Lung cancer is by far the leading cause of cancer death among both men and women. It accounts for almost 25% of all cancer deaths. The American Cancer Society estimated that in 2021, approximately 235,760 new cases of lung cancer will be diagnosed and 131,880 people will succumb to the disease.
Lung cancer screening provides an opportunity to detect lung cancer at an early stage when surgical intervention can be curative. Screening guidelines strongly influence who gets referred for screening and what tests insurance providers will cover for whom. But the current screening guidelines may overlook vulnerable populations with disproportionate lung cancer burden and inadvertently lead to delayed diagnoses and poorer outcomes. Research shows that Black people are at a higher risk of lung cancer than the general population, even if they smoke less over time.
Few people understand how screening guidelines are developed and their impact on personal health. Health journalists can use research about lung cancer screening disparities to shed light on the process and help people advocate for the screenings they deserve.
Racial and ethnic lung screening disparities
The lung cancer screening guidelines are based on clinical trials conducted with subjects who are predominantly white Europeans. The 2011 National Lung Cancer Screening trial studied more than 53,000 current or former heavy smokers to determine the cost and effectiveness of a form of screening called low-dose computed tomography (LDCT). Fewer than 5% of participants were Black.
A European trial on the same topic, the NELSON lung cancer study, also studied LDCT screening with 7,557 participants. The researchers made no mention of people of African ancestry. Including more people of color in clinical trials could have a significant impact on screening guidelines.
Photo by Kenjacobsen35 via Flickr.
New York City made national news when its Board of Health declared racism a public health issue last month. According to an American Public Health Association database, 227 similar declarations have been made by governments, health agencies and elected officials around the country; 49 declarations were passed in western states and 79 in midwestern states.
Milwaukee County, Wisconsin, was the tip of the spear when it passed its declaration of racism as a public health crisis on May 20, 2019. At the time, then-Milwaukee County Executive Chris Abele said the resolution was about making a public commitment to taking action. He said every decision across the county should be framed in terms of how to make a difference by addressing disparities.
In February, Congresswoman Ayanna Pressley (MA-07), Sen. Elizabeth Warren (D-MA) and Congresswoman Barbara Lee (CA-13) reintroduced the bicameral Anti-Racism in Public Health Act to declare structural racism a public health crisis. The CDC has also called attention to how racism affects illness rates and life expectancy.
These important milestones should be covered as such by health equity reporters. Viewing racism as a public health and systemic issue impacting our collective health rather than personal actions that need to be addressed on a case-by-case basis is a notable shift.
Photo by Dr. Matthias Ripp via Flickr
I have reported extensively on the COVID-19 pandemic with many of my stories highlighting health care disparities. I quickly noticed the intersection with environmental issues and climate change. Before long, I could barely write about one topic without writing about the other they were so intertwined.
When President Biden created the Department of Health and Human Services Office of Climate Change and Health Equity (OCCHE) last summer, I realized I hadn’t made some brilliant discovery, I was simply catching up to what the public health and environmental thought leaders had known for some time. It’s hard to overstate the interconnections between climate change and health equity. The root causes and upstream drivers for both are often the same.
This is an opportune time for journalists who aren’t already doing so to begin reporting on climate change as a health equity issue.
When it comes to health inequities or preventable differences in health outcomes, climate change is one of the biggest public health threats today. The consequences of this global phenomenon impacts places, people and communities at the local level with low-wealth communities and communities of color caring a substantially higher burden.
The new climate change tip sheet includes research and studies to help journalists better understand the connection between health equity and climate change, resources, experts, organizations, suggested story ideas such as the impact on particular communities, as well as relevant terms and definitions.
Photo by IRRI Photos via Flickr
Social determinants are well-known factors in individual health outcomes, but the coronavirus pandemic appears to have created urgency in the White House and Congress to highlight and address health equity.
Shortly after being sworn in, President Joe Biden announced a new presidential-appointed position, the Special Presidential Envoy for Climate, and a National Climate Task Force. In one of his first executive orders, Tackling the Climate Crisis at Home and Abroad, Biden said he would elevate climate change and underscore the administration’s commitment to address it. Continue reading
Courtesy of Jallicia Jolly
When Jallicia Jolly gave birth to her first child, Rose, in February, she experienced some of the disparities in care she studies and writes about in her academic life.
Her essay published in USA Today, “I survived childbirth during three pandemics – COVID, racism, Black maternal health crisis,” places her own mistreatment at the hands of an anesthesiologist in the context of maternal health care across the country. “In looking back at my own experience giving birth to my healthy daughter, I am reminded of the stories of Black women who have received substandard care in health care systems and whose needs are deprioritized — and didn’t live to tell their own stories,” she writes. Continue reading