Abstract
The objective of this article is to call for integrating biological pathways of social experiences in the concept model of cancer disparities and social determinants of health (SDH) fields. Black, Indigenous, and People of Color (BIPOC) populations experience more negative outcomes across the cancer continuum. Social conditions are instrumental in better understanding the contemporary and historical constructs that create these patterns of disparities. There is an equally important body of evidence that points to the ways that social conditions shape biological pathways. To date, these areas of research are, for the most part, separate. This paper calls for a bridging of these two areas of research to create new directions for the field of cancer disparities. We discuss inflammation, epigenetic changes, co-morbidities, and early onset as examples of the biological consequences of social conditions that BIPOC populations experience throughout their lifespan that may contribute to disproportionate tumorigenesis and tumor progression.
Highlights
Cancer persists as one of the leading forms of disease burden in the United States (U.S.)with one in three individuals receiving a cancer diagnosis at some point in their lifetime [1].Cancer is the second leading cause of mortality in non-Hispanic White (NHW), Black, and American Indian/Alaska Native (AI/AN) populations and is the leading cause of mortality for Latinos [2]
The field of epigenetics provides empirical evidence demonstrating that changes to biological pathways are shaped by social experiences across the lifespan beginning in utero
Historical trauma and social exposures during childhood and adolescence are notable social experiences in BIPOC populations that need to be further evaluated in the field of cancer disparities
Summary
Cancer persists as one of the leading forms of disease burden in the United States (U.S.). Across the continuum, pronounced disparities in BIPOC communities have been identified Examples of these patterns of difference seen in BIPOC include: less engagement in routine cancer screenings, differences in cancer treatment initiation and surgical interventions, and higher mortality rates within five years of diagnosis. The relationship between social inequality and cancer disparities among BIPOC communities has been the focus of previous studies [10,11]. This body of evidence points to the social phenomenon as being instructive in better understanding unequal cancer burdens in these populations. To fully consider cancer disparities, there is a need to bridge the literature that focuses on social conditions that shape biological and physiological pathways to the biological pathways that increase cancer risk. From this integrated conceptualization of these bridged areas of evidence comes new horizons to move the field forward and enable new strategies for building cancer equity
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