Description:
Centuries of structural racism have contributed to discrimination, environmental and social injustice, and household material hardship among historically marginalized populations. Recent studies have highlighted the impact of factors such as income and insurance status on cancer outcomes and health equity. Under-representation of specific groups has limited our understanding of cancer risk, disease biology, treatment-related toxicities, and patient-reported outcomes. The educational objective of this session is to present the latest evidence regarding modifiable factors that contribute to outcome disparities in childhood/adolescent and young adult (AYA) hematologic malignancies, and to discuss potential targets for interventions that address these disparities. Dr. Ji will present an in-depth overview of public health insurance programs in the U.S. and related implications on outcome disparities among AYAs with blood cancers. Using a case-based approach, Dr. Ji will discuss opportunities to improve access to high-quality public health insurance, subsequent to the Affordable Care Act. Dr. Umaretiya will discuss the role of social determinants of health (SDOH) as modifiable drivers of outcome inequities in pediatric oncology. She will review the prevalence of SDOH in pediatric oncology, present historically marginalized parent perspectives on unmet social needs during cancer care, and highlight novel interventions addressing this population’s SDOH and social needs. Dr. Mittal will discuss factors contributing to low rates of enrollment of AYAs with hematologic malignancies to clinical trials, including a lack of availability and accessibility. She will provide an up-to-date review of collaborative initiatives that are addressing some of these barriers to improve AYA access to cancer clinical trials.