"The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries."
-World Health Organization
"Social determinants of health care are more important than health care. Seventy to ninety-five percent of health is unrelated to health care and instead due to social issues."
-Clement Bezold, Institute for Alternative Futures
What are social disparities in cancer?
Social disparities in cancer are health inequities. Each person is not on a level playing field. Inequality is often associated with a lack of fairness and injustice. An unequal burden of suffering and death due to cancer continues in the United States and many parts of the world. Improved cancer prevention, treatment, outcomes, and survival are dependent on addressing inequities related to the disease1.
What are some areas of social inequality in cancer?
The following areas of social inequality exist alone and in combination involving adverse conditions and discrimination at multiple levels throughout life2. These factors influence outcomes when dealing with cancer as a patient or loved one, as well as supporting cancer risk reduction.
- Socioeconomic position (income, wealth, poverty, and debt)
- Work status and environment
- Insurance status
- Education
- Geographic location such as urban or rural
- Housing status
- Gender
- Age
- Race/ethnicity and racism
- Language
- Literacy
- Immigrant status
- Disability
- Sexuality
What are the multiple levels that impact inequality?
The many levels at which these factors exist and may be socially determined include the following and others. The specific components impacting each level influence health behaviors3.
Individual
Income, debt load, owning a car, resources for childcare, daily hassles, worries associated with living in disadvantaged situations
Interpersonal
Family roles and responsibilities, diversity of friendship patterns, availability of community members, social ties
Organizational
Work organization, job strain, occupational culture and norms, factors in the health care setting that facilitate access to care and effective communication with one's physician
Neighborhood and community
Safe place to exercise, access to neighborhood resources such as fresh produce at reasonable prices, housing, transportation
Societal forces
Access to health care, access to education, public policy, discrimination
Culture
Any learned and shared knowledge, beliefs, and rules that people use to interpret experience and generate social behaviors such as social norms, social networks, and specific health behaviors
Our most popular resources
 Diet and Cancer
You are what you eat! Some foods kill cancer cells and others promote cancer cell growth. Learning the difference between healthy and unhealthy foods in the midst of cancer is essential.
 Cancer Resources
Knowledge is power. Reliable resources are empowering. We provide clear information, explanations, and maps to educate and empower. Explore our integrative cancer care resources for navigation tools and support.
 Mind-Body Strategies
The mental and emotional inner life impacts health and healing through the mind-body connection. Learn about empowering mind-body practices supporting mind, body, and spirit for cancer patients and caregivers.
 Spiritual Support
The spiritual dimensions of life often become more prominent in the midst of cancer for cancer patients and their loved ones. Explore our empowering information about spirituality for support and strategies.
References
- Toward the Elimination of Cancer Disparities Edited by Howard K. Koh, MD, MPH, Chapter 1, Defining, Investigating, and Addressing Cancer Inequities: Critical Issues by Nancy Kreiger, Karen M. Emmons, and David Williams, 2009.
- Krieger N. Defining and investigating social disparities in cancer: critical issues. Cancer Causes Control. 2005 Feb;16(1):5-14. Review. PubMed PMID:15750853.
- Toward the Elimination of Cancer Disparities Edited by Howard K. Koh, MD, MPH, Chapter 1, Defining, Investigating, and Addressing Cancer Inequities: Critical Issues by Nancy Kreiger, Karen M. Emmons, and David Williams, 2009.
|