Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center, Rochester, NY.
James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY.
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-13. doi: 10.1200/EDBK_349825.
The population of older adults with cancer in the United States is rapidly increasing, which will have a substantial impact on the oncology and public health workforces across the cancer continuum, from prevention to end of life. Unfortunately, inequities in existing social structures that cause increased psychosocial stressors have led to disparities in the incidence of cancer and the morbidity and mortality of cancer for individuals from marginalized backgrounds. It is imperative that older adults, especially those from historically marginalized backgrounds, be adequately represented in all stages of cancer research to address health inequities. Continued efforts and progress toward achieving social justice and health equity require a deeper commitment to and better understanding of the impact of social determinants of health within the cancer domain. Undoubtedly, a more holistic and integrated view that extends beyond the biologic and genetic factors of health must be adopted for health entities to recognize the critical role of environmental, behavioral, and social determinants in cancer health disparities. Against this backdrop, this paper uses a life course approach to present a multifactorial framework for understanding and addressing cancer disparities in an effort to advance social justice and health equity for racially and ethnically diverse older adults.
美国癌症老年患者人群数量正在迅速增加，这将对肿瘤学和公共卫生领域的工作人员产生重大影响，涵盖癌症防治的各个阶段，从预防到临终关怀。不幸的是，导致心理社会压力增加的现有社会结构中的不平等现象，导致来自边缘化背景的个体的癌症发病率、发病率和死亡率存在差异。至关重要的是，老年人，特别是那些来自历史上处于边缘地位的老年人，应该在癌症研究的所有阶段都得到充分代表，以解决健康不平等问题。要实现社会正义和健康公平，就必须进一步承诺并更好地理解健康领域社会决定因素的影响。毫无疑问，为了使卫生实体认识到环境、行为和社会决定因素在癌症健康差异中的关键作用，必须采取更全面和综合的观点，超越健康的生物和遗传因素。有鉴于此，本文采用生命历程方法提出了一个多因素框架，以努力推进不同种族和族裔的老年群体的社会正义和健康公平，从而理解和解决癌症差异问题。
