Cancer disparities and health equity: Contributing regional factors among the underserved in MA

Introduction: The Massachusetts Comprehensive Cancer Prevention and Control Program (MCCPCP), in collaboration with JSI Research & Training Institute (JSI), conducted a regional assessment to address cancer disparities and health equity to advance its state plan goals. Methods: Southeastern MA was identified as a priority due to high incidence, late stage diagnosis, and poorer health outcomes relative to other regions of the state. Factors specific to the region were gathered through secondary data analyses, focus groups with target populations, and key informant interviews and group discussions with local stakeholders including Community Health Workers, health providers, regional public health officials, and community service providers. In addition to cancer disparities, we explored preventable risk factors including tobacco use, second-hand smoke, carcinogens in occupational and environmental settings, and barriers to physical activity and good nutrition. Results: Among key findings were that social determinants of health including poverty, low levels of education, limited English proficiency and literacy, and racial discrimination including fear of deportation were identified as significant barriers to care. Discussion/Conclusion: Despite health care reform in Massachusetts, access to cancer services was found to remain difficult for underserved populations. At the same time, the assessment identified many community and regional organizations actively working to address disparities. Their engagement led to recommendations for strategies and programmatic options to advance and help inform regional prevention activities, ensure appropriate screening, and improve access to culturally competent, high quality health care services. The MCCPCP is using findings in collaborative strategic planning with its Disparities/Health Equity Workgroup.