Rural & Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29210, USA.
Big Data Health Science Center, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
Int J Environ Res Public Health. 2021 Feb 3;18(4):1384. doi: 10.3390/ijerph18041384.
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.
在美国,每二十五个人中就有一个是生活在农村地区的少数族裔或少数民族。我们的目标是总结种族主义以及健康的社会决定因素如何不成比例地影响农村少数民族群体,综述农村少数族裔群体经历的癌症差异,并建议采取政策、研究和干预措施来减少这些差异。我们发现,农村黑人和美国印第安人/阿拉斯加原住民人口面临更大的贫困和医疗保健获取障碍,这使他们面临更大的癌症发病风险,在治疗和最终生存方面的癌症结局更差。我们迫切需要开展更多的研究,以了解所有农村少数族裔群体所经历的差异。我们建议采取旨在增加这些社区获得医疗保健和医疗资源的政策。此外,观察性和干预性研究应通过减少癌症护理中的结构性和人际偏见、增加数据获取、更多研究新的癌症筛查和治疗方式,以及继续开展干预和实施研究以了解基于证据的实践如何最有效地减少这些人群中的差异,从而更有效地解决农村和种族/族裔之间的交叉问题。