Healthcare Disparities: Video Discussion

In this series of videos, Lisa Ha, MSN, APRN, CNP, from Northwestern University Memorial Hospital in Chicago, Illinois, and Massey Nematollahi, RN, MScN, CNS, CON©, OCN,®, Immuno-Oncology Clinical Nurse Specialist at William Osler Health System in Ontario, Canada, discuss healthcare disparities in patients receiving checkpoint inhibitors. They provide strategies to overcome barriers to care and provide culturally competent education for immune-related adverse event (irAE) management. We hope you find this content helpful in your efforts to optimize the outcomes from immunotherapy for every patient.

Healthcare disparities in oncology


Healthcare disparities in immuno-oncology


Impact of COVID-19 on healthcare disparities


Impact of disparities on clinical-trial enrollment

Experience with irAEs in different populations


Culturally-competent education regarding irAEs


Encouraging irAE reporting

Reference List

AACR, Cancer Health Disparities. Accessed from https://www.aacr.org/patients-caregivers/about-cancer/cancer-health-disparities/  on October 6, 2021.

Andermann A. Taking action on the social determinants of health in clinical practice: a framework for health professionals. CMAJ. 2016;188(17-18):E474-E483. doi:10.1503/cmaj.160177

Andermann A. Screening for social determinants of health in clinical care: moving from the margins to the mainstream. Public Health Rev. 2018;39:19. doi:10.1186/s40985-018-0094-7

Cloyes KG, Hull W, Davis A. Palliative and End-of-Life Care for Lesbian, Gay, Bisexual, and Transgender (LGBT) Cancer Patients and Their Caregivers. Semin Oncol Nurs. 2018;34(1):60-71. doi:10.1016/j.soncn.2017.12.003

Fenton, Health Care’s Blind Side. Accessed from https://www.rwjf.org/en/library/research/2011/12/health-care-s-blind-side.html on February 2, 2022

FitzGerald C, Hurst S. Implicit bias in healthcare professionals: a systematic review. BMC Med Ethics. 2017;18(1):19. doi:10.1186/s12910-017-0179-8

Klein SL, Morgan R. The impact of sex and gender on immunotherapy outcomes. Biol Sex Differ. 2020;11(1):24. doi:10.1186/s13293-020-00301-y

LaForge K, Gold R, Cottrell E, et al. How 6 Organizations Developed Tools and Processes for Social Determinants of Health Screening in Primary Care: An Overview. J Ambul Care Manage. 2018;41(1):2-14. doi:10.1097/JAC.0000000000000221

Li D, Duan H, Jiang P, et al. Trend and socioeconomic disparities in survival outcome of metastatic melanoma after approval of immune checkpoint inhibitors: a population-based study. Am J Transl Res. 2020;12(7):3767-3779.

Nazha B, Mishra M, Pentz R, Owonikoko TK. Enrollment of Racial Minorities in Clinical Trials: Old Problem Assumes New Urgency in the Age of Immunotherapy. Am Soc Clin Oncol Educ Book. 2019;39:3-10. doi:10.1200/EDBK_100021

O’Connor JM, Seidl-Rathkopf K, Torres AZ, et al. Disparities in the Use of Programmed Death 1 Immune Checkpoint Inhibitors. Oncologist. 2018;23(11):1388-1390. doi:10.1634/theoncologist.2017-0673

Parikh AB, Zhong X, Mellgard G, et al. Risk Factors for Emergency Room and Hospital Care Among Patients With Solid Tumors on Immune Checkpoint Inhibitor Therapy. Am J Clin Oncol. 2021;44(3):114-120. doi:10.1097/COC.0000000000000793

Sawchuk CN, Van Dyke E, Omidpanah A, Russo JE, Tsosie U, Buchwald D. Caregiving among American Indians and Alaska Natives with cancer. Support Care Cancer. 2015;23(6):1607-1614. doi:10.1007/s00520-014-2512-9

Taylor LA, Tan AX, Coyle CE, et al. Leveraging the Social Determinants of Health: What Works?. PLoS One. 2016;11(8):e0160217. doi:10.1371/journal.pone.0160217

Thompson LL, Pan CX, Chang MS, Krasnow NA, Blum AE, Chen ST. Impact of ethnicity on the diagnosis and management of cutaneous toxicities from immune checkpoint inhibitors. J Am Acad Dermatol. 2021;84(3):851-854. doi:10.1016/j.jaad.2020.09.096

Thornton R, Glover C, Cene C, Glik D, et al. Evaluating strategies for reducing health disparities by addressing the social determinants of health. Health Aff (Millwood), 35(8):1416-23. doi: 10.1377/hlthaff.2015.1357

Tripathi R, Archibald LK, Mazmudar RS, et al. Racial differences in time to treatment for melanoma. J Am Acad Dermatol. 2020;83(3):854-859. doi:10.1016/j.jaad.2020.03.094

van Ryn M, Burgess DJ, Dovidio JF, et al. The impact of racism on clinician cognition, behavior, and clinical decision making. Du Bois Rev. 2011;8(1):199-218. doi:10.1017/S1742058X11000191

WHO, Social determinants of health. Accessed from  https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1 on February 2, 2022

Williams DR, Priest N, Anderson NB. Understanding associations among race, socioeconomic status, and health: Patterns and prospects. Health Psychol. 2016;35(4):407-411. doi:10.1037/hea0000242

 

Resource List