Structural racism as a contributor to lung cancer incidence and mortality rates among Black populations in the United States (2 May 2024)

Summary

Although racial disparities in lung cancer incidence and mortality have diminished in recent years, lung cancer remains the second most diagnosed cancer among US Black populations. Many factors contributing to disparities in lung cancer are rooted in structural racism. To quantify this relationship, Robinson-Oghogho et al. examined associations between a multidimensional measure of county-level structural racism and county lung cancer incidence and mortality rates among Black populations, while accounting for county levels of environmental quality.

Content

This study adds to the existing body of research which has demonstrated how communities’ social characteristics influence the health of the people residing there. In the context of lung cancer specifically, several studies have highlighted how higher amounts of residential segregation, and neighbourhood deprivation are associated with lung cancer incidence and mortality. These predictors are often considered indicators of structural racism, reflecting the contemporary and historical ways power and privilege have systematically limited access to resources, particularly for Black people in the United States.

The findings align with previous work. Studies examining racial disparities in lung cancer have noted a variety of contributing factors including adverse social determinants of health and inequities in receipt of guideline concordant treatment for lung cancer, healthcare utilisation, and clinical trial participation, among Black people compared to White people. However, these factors are rooted in historical and contemporary ideologies, practices, and policies that disadvantage certain race groups (i.e., structural racism). Thus, assessing the role of structural racism as a root cause of lung cancer disparities further illuminates it as a key determinant and helps move towards the eradication of racism and other connected systems of oppression that promote poor health.

This study advances this body of research through the inclusion of a structural racism index that explicitly captures race-based differences across multiple social determinants of health at a population level, while also accounting for the overall quality of social and physical environment, through the numerous variables represented in the Environmental Quality Index.