Abstract
Purpose: Structural racism could contribute to racial and ethnic disparities in cancer mortality via its broad effects on housing, economic opportunities, and health care. However, there has been limited focus on incorporating structural racism into simulation models designed to identify practice and policy strategies to support health equity. We reviewed studies evaluating structural racism and cancer mortality disparities to highlight opportunities, challenges, and future directions to capture this broad concept in simulation modeling research. Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review Extension guidelines. Articles published between 2018 and 2023 were searched including terms related to race, ethnicity, cancer-specific and all-cause mortality, and structural racism. We included studies evaluating the effects of structural racism on racial and ethnic disparities in cancer mortality in the United States. Results: A total of 8345 articles were identified, and 183 articles were included. Studies used different measures, data sources, and methods. For example, in 20 studies, racial residential segregation, one component of structural racism, was measured by indices of dissimilarity, concentration at the extremes, redlining, or isolation. Data sources included cancer registries, claims, or institutional data linked to area-level metrics from the US census or historical mortgage data. Segregation was associated with worse survival. Nine studies were location specific, and the segregation measures were developed for Black, Hispanic, and White residents. Conclusions: A range of measures and data sources are available to capture the effects of structural racism. We provide a set of recommendations for best practices for modelers to consider when incorporating the effects of structural racism into simulation models.
Original language | English (US) |
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Pages (from-to) | 231-245 |
Number of pages | 15 |
Journal | Journal of the National Cancer Institute - Monographs |
Volume | 2023 |
Issue number | 62 |
DOIs | |
State | Published - Nov 1 2023 |
Funding
Jinani Jayasekera and Allana T. Forde were supported by the Division of Intramural Research at the National Institute on Minority Health and Health Disparities of the National Institutes of Health, and the National Institutes of Health Distinguished Scholars Program (Grant Number: N/A). Jessica R. Fernandez was supported by the Division of Intramural Research at the National Institute on Minority Health and Health Disparities of the National Institutes of Health (Grant Number: N/A). Traci Bethea is supported in part by the National Cancer Institute (Grant Number: K01CA212056). Kemi Ogunsina, Jennifer M.P. Woo, Che-Jung Chang, and Jennifer L. Ish are supported by the Intramural Research Program at the National Institutes of Health, National Institute of Environmental Health Sciences (Grant Number: N/A). Adaora Ezeani was supported by the Intramural Continuing Umbrella of Research Experiences (iCURE) program at the National Cancer Institute. Amrita L. Ramanathan was supported in part by the Intramural Research Program of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Washington, DC. The work of Camryn M. Cohen was supported by the intramural research program, Division of Cancer Epidemiology and Genetics, National Cancer Institute. Marquita Lewis-Thames was supported by a grant from the National Cancer Institute (Grant Number: K01CA262342), Northwestern University Clinical and Translational Sciences Institute grant (Grant Numbers: NUCATS; UL1TR001422, PI: D’Aquilla), National Institutes of Health’s National Institute on Aging (Grant Number: P30AG059988), and funds from the Northwestern University Center for Community Health (Grant Number: N/A). Shakira Grant is supported by a National Cancer Institute grant (Grant Number: 5-K12-CA120780-13, PI: William Kim) and a National Institute on Aging grant (Grant Number: 1 R03 AG074030-01). This work is supported in part by the National Institutes of Health under National Cancer Institute Grant U01 CA199218. This article appears as part of the monograph “Reducing Disparities to Achieve Cancer Health Equity: Using Simulation Modeling to Inform Policy and Practice Change,” sponsored by the National Cancer Institute, National Institutes of Health ([Comparative Modeling of Precision Breast Cancer Control Across the Translational Continuum; 3 U01 CA253911-03S2]).
ASJC Scopus subject areas
- Oncology
- Cancer Research