Barriers to cancer treatment and care for people experiencing structural vulnerability: a secondary analysis of ethnographic data

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dc.contributor.authorBourgeois, Amber
dc.contributor.authorHorrill, Tara C.
dc.contributor.authorMollison, Ashley
dc.contributor.authorLambert, Leah K.
dc.contributor.authorStajduhar, Kelli I.
dc.date.accessioned2023-05-23T14:51:22Z
dc.date.available2023-05-23T14:51:22Z
dc.date.issued2023-03-30
dc.date.updated2023-04-04T17:42:11Z
dc.description.abstractAbstract Background A key pillar of Canada’s healthcare system is universal access, yet significant barriers to cancer services remain for people impacted by structural vulnerability (e.g., poverty, homelessness, racism). For this reason, cancer is diagnosed at a later stage, resulting in worse patient outcomes, a reduced quality of life, and at a higher cost to the healthcare system. Those who face significant barriers to access are under-represented in cancer control services Consequently, these inequities result in people dying from cancers that are highly treatable and preventable, however; little is known about their treatment and care course. The aim of this study was to explore barriers to accessing cancer treatment among people experiencing structural vulnerability within a Canadian context. Methods We conducted a secondary analysis of ethnographic data informed by critical theoretical perspectives of equity and social justice. The original research draws from 30 months of repeated interviews (n = 147) and 300 h of observational fieldwork with people experiencing health and social inequities at the end-of-life, their support persons, and service providers. Results Our analysis identified four themes presenting as ‘modifiable’ barriers to inequitable access to cancer treatment: (1) housing as a key determinant for cancer treatment (2) impact of lower health literacy (3) addressing social care needs is a pre-requisite for treatment (4) intersecting and compounding barriers reinforce exclusion from cancer care. These inter-related themes point to how people impacted by health and social inequities are at times ‘dropped’ out of the cancer system and therefore unable to access cancer treatment. Conclusion Findings make visible the contextual and structural factors contributing to inequitable access to cancer treatment within a publically funded healthcare system. Identifying people who experience structural vulnerability, and approaches to delivering cancer services that are explicitly equity-oriented are urgently needed.en_US
dc.identifier.citationInternational Journal for Equity in Health. 2023 Mar 30;22(1):58
dc.identifier.citationInternational Journal for Equity in Health. 2023 Mar 30;22(1):58
dc.identifier.citationInternational Journal for Equity in Health. 2023 Mar 30;22(1):58
dc.identifier.citationInternational Journal for Equity in Health. 2023 Mar 30;22(1):58
dc.identifier.doi10.1186/s12939-023-01860-3
dc.identifier.urihttps://doi.org/10.1186/s12939-023-01860-3
dc.identifier.urihttp://hdl.handle.net/1993/37347
dc.language.isoengen_US
dc.language.rfc3066en
dc.publisherBioMed Central (BMC)en_US
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectcanceren_US
dc.subjectcancer treatment accessen_US
dc.subjectcancer treatment adherenceen_US
dc.subjecthealth equityen_US
dc.subjecthealth disparitiesen_US
dc.subjectsocial determinants of healthen_US
dc.subjectstructural vulnerabilityen_US
dc.subjectvulnerable populationsen_US
dc.titleBarriers to cancer treatment and care for people experiencing structural vulnerability: a secondary analysis of ethnographic dataen_US
dc.typejournal articleen_US
local.author.affiliationRady Faculty of Health Sciences::College of Nursingen_US
oaire.citation.issue1en_US
oaire.citation.startPage58en_US
oaire.citation.titleInternational Journal for Equity in Healthen_US
oaire.citation.volume22en_US
project.funder.identifierhttps://doi.org/10.13039/501100000024en_US
project.funder.nameCanadian Institutes of Health Researchen_US
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