Cancer

cancer

With the release of the Greater Lowell Cancer Disparities Needs Assessment, the GLHA has launched a significant initiative in helping to reduce the impact of cancer, while reducing cancer disparities and promoting health equity in the Greater Lowell region.

Addressing the Need

As the leading cause of death in Massachusetts, cancer claims approximately 13,000 lives annually. Racial and socioeconomic disparities continue to impact cancer incidence and mortality in Massachusetts and the Greater Lowell communities experience a higher age-adjusted overall cancer death rate than the state (224.7 per 100,000 versus 185.2 per 100,000) based on the most recent MassCHIP reports from the Massachusetts Department of Public Health.

Greater Lowell community residents are burdened with higher mortality rates across almost all cancer types including lung, breast, uterine and oropharyngeal disease sites.

Created by the MCCPCN’s Survivorship Work Group, the Massachusetts Department of Public Health recently released a Wellness Guide for Cancer Survivors. With an overall message of: “You are not alone” the guide covers topics of Physical, Emotional, Social, Spiritual, Thinking (cognitive), and Work wellness.
Wellness Guide for Cancer Survivors

For additional resources, visit our Resources page.

Our Impact

In the spring of 2015, the GLHA conducted a Cancer Disparities Needs Assessment in the Greater Lowell region, funded by a $50,000 grant through the Massachusetts Department of Public Health (DPH) by the Centers for Disease Control and Prevention (CDC) for Phase I of the Cancer Disparities Capacity Building Pilot Project. The needs assessment was conducted by researchers at the University of Massachusetts Lowell, in partnership with Lowell General Hospital and the Lowell Community Health Center.

The needs assessment provides an overview of the health status of area residents and reports cancer disparities and health inequities of interest and importance to the community.

Focus groups, key informant interviews, and provider roundtable discussions were conducted in the Greater Lowell region to obtain valuable input from community members.

Below is the needs assessment executive summary. Read the entire report

Executive Summary:
Greater Lowell Cancer Disparities Needs Assessment

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The Greater Lowell Health Alliance, in partnership with the University of Massachusetts Lowell, conducted an assessment of cancer disparities for the Greater Lowell area, which includes the towns of Billerica, Chelmsford, Dracut, Dunstable, Lowell, Tewksbury, Tyngsborough, and Westford. The purpose of this assessment is to evaluate what providers, professionals and community members know, think, and understand about cancer and cancer disparities  facing area residents.

By identifying the key factors and concerns involved in the higher prevalence of cancer in the Greater Lowell area, recommending actions to address priority concerns, and providing information that informs a community process, this assessment intends to build consensus around strategies to improve the cancer outcomes of Greater Lowell residents.

This report summarizes the major findings from our cancer disparities assessment. The primary data sources included interviews with nine key informants, twelve focus groups, and provider roundtables – for a total of 116 participants – and secondary data sources included demographic, socioeconomic, and public health data.

Top Concerns
The top concerns and issues identified in the focus groups and interviews, and supported by public health data, include lack of insurance or access to insurance, lack of access to providers, lack of cultural awareness/sensitivity/competency on the part of providers, lack of cancer prevention education geared toward non-English-speaking communities, lack of culturally appropriate outreach at the community level, and poverty/low socioeconomic status (SES).

The residents identified at greatest risk of cancer care disparity include documented and undocumented immigrants of a variety of ethnicities, those in minority communities, low income individuals, the uninsured, the elderly in the previously identified communities, and those in the homeless populations.

Major Issues Identified
The major issues identified include insufficient access to insurance, insufficient low income/free care in local hospitals, insufficient cultural awareness/sensitivity/competency on the part of some providers, and inadequate culturally sensitive prevention outreach efforts. In addition, community-level focus groups indicated a lack of availability of the following services: care navigator support for non-English-speaking patients, interpreting/translation services, and Portuguese- and Khmer- language support groups for cancer
patients and their families.

Social Determinants
Social determinants that affect community health in general and cancer specifically are highlighted below:

• For members of minority communities, discrimination on the basis of race and ethnicity is an issue when accessing care.
• For members of newly immigrated communities, cultural factors contribute to cancer disparities.
• The high incidence of tobacco use in immigrant communities, specifically the Asian community, contributes to lower health outcomes in general, and higher incidence of all cancers.
• For those with no insurance, insufficient insurance coverage, or those who are undocumented, lack of local free care for cancer in the Greater Lowell area is a barrier.
• For those of lower SES, access to nutritious foods is inadequate, and more affordable nutritious foods are less accessible to those without transportation.
• For those in low wage jobs, access to after-hours appointments with providers and for screening services is a barrier.
• For those with lower SES, health care is often a luxury.
• For those with no insurance, insufficient insurance coverage, or those who are undocumented, lack of local free care for cancer in the Greater Lowell area is a barrier.

Key Recommendations
Key recommendations suggest a two pronged approach: first, improving access to health care services for under insured, minority, undocumented and low SES populations; and second, increasing the cultural awareness and competency of area providers, increasing the availability of culturally and linguistically appropriate outreach directly into communities.

The efforts could include:

  • Improving access to health care services for the uninsured and under insured
  • Increasing health care advocacy for the uninsured, those of lower SES and minority populations
  • Increasing community outreach and focus on community-level culturally appropriate strategies for cancer prevention and lifestyle awareness, including smoking cessation and nutrition programs
  • Providing cultural competency and sensitivity training for providers at all levels
  • Expanding interpreter/language services
  • Implementing strategies to make the health delivery system more sensitive to the needs of minority patients, such as increasing the number of care navigators for
    non-English speakers, expanding care related transportation
    services, and increasing the availability of after-hours care.