Whenever social risk factors arise, “there’s an opportunity for someone to fall through the cracks or be delayed,” says Phillips, who is now a data scientist at Georgia State University (she did not participate in the research). This delay can take many forms, “whether it’s not being diagnosed with cancer as early as it should have been, receiving treatment, missing appointments, or not receiving treatment as they should. “, she says.
But whether housing insecurity is specifically responsible for the increase in cancer mortality is not yet proven. The housing issue could simply “mimic other factors,” says Stuart Butler, senior research fellow in economic studies at the Brookings Institution. A precarious living situation could be just another indicator of financial insecurity, which itself has negative effects on health. Social risks “are rarely isolated,” says Banegas, the study’s leader. “It’s rare for a person to have only housing instability. The table is more complex. »
Although the exact nature of the link is unclear, the link between housing and health suggests that improving people’s life security would have compound benefits. But it’s a big problem to solve. In the United States, some programs exist to help people with housing, but they are limited in the amount of assistance they can provide and who qualifies for benefits, leaving huge gaps in affordable housing for many. many people.
The question then becomes, “Who is best available to invest?” Butler said. Whether it’s a manager in a housing agency or the head of a hospital, investing in housing – or measures to tackle social poverty more generally – will often not be seen as doing integral part of their business model. America’s health care system, including the people who provide cancer care, is doing what it can, but social risks are broad issues that require policies and funding to address them. There’s no “silver bullet” to getting the scale of investment needed to tackle something like housing insecurity, Butler says.
Another dimension is that certain groups are more likely to suffer from housing insecurity, potentially putting them at increased risk of cancer. To research published in 2019 showed that in parts of the United States where black populations suffer from mortgage discrimination, that is, where lenders discriminate against customers based on their race, the disparity in cancer mortality between Blacks and whites is also greater. Groups that disproportionately experience housing insecurity are more likely to be those “who have been historically marginalized and have fewer financial resources to overcome their cancer and receive treatment,” says Pollack.
So it’s not a single factor that likely contributes to cancer disparities, but rather the joint impact of race, ethnicity, housing and other different factors acting together, says Biplab Datta, Professor Assistant at the Institute of Public and Preventive Health at the University of Augusta. One potential solution is to identify populations most at risk for cancer, he says, and if housing insecurity is higher within a population or location, critical improvements, such as improving the cancer screening and quality of care, and stress reduction, should be pursued. in these places, through policies.
In New York, the patient Phillips saw was blessed with timely cancer care, despite her barriers and social risks. But this is not the case for all patients – and it will remain so as long as housing insecurity remains widespread.