Cancer health disparities exist. We have known this for so many years and yet tragically and unconscionably, this continues to be the reality. If we are to change this course, we must focus on evidence-based solutions.
Over the last 25 years, the many reasons why cancer disparities exist have been analyzed and well described. The role that social determinants of health, access to care, and culturally relevant health communications can play in cancer prevention and optimal health outcomes has been studied, and significant advances have been made in defining the scientific and political issues that cause health care disparities. This much-needed information lays the foundation of our understanding; yet if we are truly going to impact these ongoing disparities, our focus must shift to effective solutions. That’s why we compiled and edited Cancer Disparities: Causes and Evidence Based Solutions, the first published book that focuses on evidence-based solutions to cancer disparities.
We designed this book with several goals in mind. Public health professors can use it to teach students that effective solutions, from prevention to end of life, are available; and, in turn, students may be so inspired by the impact such programs can have on reducing disparities, that many may then choose health equity as a career. We also understood that public health practitioners, cancer control workers in the field, and community members who work each day to make theirs a healthier community, are the ones who can make the difference in the real world. They are ready and willing to do the work, all they ask for are evidence-based solutions that they can adapt to their own community’s needs. That’s why we included examples of interventions conducted among different ethnic groups including African American, Hispanic, Native American, as well as those who are otherwise marginalized, such as sexual minority women and low-literacy men, each of which has their own unique culture. We recognized that different situations call for different solutions, so we included a wide range of examples, ranging from one-on-one, group, and community interventions, as well as those that focus on broader systems such as health care system and policy change.
The community-based interventions include all that is “right” in conducting such interventions, including full collaboration with the community, beginning with building relationships, identifying the problems to be addressed in full partnership, conceptualizing solutions, and then moving together to implementation. This often painfully slow and time-consuming method is one that reaps rewards time and again, and the careful description of it will help those who are considering applying this in their community.
Implementing interventions often include considerable challenges both in the planning and execution phase. In order to help others avoid these, we dealt with these head-on in several of the book’s chapters. Sometimes, even with all good intent, interventions are designed which are unsuitable for that population, a difficult lesson but one that needs to be acknowledged and learned from if we want to build effective community bridges. Working within health care systems allows a broader reach, but this approach too is not without its challenges. These challenges, including unintended consequences, lessons learned, and helpful strategies to prevent such challenges in the future, are all carefully described.
Over and above these evidence-based solutions is the deeper recognition that all of us—policy makers, researchers, professors, students, health care workers and community members, in fact all of us as a society—must understand and commit to. In order to achieve health equity, we as a society have to place social justice at the core. There is a role for each and every one of us in this journey. We hope you will join us. Together we can, and we will, change the course.