The Health Care Access Index as a Determinant of Delayed Cancer Detection Through Principal Component Analysis

Abstract

In the past two decades, cancer mortality declined significantly in the United States (Byers, 2010). Although the reasons for the decline have not been well-established, many factors such as the reduction in the number of smokers, increased cancer screening, and better treatment may have played an important role (Byers, 2010, Richardson et al. 2010). However, disparities in cancer mortality persisted among different ethnic groups and social classes (Byers, 2010). Health status and health disparities among different social and ethnic groups are to a large degree determined by socioeconomic status and living conditions in general (Pamies and Nsiah-Kumi, 2008; World Health Organization [WHO], 2008). For example, life expectancy worldwide increased from 48 years in 1955 to 66 years in 2000 mainly as a result of improvement of overall living conditions in addition to advancement in medical science and large-scale preventive interventions (Centers for Disease Control and Prevention [CDC], 2011). Large health disparities exist between poor and rich countries or within any given rich or poor country (WHO 2008). In the case of cancer mortality due to delayed detection, socioeconomic status may determine health insurance coverage status, which in turn affects health behaviour including regular check-ups and participation in cancer surveillance among high risk groups. Regular cancer surveillance is critical for cancer control (Byers, 2010, Richardson et al. 2010). Lack of health insurance due to economic hardship may result in the delay in cancer detection.