Explaining Reduced Cancer Survival among the Disadvantaged

• Published in: The Milbank quarterly Vol. 74; no. 2; pp. 215 - 238
• Main Authors: Greenwald, Howard P., Borgatta, Edgar F., McCorkle, Ruth, Polissar, Nayak
• Format: Journal Article
• Language: English
• Published: Malden, MA Blackwell Publishers 01-01-1996; Blackwell; Blackwell Publishing Ltd
• Subjects: Adult; Aged; Aged, 80 and over; Breast cancer; Cancer; Class; Coefficients; Cultural Deprivation; Disadvantaged; Disadvantaged people; Education; Ethnic Groups; Female; Health care; Humans; Income; Life expectancy; Life tables; Logistic regression; Low income groups; Lung neoplasms; Male; Middle Aged; Mortality; Mortality Rates; Neoplasms - economics; Neoplasms - ethnology; Neoplasms - mortality; Poor; Population Surveillance; Poverty; Prostate cancer; Public health; Social Class; Socioeconomic Factors; Socioeconomic Status; Sociology; Sociology of health and medicine; Statistical significance; Survival; United States - epidemiology; Washington (State); United States Of America; United States; Health; Upper Class; Interaction; Mortality; Patient; Biology; Recovery; Survival; Reduction; Health Care; Middle Class; Luck; Illness; Social Differentiation; Social Factor; Lower Class; Hazard; Cancer
• ISSN: 0887-378X; 1468-0009
• DOI: 10.2307/3350247

The fact that socially disadvantaged cancer patients face a greater risk of mortality than the advantaged is well recognized but poorly understood. Existing research and a newly completed 10-year survival study suggest that complex interrelations among biological factors, medical interventions, and specific dimensions of social differentiation determine survival differences. Patterns of interrelations among determinants of survival appear compatible with an "economic" model in some forms of cancer and a "cognitive-behavioral" model in others. Findings presented here suggest that improved access to health care will reduce mortality risk among the disadvantaged in at least some malignancies, but will not alone make their survival chances equal to those of the advantaged.