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Cancer Epidemiol Biomarkers Prev. 2011 Sep;20(9):1809-14. doi: 10.1158/1055-9965.EPI-11-0628. Epub 2011 Jul 22.
The first 20 years of publication of Cancer Epidemiology, Biomarkers & Prevention occurred during a period of increased attention to health disparities and advances in knowledge about their determinants. Yet, despite clear documentation of disparities and advanced understanding of determinants, we have made little headway in reducing disparities at the population level. Multilevel models, such as one produced by the Centers for Population Health and Health Disparities (CPHHD), hold promise for understanding the complex determinants of cancer disparities and their interactions as well as translating scientific discoveries into solutions. The CPHHD model maps across a range of scientific disciplines, from the biological to the social, each with its own disciplinary language and methods. The ability to work effectively across disciplinary boundaries is essential to framing comprehensive solutions.
After briefly characterizing the current state of knowledge about health disparities, we outline three major challenges faced by disparities researchers and practitioners and offer suggestions for addressing these challenges.
These challenges are how to consider race and ethnicity in disparities research, how best to translate discoveries into public health solutions to cancer disparities, and how to create a research environment that supports the successful execution of multilevel research.
Attention to all three of the challenges outlined above is urgently needed to advance our efforts to eliminate cancer disparities.
Addressing the challenges outlined above will help to eliminate disparities in the future.
癌症流行病学、生物标志物与预防杂志创刊的前 20 年正值人们日益关注健康差异和对其决定因素的认识不断深入的时期。然而，尽管我们清楚地记录了差异，并对决定因素有了更深入的了解，但在缩小人口层面的差异方面却收效甚微。多层次模型，如人口健康与健康差异中心（CPHHD）所产生的模型，有望帮助我们理解癌症差异的复杂决定因素及其相互作用，并将科学发现转化为解决方案。CPHHD 模型跨越了从生物学到社会学等一系列科学学科，每个学科都有自己的学科语言和方法。跨学科界限有效工作的能力对于构建全面的解决方案至关重要。
简要描述当前关于健康差异的知识状况后，我们概述了差异研究人员和实践者面临的三个主要挑战，并提出了应对这些挑战的建议。
这些挑战是如何在差异研究中考虑种族和民族，如何将发现最好地转化为解决癌症差异的公共卫生解决方案，以及如何创造一个支持多层次研究成功执行的研究环境。
迫切需要关注上述三个挑战，以推进我们消除癌症差异的努力。
解决上述挑战将有助于未来消除差异。
