A Model for Addressing Health Care Disparities
In late March, the trans-HHS Cancer Health Disparities Progress Review Group (PRG) released its report, Making Cancer Health Disparities History. The report includes recommendations to the U.S. Department of Health and Human Services (HHS) intended to significantly reduce cancer health disparities in the United States.
Last week I had the honor of officially presenting the PRG's final report to the recently formed HHS Health Disparities Council. The council, which is charged with establishing a coordinated, HHS-wide approach to battling health care disparities, will review the report and decide which recommendations can and should be pursued.
Reports describing health care disparities are not new; however, this report was unique in several respects. First, HHS Secretary Tommy Thompson requested that the National Cancer Institute (NCI) lead an HHS-wide review of cancer health disparity reduction initiatives. The report was to include recommendations that HHS could use to make swift progress in reducing cancer health disparities. Second, a federal steering committee, including representatives from HHS agencies, participated side by side with representatives from the scientific and health policy communities in the progress review process and in formulating the final recommendations.
One of the most remarkable aspects of this report is that it represents the first time that NCI's PRG process was used to review and produce recommendations on such a large-scale problem as cancer health disparities. The PRG process, created by NCI, was designed to provide periodic state-of-the-science reviews and recommendations on specific cancer sites such as prostate and lung cancer. The PRG recommendations are produced as a result of a standard, disciplined, broad process that incorporates a comprehensive literature review and a concept-mapping technique, as well as the traditional contributions of expert panels. The successful adaptation of the PRG process to cancer health disparities opens the door to using the process to review and provide recommendations for other health disparities.
As a member of the trans-HHS Cancer Health Disparities PRG, I am proud of the product that our group produced. It offers priority areas that need to be addressed, with recommendations that span the spectrum from the practical (e.g., expand screening for breast, cervical, and colorectal cancer) to the conceptual (e.g., ensure that every cancer patient has access to state-of-the-science care).
The PRG understood that our recommendations must and will be considered in the context of real-world practicality. Every recommendation cannot simply be implemented tomorrow. Some will require legislative action; others would require structural changes within HHS; and all must compete for limited funding. I think I can safely speak for the entire PRG when I say that implementing even some of the report's recommendations will help reduce cancer care disparities. To read the full report, visit www.hhs.gov/chdprg.
My presentation to the HHS Disparities Council happened to occur during National Minority Cancer Awareness Week. Earlier in the week, I had the opportunity to do an interview on a popular, Washington, D.C.-based African American radio station to talk about how the staggering obesity rates in the African American community are further exacerbating many African Americans' already increased risk of cancer. Simple outreach efforts like radio interviews, op-ed articles in the local newspaper, and community events will also be very important components of any effort to decrease disparities in cancer. No matter what actions are taken on the Federal level, each of us must continue to spread the word in our communities about the threat that cancer poses to all Americans and the most effective ways to prevent, diagnose, and treat it.
Dr. Mark Clanton