Although cancer is becoming more survivable, cancer diagnoses in the younger population and deaths are expected to rise because of resources and health disparities.
This trend in increased cancer diagnoses and deaths reflects racial, ethnic, and socioeconomic disparities that are largely driven by social determinants of health (SDOH), which are shown to contribute as much as 80 percent to a person’s health versus clinical care, which is only 20 percent.
Health inequity and SDOH are multifaceted, but in many cases relate to unequal access to resources, such as food, housing, reliable transportation and care.
Knowing that more than half of Americans receive their health insurance through their jobs, employers play a critical role in addressing these health inequities.
Cancer disparities in the U.S.
There are many ways that cancer disparities can show up in the U.S., which include demographic, socio-economic and geographic populations:
- African American/Black women continue to have the highest cancer death rate of any racial or ethnic group in the U.S.
- Rural Americans face a higher risk of certain cancers and are less likely to receive recommended preventive care and cancer screenings than their urban counterparts.
- Low income women are less likely to be up-to-date with cervical cancer screening than women in the highest income bracket.
- Rural Appalachians have higher incidence rates of colorectal, lung, and cervical cancers than those who live in urban areas in the region.
- American Indians/Alaska Natives have higher death rates from kidney cancer compared to their White counterparts.
- Hispanic/Latino children and adolescents have the highest leukemia incidence rate of any racial and ethnic group in the U.S.
Unconscious bias in medical settings can also lead to members receiving poor treatment, inaccurate, or delays, in diagnosis.
Other factors that may contribute to cancer disparities include later stage of disease at diagnosis, lower stage-specific survival, lower overall rate of cancer screening, differences in disease biology, and treatment efficacy.
But there has been progress to reduce cancer survival gaps in the country over the past 20 years, according to the American Association for Cancer Research. The disparity in age-adjusted cancer deaths between African American/Black and White U.S. residents has shrunk from 32% in 1991 to 11% in 2020.
That said, higher-quality health care is needed to help further prevent, diagnose and treat cancer, according to a JAMA research study.
Cancer and health inequities’ impact on the workplace
Employers have many reasons for taking a stand against health inequities as they impact their workforce and their business’ bottom line. Health disparities are responsible for $320 billion in excess health care costs annually. Cancer costs recently surpassed musculoskeletal conditions as the top driver of employers’ health care expenditures, costing $125 billion in treatment every year and another $139 billion due to workplace absenteeism and diminished productivity.
Recruitment and retention challenges may also arise if employers don’t address the health disparities their employees face throughout the cancer care journey. A perception of lack of support for employees diagnosed with cancer could negatively affect an employer’s reputation and ability to attract and retain top talent.
Lastly, SDOH impacting employees’ ability to access treatment may result in them needing to take frequent medical leave, thereby resulting in increased absenteeism and reduced productivity. The same can be said for caregivers, who may need to adjust work schedules because of increased stress, which negatively impacts overall company and workplace performance.
An employer action plan to overcome health disparities
But there are steps that employers can take to overcome these health disparities across the oncology landscape. By providing oncology benefits beyond the most basic levels of health coverage, employers can help address modifiable risk factors such as smoking and obesity and promote early detection while also improving their business’ bottom line.
Employers play critical role in reducing health disparities and improving health outcomes for their employees by:
- Improving health literacy. A recent study from the Evernorth Research Institute shows that a majority of employers overestimate their members’ ability to manage the complexities of their health coverage and care. Employers should consider a focused approach with personalized education and clear communication to members about their plan's oncology benefit to drive better engagement.
Employers may also benefit from a partnership with a cancer screening education program to overcome cultural stigmas and communicate with employees who have low health literacy in multiple languages.
- Improving access to cancer screenings, diagnosis and treatment.
Increasing cancer awareness and screening among employee populations with inequities in screening rates and overall cancer burden help improve health outcomes.
Second opinion services can provide patients with an expert second review of their case for peace of mind along their treatment journey. Leveraging a patient-centric approach to care can also allow patients to receive care in their community and on their terms through health systems and cancer care centers.
- Offering a wide range of resources to support members and caregivers through the emotionally-taxing oncology experience. Employers can offer return-to-work support for employees juggling navigating the costly cancer care journey and ensuring their income protection.
Caregiver and post-treatment support are other options to consider for members diagnosed with cancer. Employees and their caregivers may benefit from a single, personal oncology nurse advocate to identify and address their most pressing needs, including SDOH.
Increasing access to specialty medications and treatments. According to Evernorth’s 2024 Health Care in Focus report, oncology was identified as one of the top five therapeutic drug classes driving pharmacy spend. With that in mind, it is critical for members to have access to specialty therapies/medications available on the market today. Employers that are equipped to help patients dealing with health care barriers via home delivery, language lines, large type and braille labels have a competitive advantage in the workplace.
Moreover, an oncology consult service can help members who have complex diagnoses and their oncologists with National Cancer Institute (NCI) subspecialists, eliminating the time and transportation barriers usually associated with accessing additional expertise.
- Coordinating financial assistance to deliver care beyond cost barriers. Patients struggling with navigating copay assistance coordination may need payment options like a simplified financial billing structure that helps to reduce financial burden by aligning to the lowest available cost for services.
Employers are uniquely positioned to address the rise in cancer health disparities. By embracing comprehensive health solutions to help the underserved and vulnerable in the prevention, detection, diagnosis and treatment of cancer, companies can help ease the financial burden while simultaneously improving health outcomes.
