Racial and ethnic disparities found in health care among older male cancer survivors

Older African-American and Hispanic men who have survived cancer are less likely than their white counterparts to see a specialist or receive basic preventive care, such as vaccinations, according to new research.

Researchers examined racial/ethnic disparities in receiving health care among a nationally representative sample of male cancer survivors. They found that disparities are evident among older, but not younger, cancer survivors, despite their access to Medicare.

Lead author Nynikka Palmer, DrPH, a postdoctoral fellow at Wake Forest Baptist, said his research team identified 2,714 men 18 and older from the 2006-2010 National Health Interview Survey who reported a history of cancer. The researchers looked at health care receipt in four self-reported measures: primary care visit, specialist visit, flu vaccination, and pneumonia vaccination.

“Overall, our results suggest that older minority male cancer survivors may need specific support to ensure they receive necessary post-treatment care,” Palmer said. The study was recently published online ahead of print in the American Journal of Public Health (2013; 103(7):1306-1313).

Even when the researchers adjusted for factors that contribute to disparities, such as education and health insurance, they found that African-American and Hispanic male cancer survivors 65 years and older may not be receiving appropriate follow-up and preventive care. Palmer said this is a concern “because regular follow-up care is important to monitor for recurrence, new cancers, and late and long-term effects of cancer and its treatment, particularly for those with more co-morbidities.”

Overall, among older survivors, approximately 39% of African-Americans and 42% of Hispanics did not see a specialist, compared with 26% of older non-Hispanic whites. Likewise, about 40% of African-American and Hispanic cancer survivors did not receive the flu vaccination, compared with 22% of non-Hispanic white cancer survivors.

Similarly, 51% of African-Americans and 59% of Hispanic cancer survivors did not report receiving the pneumonia vaccine, compared with 29% of non-Hispanic whites.

“These findings are consistent with other reports of health care use among cancer survivors and suggest there may be differences in types of Medicare health plans, supplemental insurance and out-of-pocket costs among older survivors that could be contributing to this disparity,” Palmer said.

Palmer said further study is needed to identify other factors that may influence racial/ethnic disparities among male survivors, such as patients' beliefs about care after cancer and patient-provider communication.
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