People living in areas with fewer resources are less likely to receive cancer screenings from federal clinics, according to a recent study.
About one in 11 Americans receive health care from Federally Qualified Health Centers, also known as FQHCs. These clinics provide medical treatment and preventive services to people in low-income areas. They also connect patients with resources to help with housing, food and transportation needs.
The researchers found wide gaps in cancer screening rates between FQHCs, with those serving the most vulnerable areas having the lowest.
Colorectal cancer screening had the greatest disparity, with people in the most underserved communities being screened around 15 percentage points less than individuals in areas with more resources. People in lower-resource areas were also screened for breast cancer about 11 percentage points less and cervical cancer about 8 percentage points less.
“These findings are really concerning because studies have shown that people in these more vulnerable areas tend to have a poorer diet, are not involved in physical activities, and have a higher tobacco utilization rate,” says Eunhae Shin, lead author of the study and an assistant professor in the University of Georgia College of Public Health.
“Those factors lead to a higher risk of developing cancer. Yet they are not getting services that can be lifesaving.”
The study relied on publicly available data from the 2022 Health Resources and Services Administration Uniform Data System. The dataset includes more than 1,300 FQHCs serving 29.8 million patients in all 50 states and Washington, DC.
Socioeconomic status had the biggest impact on screening rates. This includes factors such as income, unemployment, and education, the researchers say.
“Those who live in areas with low education levels and low income face a lot of logistical barriers to receiving preventive services,” Shin says. Those obstacles include low health literacy and being unable to take time off work for doctor appointments.
People with disabilities or lower English proficiency also faced additional challenges in getting screened for cancer.
At-home test kits for colorectal cancer and telehealth services could help overcome some of the barriers people face by enabling patients to access health care services from their homes or local community centers, the researchers says.
FQHCs face unique financial and staffing obstacles that can make providing services difficult. Reforming how the centers are reimbursed for services could also help, the researchers says.
“We need to pay more attention to these FQHC patients. When we talk about health systems, people talk about hospitals and physicians, but FQHCs play such an important role,” Shin says.
“More research should be done in this area, and there needs to be more policy attention to improve not only cancer disparities but disparities in other chronic conditions as well.”
This study appears in the Journal of General Internal Medicine.
Source: University of Georgia
