Journal article
Measuring and addressing health equity: an assessment of cancer center designation requirements
Cancer causes & control, Vol.34(S1), pp.23-33
12/2023
DOI: 10.1007/s10552-023-01680-4
PMCID: PMC10512189
PMID: 36939948
Abstract
By requiring specific measures, cancer endorsements (e.g., accreditations, designations, certifications) promote high-quality cancer care. While 'quality' is the defining feature, less is known about how these endorsements consider equity. Given the inequities in access to high-quality cancer care, we assessed the extent to which equity structures, processes, and outcomes were required for cancer center endorsements.
We performed a content analysis of medical oncology, radiation oncology, surgical oncology, and research hospital endorsements from the American Society of Clinical Oncology (ASCO), American Society of Radiation Oncology (ASTRO), American College of Surgeons Commission on Cancer (CoC), and the National Cancer Institute (NCI), respectively. We analyzed requirements for equity-focused content and compared how each endorsing body included equity as a requirement along three axes: structures, processes, and outcomes.
ASCO guidelines centered on processes assessing financial, health literacy, and psychosocial barriers to care. ASTRO guidelines related to language needs and processes to address financial barriers. CoC equity-related guidelines focused on processes addressing financial and psychosocial concerns of survivors, and hospital-identified barriers to care. NCI guidelines considered equity related to cancer disparities research, inclusion of diverse groups in outreach and clinical trials, and diversification of investigators. None of the guidelines explicitly required measures of equitable care delivery or outcomes beyond clinical trial enrollment.
Overall, equity requirements were limited. Leveraging the influence and infrastructure of cancer quality endorsements could enhance progress toward achieving cancer care equity. We recommend that endorsing organizations 1) require cancer centers to implement processes for measuring and tracking health equity outcomes and 2) engage diverse community stakeholders to develop strategies for addressing discrimination.
Details
- Title: Subtitle
- Measuring and addressing health equity: an assessment of cancer center designation requirements
- Creators
- Jason T Semprini - Department of Health Management and Policy, College of Public Health, University of Iowa, 145 N. Riverside Dr. N277, Iowa City, IA, 52240, USA. jason-semprini@uiowa.eduCaitlin B Biddell - University of North Carolina at Chapel HillJan M Eberth - Drexel UniversityMary E Charlton - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USASarah H Nash - University of IowaKatherine A Yeager - Emory UniversityDonoria Evans - National Partnerships and Innovations, American Cancer Society, Decatur, GA, USAPurnima Madhivanan - University of ArizonaHeather M Brandt - St. Jude Children's Research HospitalNatoshia M Askelson - University of IowaAaron T Seaman - Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USAWhitney E Zahnd - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Cancer causes & control, Vol.34(S1), pp.23-33
- DOI
- 10.1007/s10552-023-01680-4
- PMID
- 36939948
- PMCID
- PMC10512189
- NLM abbreviation
- Cancer Causes Control
- ISSN
- 0957-5243
- eISSN
- 1573-7225
- Grant note
- HHSN261201800012I / NCI NIH HHS U48 DP006399; U48 DP006377; U48 DP006396; U48 DP006413; U48 DP006389; U48 DP006400; U48 DP006401; U48 DP006398 / CDC HHS 1F31DE032250-01 / NIDCR NIH HHS R01CA254628 / NCI NIH HHS P30CA086862 / National Cancer Institute, United States T32-CA-116339 / NCI NIH HHS
- Language
- English
- Electronic publication date
- 03/20/2023
- Date published
- 12/2023
- Academic Unit
- Health Management and Policy; Epidemiology; Center for Social Science Innovation; Injury Prevention Research Center; Public Policy Center (Archive); General Internal Medicine; Community and Behavioral Health; Internal Medicine
- Record Identifier
- 9984380464402771
Metrics
33 Record Views