Study: Structural Racism Increases Cancer Mortality within Racial Minoritized Groups

In a study presented at the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorites and the Medically Underserved, researchers found that structural racism was related to an increased cancer mortality rate in minority populations. The researchers analyzed associations between county level measures of structural racism and cancer mortality rates, taking environmental burdens into account.

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Structural racism is defined by the American Medical Associationas ways society has fostered racial discrimination through mutually reinforcing systems, and one of these systems is health care.

“Applying measures that attempt to capture the multiple and compounding ways racism presents in policies, laws, and practices at a population level shows how racism manifests beyond interpersonal interactions to negatively impact cancer outcomes,” said presenter Joelle N. Robinson-Oghogho, PhD, MPH, a postdoctoral fellow at the Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior and Society, in a press release. “Studying the impact of structural racism on cancer outcomes allows us to further understand the persistent racial disparities in cancer and broaden our scope of intervention.”

Robinson-Oghogho and colleagues led the study and used data that was publicly available from the US Cancer Statistics Data Visualization Tool of cancer mortality rates from 2015 to 2019. Data was also used from the 2019 County Health Ranking and Roadmaps, the US Environmental Protection Agency’s 2006 to 2010 Environmental Quality Index report, and the 2015 to 2019 estimates from the US Census American Community Survey.

The press release noted that the researchers studied cancer mortality rates in 1026 counties to define whether the increase varied by race, including non-Hispanic Black, white, Asian/Pacific Islander, and American Indian and Alaskan Native individuals.

To properly measure structural racism at the county level, the researchers used a standardized index of a model to measure the latent construct of structural racism, which was previously created for researchers to use to connect structural racism to racial health disparities at a county level. This model assesses residential segregation, incarceration, employment, economic status or wealth, and education.

“The county-level structural racism factor scores obtained through this method represent the number of standard deviations that separate the structural racism value for a given county from the mean value for all counties,” said the study authors.

The press release noted that adjustments regarding smoking, obesity, excessive alcohol consumption, health insurance coverage, sexually transmitted infection rates, mammography screening rates, primary care physician-to-population ratio, rurality, and geographic mobility was considered prior to the standardized index.

The results concluded that the cancer mortality rates increased by 3.3 deaths per 100,000 individuals. This score was associated with every standard deviation increase.

The increase of mortality rate was higher among minoritized individuals compared to white individuals. The press release noted that the cancer mortality rates increased by 11.9 deaths for non-Hispanic Blacks, 4.7 deaths for Asian/Pacific Islander individuals, and 17.4 deaths for American Indian/Alaskan Native individuals, each per 100,000 individuals.

“This finding demonstrates how racial groups can be differentially impacted by the social characteristics of their environment. Addressing these disparities will require incorporating processes and tools that tackle structural racism,” said Robinson-Oghogho, in a press release.

Reference

Structural Racism May Play a Role in Increased Cancer Mortality Rates Among Racial Minorities. American Association for Cancer Research. News release. September 29, 2023. Accessed September 29, 2023. https://aacr.ent.box.com/s/ress0eclndv4tl1yyku8x5sszmo4mzk4.