State Study Looks at Cancer and Poverty
Monday, Dec. 1, 2008 - DENVER - A report released today
by the Colorado Cancer Coalition and the Colorado
Comprehensive Cancer Program of the Colorado Department of
Public Health and Environment recommends that efforts should
be made to reduce health disparities in disadvantaged
populations by ensuring that Colorado residents, regardless
of income, have access to quality health education, cancer
screening and cancer treatment.
The report, “Cancer and Poverty in Colorado: 1995-2006,”
is a study of the relationship between cancer and poverty in
the state. The report found that in Colorado poverty
continues to be an important factor associated with the risk
of getting cancer, having cancer diagnosed at a later stage
and dying due to cancer. According to the report:
- Poorer Coloradans are more likely to have the
behaviors or risk factors that lead to increased cancer
risk, such as obesity, smoking, poor diet and lack of
exercise.
- The inequities of the health care system put poor
people at a tremendous disadvantage in the fight against
cancer. Poor people are less likely to get properly
screened for cancer, although early detection is a
crucial component in fighting its development. Poor
people also are likely to have poorer health insurance
coverage or no coverage, and coverage plays a crucial
role in an individual’s course of cancer.
Jillian Jacobellis, director of the Prevention Services
Division at the state Health Department, said, “We are not
saying poverty causes cancer, but this report illustrates
how poverty is related to the onset and course of cancer in
Colorado. The findings underscore the need for attention to
our health care system, to our system of health care
coverage and to assisting low-income populations in making
healthy choices.”
The publication of “Cancer and Poverty in Colorado:
1995-2006” continues a series of the department’s reports
that examine Colorado health data on cancers, health
behaviors and deaths. Findings from the report may be useful
for policy-makers, health care professionals and community
groups in developing and evaluating prevention and
intervention strategies, identifying high risk populations,
and prioritizing resource allocations for cancer-related
services.
Ned Calonge, chief medical officer at the state Health
Department, said, “Colorado is one of the first states to
have looked closely at the relationship between poverty and
cancer. We know that early diagnosis and regular screening
can lead to better survival. However, those in the lower
socioeconomic groups and those having no health insurance or
only Medicaid coverage are more likely to be diagnosed with
cancers at a later stage of disease, where prospects for
survival are worse.”
Although there has been some overall improvement in
cancer rates and preventive behaviors between the periods of
1995-2000 and 2001-2006, the report found that the
underlying relationship between poverty and cancer first
identified in 2003 remains unchanged.
- Coloradans with lower incomes were more likely to
smoke tobacco; be obese; be less physically active; and
not participate in screening tests for breast, cervical
or colorectal cancer.
- For most cancers, Coloradans who lived in poorer
neighborhoods and had no health insurance were more
likely to have had a more advanced stage of cancer at
the time of diagnosis.
- For most cancers, Coloradans who lived in poorer
neighborhoods were more likely to die within the first
five years following cancer diagnosis.
The report also showed that the relationship between
poverty and cancer weakened among those over age 65, the age
at which Medicare coverage begins for most elderly
Americans.
“For those 65 years and older, when Medicare covers
screening tests for colorectal cancer for nearly everyone,
there is less of a difference in late-stage diagnosis
between those living in low-poverty and high-poverty areas,”
explained Tim Byers, associate director of the Cancer Center
at the University of Colorado, and a member of the Colorado
Cancer Coalition. “Once patients are diagnosed, their level
of health coverage shapes the course and aggressiveness of
their cancer treatment. Simply put, the worse your coverage,
the more likely your cancer will kill you.”
While solutions to the problems caused by poverty are
complex, the report concludes that focusing efforts on
reducing tobacco use, preventing obesity, encouraging
physical activity and increasing access to cancer screening
and appropriate cancer treatment can help reduce suffering
and death from cancer among low-income populations in
Colorado.
The report also recommends
- enhanced funding of programs that encourage adoption
of healthy behaviors, increase access to preventive
health services for early detection of cancer and
increase access to timely initiation of effective cancer
treatment right after cancer diagnosis;
- surveillance of cancers based on routine reports on
health statistics that, where possible, report data
according to poverty levels rather than only by
race/ethnicity.
Data for the report was provided by the Colorado Central
Cancer Registry and the Health Statistics Section at the
Colorado Department of Public Health and Environment.
To contact the Comprehensive Cancer Program or the
Colorado Central Cancer Registry at the Colorado Department
of Public Health and Environment, call 303-692-2520or visit
http://www.cdphe.state.co.us/pp/ccpc/index.html
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