Colorectal cancer, or CRC, affects African American men and women more than Caucasians, at a rate 20% higher. This is concerning when faced with the mortality rates among African Americans, 28% higher for women and 14% higher for men than for Whites. African Americans are also more likely to be in later stages of the disease when diagnosed. There is a need to study and evaluate why these factors exist, as proper screening and early diagnosis can severely impact survival rates for CRC. One study attempts to find the solution through testing, however, this study slightly discredits itself along the way. In the article “Culturally Targeted Educational Intervention to Increase Colorectal Health Awareness Among African Americans”, written by Phyllis Morgan, PhD, Joshua Fogel, PhD, Indira Tyler, MS, RN, and John Jones, MD, in 2009, CRC is evaluated in the African American community. The four, working with the Department of Nursing at Fayetteville State University in North Carolina, started a research project entitled “The Fayetteville Area Inter-Faith Commitment to Colorectal Health Awareness and Cancer Reduction in African Americans”, abbreviated “The F.A.I.T.H. Project”. The project’s intent was to increase CRC knowledge and increase CRC screening among African Americans. The doctors participating handed out educational programs to churches and community-based organizations. The study split up 539 African American men and women, all 50 years or older, into an intervention group and a control group. The intervention group received the 90 minute educational programs while the control group did not. To evaluate the effectiveness of the handouts, pre-test and post-test questionnaires were handed out to both groups. The study... ... middle of paper ... ...making the anonymous aspects of the test questionable. The project has good intentions, but lacks the proper structure to make it a credible test for CRC among the African American community. If another test were to be done, it would need to clearly define the variables, eliminating and singling them out one by one. It would need to consist of a wider proportion of the population, while at the same time limiting the size of the groups so that data is easily collectable. The study would need to be anonymous, without payment for the participants, and with a method of data more reliable than a simple questionnaire. The test would have to eliminate the faith-based aspects that biased this project in order for it to be credible among the medical community. The need is still great for CRC research, but researchers should be aware of the credibility of their conduct.
Cancer is one of the 9 National Health Priority Areas (NHPA), areas which account for a significant portion of the burden of disease, but have sizeable potential for improvement. In Australia, CRC is the second most common cancer, after prostate (in men) and breast cancer (in women) (AIHW, Cancer incidence projections). The incidence has gradually increased (by 13% in males from 1982-2007) (AIHW, Cancer in Australia an overview). This is compounded by the ageing population and population growth, with 14,860 new cases in 2010 (http://www.cancer.org.au/about-cancer/types-of-cancer/bowel-cancer). This graph demonstrates this upward trend ((AIHW, Cancer incidence projections):
"Eliminating Racial and Ethnic Disparities in Health." Public Health Reports. July/August 1998: 372 EBSCOhost. Available <http://www.epnet.com/ehost/login.html>. (11 February 1999)
Cohn, Jay N., The Use of Race and Ethnicity in Medicine: Lessons from the African-American Heart Failure Trial, J.L. Med. & Ethics, Race and Ethnicity, Fall 2006, p 552-554.
Jewelll, N., & Russell, K. (1992). Current health status of african americans. Journal of community health nursing, 9(3), 161-169.
African American people are also more susceptible to pancreatic cancer, the cause of this is not known. Specifically “TP53, p16INK4A, and SMAD4. The p53 nuclear protein activates transcription of a cyclin kinase inhibitor p21WAF1/CIP1. Following genomic stress, inappropriate growth factor stimulation or expression of oncogenic ras increased expression of p53, and thus p21WAF1/CIP1 resulted in inactivation of specific CDK/cyclin complexes” (MedScape). If this transformed cell can escape internal and external fail-safe mechanisms, receive nutrients, and activate its proliferative program, it can form a mass of cancerous cells.
The absence of cultural competency in some health care providers, lack of community perspective integration in health care facilities, and low quality health care received by women in developing countries.These are the three most pressing health care concerns that need to be addressed in our ever changing world. The first of the issues I’ll be discussing is the lack of cultural competency amongst health care providers, as well as the shortage of education and training in cultural competency. As we all know and see the United States is a racially and ethnically diverse nation which means our health care providers need to be equipped with the necessary education and training to be able to provide for diverse populations. As an East African
Rajaram, S. S., Vinson, V. (1998). African american women and diabetes: a sociocultural context. Journal of Health Care for the Poor & Underserved, 9(3), 236-247.
