Iowa’s black population faces heightened barriers to cancer prevention

Increasing barriers to cancer prevention services result in black people in Iowa having the highest cancer incidence rates of all racial and ethnic groups between the ages of 50 and 79.

Daniel McGregor-Huyer

Whitney Zahnd, assistant professor in the Department of UI Health Management and Policy, poses for a portrait at the College of Public Health on Feb. 16, 2022.


Iowa’s black population has the highest cancer incidence rates for racial and ethnic groups ages 50 to 79 in the state. Trends show that cancer affects the black population at a younger age than whites, who have the highest cancer rates among those aged 80 and over.

Contributing to high cancer incidence rates, African Americans face increased barriers to cancer prevention resources than other groups.

Whitney Zahnd, an assistant professor in the Department of Health Management and Policy at the University of Iowa, said barriers to cancer prevention include lack of access to health services, health insurance and higher poverty rates.

“Another aspect is that some of the policies that we have in the United States have led to things like residential segregation and that can also lead to black communities sometimes having less access to healthy food or places to go. exercise safely,” Zahnd said.

Segregated communities, especially those with high populations of African Americans, are associated with higher death rates and lower survival rates from breast and lung cancers, as well as greater odds of receiving a diagnosis of cancer after it has spread.

Paul Gilbert, associate professor of user interface and training lead at the Prevention Research Center for Rural Health, said the 2021 Iowa Cancer Report focused largely on racial and ethnic disparities.

“The whole notion of disparities is that they’re unnecessary differences, and they’re rooted in some kind of something that’s unfair, unfair, usually in the sense of resource distribution,” Gilbert said.

The Iowa Cancer Report is an annual report produced by the Iowa Cancer Registry to provide information about cancer trends in Iowa. Data is collected from hospitals and clinics across the state.

Due to greater health disparities, the life expectancy for the black population of Iowa is only 74.8 years, different from 79.3 years for the white population, according to the report.

The report found that social factors may differ by race or ethnicity, such as income, level of education, access to health care and occupation may contribute to cancer disparities and influence psychological, behavioral and environmental factors that impact health.

The Center for Prevention and Rural Health Research, located in UI’s College of Public Health, addresses disparities in health prevention. The center focuses on three areas: rural health, health equity and social justice, and adapting interventions to rural areas.

Rima Afifi, professor of user interface and director of the Prevention and Research Center for Rural Health, said that to truly create change in health equity issues and disparities, changes must also be made to the economy, social structure and social norms.

“Regardless of health outcomes, we know that very little health equity is going to change just by staying in the health care system,” Afifi said.

To address health inequities, the center engages in state-level training in health equity and the social, economic and structural determinants of health, Afifi said. There are also other initiatives, she said, such as a poverty reduction program in Muscatine County to influence various determinants of health.

“The PRC [Prevention and Research Center] takes that step back and thinks about what are these real structural interventions that need to happen for every health outcome, including cancer, to be influenced,” Afifi said. “And those are the types of projects that we get involved in at the center level.”

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