Yesterday I had the opportunity to virtually attend a lecture on racial disparities in colorectal cancer screening. This was purposely scheduled to fall in line with Black History Month, which was much appreciated. One of the quotes that I have heard many times previously and still holds so much impact each time I hear it is “your zip code matters more than your genetic code when it comes to health.” This illustrates the extreme significance of structural determinants of health in determining a patient’s health outcomes. It is a known fact that those who live in impoverished areas with restricted access to healthy foods, quality education, transportation, poor air and water quality, etc. do worse in numerous avenues of wellbeing. Cardiovascular disease and diabetes for example, two of the most common chronic conditions contributing to mortality, are more prevalent in less affluent neighborhoods. It was pointed out that as physicians, we can help in many ways by engaging with our community. Patients and community members place high value on a physician’s words and actions, and we can certainly make a difference even with seemingly small interactions.
The speaker presented a case where a patient who certainly should have been screened for colon cancer prior to leaving the hospital was missed the opportunity, and ended up dying. It was pointed out that African Americans are screened less often for colon cancer compared to non-Hispanic whites. Additionally, African Americans are referred for genetic testing less often than non-Hispanic whites, even when a cancer is identified. Genetic testing has huge implications in parenthood planning, screening for other types of cancers, and understanding one’s prognosis. The speaker emphasized the significance of offering genetic testing when indicated, as cancers may occur in syndromes.