On November 11th, 2004, NitroMed, a Massachusetts based pharmaceutical company published a study on the effects of a new drug called BiDil in treating heart failure among African Americans in the New England Journal of Medicine (Taylor 2049). Since announcing the study, NitroMed’s research has sparked controversy surrounding the ethical implications and scientific evidence of race-based medicine. This study marks a breakthrough in race-based drug treatments as the first pharmaceutical ever researched, endorsed and targeted for a single ethnic group (Pollack 1). The racially-specific pharmaceutical initiative is a product of tremendous government funding allotted by the Clinton administration to the Human Genome Project at the turn of the millennium. Since then, much medical research has focused on understanding the human genome in search of genetic explanations for health problems while funding and interest have decreased in social-related health research and medical programs for poor and underserved populations (Braun 162).
Studies have analyzed how African Americans deal with an enormous amount of disease, injury, death, and disability compared to other ethnic group, and whites, Utilization of health services by African Americans is less frequent than other ethnic groups in the country. This non utilization of services contributes to health disparities amongst African Americans in the United States. Current and past studies have shown that because of discrimination, medical mistrust, racial/ethnic background, and poor communication African Americans tend to not seek medical care unless they are in dire need or forced to seek professional care. African Americans would rather self –medicate than to trust a doctor who might show some type of discriminatory
As of today, there are many programs and efforts being made that have either already decreased the gap or are attempting to bring change to the problem of increased deaths of African American women from breast cancer. One example is a study that was done in Massachusetts that gave low-income African American women aged 50-70 resources and education for six years, and it was “concluded that the Massachusetts program appeared to mitigate the disadvantages of living in high-poverty neighborhoods” for the incidence of breast cancer in that specific area (Cunningham 595). This study shows that these women need help that has not been previously provided to them in order to reduce the disparity. In this regard, the role of affordable health care needs to be available in order to decrease this problem. The same study showed that “among women without health insurance, disproportionately large numbers are [older African Americans], providing an explanation for high rates of advanced stage cancers at presentation among [African American] women in general” (Cunningham 594). If women are to be able to access affordable screenings, affordable health care must also be provided. Once again, this brings in the role of government in the lives of African American women. Federally qualified health centers offer preventative health care and screenings for a reduced or free cost to women of low socio-economic status, many of which happened to be African American women at a particular clinic, and it was found that the incidence of breast cancer in that community was reduced from the rates that were established previously (Adams 640). Therefore, if low-income women are to be able to access quality health care, then there must be more federally qualified ...
Zenka, D. (2012, October 05). African Americans: At Higher Risk for Prostate Cancer. Prostate Cancer Foundation (PCF). Retrieved May 25, 2016
For these reasons, minorities often put off the expense of seeing a doctor until they have advanced disease and are past being easily treated. A lack of education, rural or inner city residence, unemployment, and low literacy rate may also contribute to higher cancer mortality rates for some communities. In several studies researchers investigates whether socioeconomic status is the reason for the disparity in prostate cancer incidence, where African Americans and Non- Hispanic Whites are the top two candidates for prostate cancer. Some results found that the highest level of cancer incidence was positively correlated with low socioeconomic status (Cheng, et al.,
Dorothy Roberts makes a compelling argument, at first glance, against race-based medicine. She stated many facts in her lecture which gave her argument legitimacy, but under further investigation it was discovered that many of her statistics were manipulated. The strongest part of her argument was when she incorporated ethos and pathos to convince the reader that race-based medicine was in fact racist. Her overall argument was strong, and was probably enough to convince an unbiased audience member. The major flaw with Roberts’ argument was the manipulation of statistics, and the lack legitimate
Williams, D. R., & Jackson, P. (2014, April 1). Health Affairs. Social Sources Of Racial Disparities In Health. Retrieved April 29, 2014, from http://content.healthaffairs.org/content/24/2/325.short
A plurality of projects presented the CABs related to the overall community and recruitment based on geographic location not just race, ethnicity or gender. Another focus of the projects related to directly to the CAB members perceptions of the growing health concerns and scientific educational needs of members. These topics also related to the appropriate methods and process for dissemination of findings back to the general public and patient communities. Minority and immigrant health, participation, and engagement in research was another area of focus for the CABs in both locations. A growing area of interest in the research arena is the involvement of patients and caregivers in research. A growing number of projects related directly to PCORI centered research study design and recruitment. In each of these examples, the CAB agreed to serve as the community advisory board for the studies presented and asked for the presenters to return for updates.