November is Native American Heritage Month, so let's use this opportunity to talk about cancer disparities within American Indian and Alaska Native (AI/AN) populations.
Non-Hispanic American Indian and Alaska Native people not only have higher rates of liver, colorectal, kidney, lung, and stomach cancers than non-Hispanic White people, they also have unique cancer patterns due to their history and culture, where they live, how they get health care, and centuries of systemic racism.
Many Native people who live on reservation lands or in remote rural areas experience less access to health care, healthy food, and education and employment opportunities.
However, it’s not all about location: Rural and urban Native people are more likely to experience poverty, lower levels of education, and poorer housing conditions when compared to the United States population as a whole.
For example, in 2019, as the Centers for Disease Control and Prevention (CDC) points out, about 84% of AI/AN people had at least a high school diploma, as compared to about 93% of non-Hispanic White people, and the median household income for AI/AN people was $49,906 compared to $71,664 for non-Hispanic White households. Additionally, 2021 American Community Survey data showed non-Hispanic AI/AN people are uninsured at higher rates than other groups (18.8 percent, compared to 5.7 percent of non-Hispanic White people).
Not only are these challenges in and of themselves, but they can also make it more difficult to get access to proper medical care when it’s needed.
When it comes to reducing cancer disparities among American Indian and Alaska Native people, one important area of focus has been to improve the quality of available health data so that needs can be properly assessed and better prevention and intervention strategies can be introduced for better health outcomes.
Why data matters: In order to be able to accurately measure and track cancer rates among any group, people need to be identified correctly. Many AI/AN people are misclassified as another race in registry records, which causes cancer incidence and death rates to appear lower among these groups.
To help correct this problem, the cancer surveillance community has partnered with the Indian Health Service to cross reference individuals and make sure their race is recorded correctly within the cancer registry record.
Additionally, to examine differences in cancer rates more accurately, CDC researchers now look at differences in six geographic regions: the Northern Plains, Alaska, Southern Plains, Pacific Coast, East, and Southwest.
Having this specific regional data has been extremely important in helping Tribes get funding for cancer prevention programs they had not been able to previously, because the original data did not show a need for such programs.
“Addressing cancer disparities can be complex and there isn’t a quick fix, especially since the issues causing disparities run so deep. The recent work to better define needs within the AI/AN group and providing funding is a great start to the journey of long awaited change,” said Emily Heath, RN BSN, Clinical Research and Outreach Nurse.