Session: Disparities in Cancer (Research that Promotes Sustainability and (re)Builds Strengths (January 15 - 18, 2009))

African Americans, Hispanics, Native Americans, Alaska Natives, Asians, and Pacific Islanders face higher rates of cancer incidence and mortality despite the fact that the overall health of Americans has improved over the past twenty years (US Department of Health and Human Services (DHHS), 2002). Both the American Cancer Society (American Cancer Society, 2006) and the National Cancer Institute (National Cancer Institute, 2006) call for the elimination of disparate health outcomes in cancer and have made it a research priority. The NCI defines cancer health disparities as the “differences in the incidence, prevalence, mortality, and burden of diseases and related adverse health conditions that exist among specific population groups in the United States” (National Cancer Institute, 2001). Contributing to these disparities are limitations to health care access, lack of education, low income, lack of insurance, and under use of effective treatment and care (Bickell et al., 2006; DHHS, 2002; Kawachi & O'Neill, 2005). In this symposium, we will present research findings that demonstrate racial and ethnic disparities in outcomes and behaviors, and identifies possible causal factors. The first paper examines subgroup differences and related determinants for colorectal cancer screening among Asian Americans. The second paper examines factors that may be associated with African Americans' participation in prostate cancer screening in the context of their significantly lower participation rate in routine diagnostic screening for disease. The third paper investigates oncology social workers own perspectives on their approach to the delivery of psychosocial services to gay and lesbian patients. The final paper examines the occurrence of non-hereditary (sporadic) mutations of breast cancer genes as a function of neighborhood and community level factors (e.g., crime, collective efficacy) and individuals' psychosocial responses to those factors. Health disparities reflect social injustice in the US as well as within our US system of health and medical care. As social workers we are obligated by our profession to address social injustice and pursue efforts to achieve justice for all (National Association of Social Workers, 1997). In this vein, our symposium will address health disparities in the context of social justice. The papers and subsequent discussion will examine issues of disparity as they occur at various points across the trajectory of cancer care (from prevention to diagnosis and treatment, and on into post-treatment survival and end-of-life). Discussion will examine individual, interpersonal, cultural and institutional factors that perpetuate disparities. We will conclude with a discussion of recommendations for social workers' involvement in advocacy, further research, intervention design and implementation.