World Cancer Day is quickly approaching on February 4, and this year, the global theme is “Close the Care Gap,” which shines a spotlight on ways of addressing barriers to cancer care.
To learn more about the health disparities faced by those in rural populations across Texas, we spoke to Sucharu Prakash, M.D., hematologist and medical oncologist at Texas Oncology–Paris, former member of the American Society Clinical Oncology task force for rural cancer care, and president-elect of Texas Society of Clinical Oncology.
Why is it important to address disparities in cancer care?
Cancer health disparities are real, and the cause of these disparities is multifactorial and often poorly understood. These include
- Behavioral factors such as tobacco abuse, obesity, and sedentary lifestyle
- Clinical factors such as poor access to quality healthcare
- Social factors such as access to education and employment
- Environmental factors such as air and water quality, lack of proper transportation, safe housing, access to healthy food
- Other factors that are increasingly recognized include stress and genetics
With two million new cancer diagnoses and 600,000 cancer-related deaths anticipated in 2022 in the United States, cancer is an enormous public health challenge, and the burden of cancer is not shared equally by various segments of our population.
How is cancer care different for people living in rural areas as opposed to larger metropolitan areas? What are the biggest challenges for cancer patients living in rural areas?
According to 2020 Census data, approximately 14% of Americans live in rural or nonmetropolitan areas. Rural populations are especially prone to cancer health disparity as they statistically tend to be older, have less education, and are more vulnerable to financial toxicity. In rural America, there also are significant insurance barriers, and many experience coverage gaps.
Texas Oncology's mission is to provide high-quality, community-based cancer care near the critical support of loved ones, as geographic isolation can cause reduced access to cancer specialists. On average, patients in rural areas have to drive 60 to 100 minutes to the nearest cancer center. To combat this issue and fulfill our mission, many of Texas Oncology’s providers and centers are in rural areas serving a large rural population.
How has Texas Oncology continued to adapt services, communications, and other aspects of care to better support patients who live in rural areas?
As part of our community-based care model to provide high-quality cancer care in communities of all sizes, we have always strived to provide advanced technology, pharmaceuticals, clinical trials, and well-trained staff and physicians all across the state. As a result, most Texas Oncology patients living in rural communities have access to those services as well as nutrition counseling and psychosocial support.
What impact do you believe virtual care has had on Texas Oncology’s ability to serve rural populations?
At the start of the pandemic, Texas Oncology expanded a telemedicine initiative that has allowed continuing delivery of cancer care, while keeping our patients, their families, and our staff safe. However, telemedicine has its challenges in rural America, with limitations on broadband access. One in four rural Americans do not have internet access at home. Reduced access to telemedicine results in worse health outcomes for rural populations. Texas Oncology's telemedicine initiative has helped mitigate some of these challenges in rural communities.
I am passionate about bringing an equitable future for rural oncology – one where young dynamic oncologists would be motivated to work in rural communities in concert with a strong community hospital providing subspecialty services to patients who will have access to advanced cancer care."
What excites you when looking toward the future of serving patients who live in rural areas?
I am passionate about bringing an equitable future for rural oncology – one where young dynamic oncologists would be motivated to work in rural communities in concert with a strong community hospital providing subspecialty services to patients who will have access to advanced cancer care. I am excited to tackle not only rural health disparity, but health disparity for all.