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Correlation of Sociodemographic Status with Personal Engagement in Cancer Screening Programs

Posted Mar 08 2010 12:00am

Of great interest to me is the strong correlation of good health and long life with one's level of education. It's a much stronger correlation than even wealth and socio-economic status. On the face of it and in order to explain this finding, one might surmise that more educated people have a better understanding about how to preserve their health or seek therapy when sick. There is also an interesting parallel theory that educated people have invested time and money over many years in themselves, postponing their high-earning years to later in life. A conclusion, based on this scenario, is that their concern for better health results from a desire to extend their careers and earning power later in life. A recent article about sociodemographic status and cancer screening provides another interesting perspective on this issue (see: Sociodemographic Characteristics Are Related To A Patient's Willingness To Participate In Cancer Screenings ):

Less-educated individuals with lower incomes received fewer cancer screenings than those with higher levels of each. These rates may lead to disparities in cancer-related mortality. Racial and ethnic minority status, age and lower income were frequently associated with willingness to receiving a cancer screening. Prior findings suggest that negative attitudes towards screenings include fear of pain or diagnosis, disbelief in the efficiency of the tests or generalized distrust of others were most predominant among racial and ethnic minorities, and accounts for their lower rates of cancer screening. The researchers also found that individuals were most willing to participate in a screening when they were examined by their personal doctor and had symptoms of cancer. Cancer screening campaigns should affect attitudinal changes whenever possible, and recognize that targeting specific population groups may be necessary.

Issues pertaining to cancer screening have been much in the news lately, notably with regard to breast cancer and cancer of the prostate. The former discussion has revolved around the frequency of mammography in younger women (see: Science-Driven Medicine Bumps Up Against Perception of Risk with Mammography ) and the latter around PSA testing in older men (see: New Prostate Cancer Screening Guidelines Boost 'Shared Decision Making' ). Putting these issues aside, it's useful for lab professionals to have a better understanding about the attitudes toward cancer screening on the part of the general public and individual groups such as racial minorities.

The article above make an interesting point. Attitudes toward cancer screening, or any disease screening for that matter, is a combination of inward-looking values (i.e., one's own health status) and outward-looking values (i.e., trust of the "system"). Clearly, providing the financial resources for improving the health of lower sociodemographic groups is absolutely critical. That's, in part, what healthcare reform is all about. However and coupled with this idea, it's also important to understand the best ways to overcome distrust for the "system" in any health screening campaign. It seems to me that the publicity associated with any such campaign needs to be carefully crafted in a way that has appeal and engenders trust in the target audience. I was making the very same point in recent notes about creating demand for on-line testing for STDs in a younger target audience (see: Direct Access Testing For STDs: How to Communicate with Young Adults ).

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