Closing Gaps: The Need for a More Equitable Approach to Cancer Care in America

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The story of cancer in America is one of stark disparities. There are disparities in cancer burden and outcomes faced by groups based on race, ethnicity, geography, sexual orientation, gender identity and those in chronic poverty. If we look solely at differences between racial and ethnic groups, we see that Black women are 40 percent more likely to die from breast cancer than their white counterparts. Cancer patients from racial and ethnic minority groups are also less likely to receive recommended chemotherapy and molecularly targeted treatments.

Medical advances have made great strides in treating cancer, detecting it early and helping people make informed decisions about their care. But clinical care alone cannot close persistent gaps in outcomes. With overall cancer rates on the rise, it's essential for health care providers to consider patients' needs and circumstances beyond the clinic.

Social Factors Can Greatly Influence Cancer Risk and Recovery

Where people live and work, what they eat, even the air they breathe can all have a profound impact on their health and, consequently, their cancer journey. What's more, the course of treatment can significantly impact all aspects of a person's life, including their work, family responsibilities and mental well-being.

Too often, disparities in cancer risk and survival are amplified by the unmet social needs that many Americans face—such as income inequality, inadequate housing, limited transportation options and lack of healthy food options. As one example, researchers have discovered significantly higher cancer mortality rates in US counties experiencing long-term poverty. To ignore these social factors is to risk allowing the gaps in cancer outcomes to persist—or even worsen.

Caring for the Whole Person, Not Just the Disease

As the causes of cancer and barriers to diagnosis and recovery become better understood, a growing number of health care organizations are addressing the unmet social needs of patients as part of their ecosystem of care. We know from extensive research that social risks, including financial instability, housing instability, and food insecurity, can lead to poor cancer outcomes and increased mortality. Patient advocates, government agencies and others are also recognizing the importance of ensuring that the needs of people with cancer and their caregivers are acknowledged at every step of the cancer journey.

Kaiser Permanente's Cancer Support Line is an example of this kind of new supportive cancer care initiative. It connects patients and their caregivers with a trained cancer support specialist who can help with non-medical needs. Areas of support include help with benefits and finances, transportation assistance, local healthy food programs, peer support groups and caregiver support resources. Patients are paired with a single specialist throughout their cancer journey, so they are recognized each time they call, and there is no need to retell previously shared details.

During the pilot period, the most common inquiries we received on the line included questions about payment assistance, insurance benefits, and eligibility. When callers were asked to evaluate their overall interaction with the line, nearly all rated their experience highly. Based on the success of the pilot, we are now expanding the line across the organization.

Kaiser Permanente is also working with external organizations and foundations to collectively solve these difficult problems. Earlier this year, Kaiser Permanente joined other key stakeholders at a summit hosted by the Sheri and Les Biller Family Foundation to collaborate on amplifying current efforts and identifying new solutions to help patients equitably navigate their cancer experience with greater ease. This led to the formation of the Together for Supportive Cancer Care coalition. Kaiser Permanente is a founding member of this national coalition that works to expand early, equitable access to supportive care that can improve the lives of all people with cancer.

At the federal level, the White House Cancer Moonshot announced CancerX, a public-private partnership committed to reducing cancer-related mortality rates and enhancing the quality of life for patients and their families through digital innovation. As one of the founding organizations, Kaiser Permanente collaborates with other CancerX stakeholders to develop best practices, toolkits and value models to improve equity in cancer care and research.

Kaiser Permanente How Health Care Organizations are Closing Gaps in Cancer Care

From a clinical perspective, some health care organizations are intensifying their efforts to tackle health disparities through prevention, treatment and research. Culturally sensitive reminders, delivered in person, over the phone, or via email, can effectively encourage individuals to complete cancer screenings. These reminders work best to boost early detection rates when combined with personalized screening schedules tailored to family history and medical backgrounds. For those who receive a cancer diagnosis, a multidisciplinary approach to cancer treatment—requiring collaboration between surgeons, oncologists and other specialists—can significantly improve patient outcomes.

A 2022 study showed that a comprehensive approach to improving colon cancer care resulted in a 24 percent decrease in mortality over seven years among Kaiser Permanente's Southern California members. This program focused on a variety of care processes that included identifying members needing screening and creating automated alerts that prompted providers to offer screenings during patient visits. Members who were not up to date on screenings were sent a home-based fecal immunochemical test (FIT) by mail. All of the screening materials patients received were crafted to be culturally sensitive—addressing potential patient mistrust of the health care system and communicating a clear message that getting screened increases a person's odds of being present for their loved ones. That same year, another study showed that colorectal cancer disparities had been eliminated between our Black and white members in Northern California after the implementation of a structured colorectal cancer screening program, which also included mailing FIT tests to members.

Because Kaiser Permanente is also one of the largest enrolling sites in the nation for the National Cancer Institute Community Oncology Research Program (NCORP), our members have access to cutting-edge treatments in the communities in which they work and live. Our large and diverse membership enables us to include patients of diverse ages, ethnicities and backgrounds in our clinical trials. This helps us determine the effects of a new treatment or medication on an extremely wide range of patients.

It is critical for health care providers to fully support patients on every part of their cancer journey and help ensure that everyone, regardless of background or circumstance, has access to the care and support they need. Only then can we begin to create a more effective and equitable cancer care system for all.

This article was done in paid partnership with Kaiser Permanente and edited by Newsweek staff.

To contact the editor of this article, please reach out to partnership.content@newsweek.com.

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Closing Gaps: The Need for a More Equitable Approach to Cancer Care in America

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