe, within the conceptual framework of intervention research. The influence of the social environment on the risk of suffering and dying from cancer is obviously a global phenomenon, as evidenced by a growing number of studies and books. In part, the underlying mechanisms are universal. Given the availability of a new standardised measure for social deprivation in Europe (the European Deprivation Index), the networking of population-based cancer registries across Europe as efficient surveillance tools, the increasing comparability of the organisation of care in European countries, and the recent launch of Europe’s Beating Cancer Plan, this extensive review of social inequalities in cancer on a European scale is both relevant and timely. The book consists of 21 chapters organised in four sections: Part I – General Considerations and Methodologic Aspects Part II – Social Disparities in Cancer Incidence and Survival – Reports Part III – Social Disparities in Cancer Incidence and Survival – Mechanisms Part IV – Towards an Evidence-Based Policy for Tackling Social Inequalities in Cancer Social Environment and Cancer in Europe: Towards an Evidence-Based Public Health Policy is a unique resource that presents up-to-date methods for analysing quantitative data. It focusses on inequalities in cancer incidence and survival within the wider framework of inequalities in health. This book will be an essential reference for policy-makers, researchers, public health professionals, social scientists and oncologists.
There has been remarkable progress in understanding, preventing, detecting, diagnosing, and treating cancer, resulting in a reduction of cancer incidence and mortality in the United States. Despite this, the cancer burden varies considerably by race/ethnicity and socioeconomic status. Cancer incidence rates vary markedly between racial/ethnic groups, but even more startling are the differences in outcome across groups. Cancer Disparities: Causes and Evidence-Based Solutions helps readers understand the scope and causes of this inequity by providing a detailed analysis of the many factors that result in cancer disparities across the cancer continuum, including the role of race/ethnicity, socioeconomic status, access to and use of services, insurance status, geographic variables, and differences in treatment provided to patients. Further, it is the first book to describe evidence-based, concrete solutions that can be used to reduce or even eliminate cancer health disparities. Fifteen previously unpublished studies of interventions designed specifically to achieve health equality are described. These studies focus on contextually and culturally appropriate strategies to enhance cancer prevention, screening and early detection, treatment, symptom management, and quality of life in underserved populations.
Thanks to advances in technology, medicine, Social Security, and Medicare, old age for many Americans is characterized by comfortable retirement, good health, and fulfilling relationships. But there are also millions of people over 65 who struggle with poverty, chronic illness, unsafe housing, social isolation, and mistreatment by their caretakers. What accounts for these disparities among older adults? Sociologist Deborah Carr’s Golden Years? draws insights from multiple disciplines to illuminate the complex ways that socioeconomic status, race, and gender shape the nearly every aspect of older adults’ lives. By focusing on an often-invisible group of vulnerable elders, Golden Years? reveals that disadvantages accumulate across the life course and can diminish the well-being of many. Carr connects research in sociology, psychology, epidemiology, gerontology, and other fields to explore the well-being of older adults. On many indicators of physical health, such as propensity for heart disease or cancer, black seniors fare worse than whites due to lifetimes of exposure to stressors such as economic hardships and racial discrimination and diminished access to health care. In terms of mental health, Carr finds that older women are at higher risk of depression and anxiety than men, yet older men are especially vulnerable to suicide, a result of complex factors including the rigid masculinity expectations placed on this generation of men. Carr finds that older adults’ physical and mental health are also closely associated with their social networks and the neighborhoods in which they live. Even though strong relationships with spouses, families, and friends can moderate some of the health declines associated with aging, women—and especially women of color—are more likely than men to live alone and often cannot afford home health care services, a combination that can be isolating and even fatal. Finally, social inequalities affect the process of dying itself, with white and affluent seniors in a better position to convey their end-of-life preferences and use hospice or palliative care than their disadvantaged peers. Carr cautions that rising economic inequality, the lingering impact of the Great Recession, and escalating rates of obesity and opioid addiction, among other factors, may contribute to even greater disparities between the haves and the have-nots in future cohorts of older adults. She concludes that policies, such as income supplements for the poorest older adults, expanded paid family leave, and universal health care could ameliorate or even reverse some disparities. A comprehensive analysis of the causes and consequences of later-life inequalities, Golden Years? demonstrates the importance of increased awareness, strong public initiatives, and creative community-based programs in ensuring that all Americans have an opportunity to age well.
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
The WHO European Region has seen remarkable health gains, though inequities persist both between and within countries. Much more is understood now about the extent and social causes of these inequities, particularly since the 2008 report of the Commission on Social Determinants of Health. This review of inequities in health across the 53 Member States of the Region was commissioned to support the development of the new European policy framework for health and well-being, Health 2020. It builds on the global evidence and recommends policies to reduce health inequities and the health divide across all countries, including those with low incomes. The report is presented in four parts. Part I provides the context and background to the review, and sets out the key principles underpinning the recommendations and the rationale for grouping them into four broad themes: life-course stages, wider society, the broader macro-level context, and governance, delivery and monitoring systems. Part II summarizes current evidence on the magnitude of the health divide among European Region countries, describing the inequities in health and their social determinants. Part III focuses on the four themes, making recommendations with supporting evidence. Part IV outlines the implementation issues, summarizes the framework for action, discusses reasons for failure, provides guidance on good practice and summarizes the review's conclusions and recommendations. The review is a wake-up call to political and professional leaders alike, an opportunity for them to facilitate the work of those dedicated to improving health outcomes and narrow the health gap between and within the countries of the Region.
