Socioeconomic disparities and health literacy: Unraveling the impact on diagnostic and cancer care in Uruguay

IF 2 Q3 HEALTH POLICY & SERVICES
Iván Lyra-González , Mauricio Cuello , David Anderson , Margarita Echeverri
{"title":"Socioeconomic disparities and health literacy: Unraveling the impact on diagnostic and cancer care in Uruguay","authors":"Iván Lyra-González ,&nbsp;Mauricio Cuello ,&nbsp;David Anderson ,&nbsp;Margarita Echeverri","doi":"10.1016/j.jcpo.2024.100472","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Disparities in the timely diagnosis and care of cancer patients, particularly concerning geographical, racial/ethnic, and economic factors, remain a global health challenge. This study explores the multifaceted interplay between socioeconomic status, health literacy, and specific patient perceptions regarding care access and treatment options that impact cancer care in Uruguay.</p></div><div><h3>Methods</h3><p>Using the Cancer Health Literacy Test, Spanish Version (CHLT-30-DKspa), and a highly comprehensive questionnaire, we dissected the factors influencing the pathway to diagnosis and route of cancer care. This was done to identify delays by analyzing diverse socioeconomic and sex subgroups across multiple healthcare settings.</p></div><div><h3>Results</h3><p>Patients with lower income took longer to get an appointment after showing symptoms (p = 0.02) and longer to get a diagnosis after having an appointment (p = 0.037). Race/ethnicity also had a significant impact on the length of time from symptoms to first appointment (p =0.019), whereas employment status had a significant impact on patients being susceptible to diagnostic delays beyond the advocated 14-day window (p = 0.02). Higher educational levels were positively associated with increased cancer health literacy scores (p = 0.043), revealing the potential to mitigate delays through health literacy-boosting initiatives. Women had significantly higher self-reported symptom duration before seeking an intervention (p = 0.022). We also found many other significant factors effecting treatment delays and cancer health literacy.</p></div><div><h3>Conclusions</h3><p>While affirming the global pertinence of socioeconomic- and literacy-focused interventions in enhancing cancer care, the findings underscore a complex, gendered, and perceptually influenced healthcare navigation journey. The results highlight the urgent necessity for strategically crafted, globally relevant interventions that transcend equitable access to integrate literacy, gender sensitivity, and patient-perception alignments in pursuit of optimized global cancer care outcomes.</p></div>","PeriodicalId":38212,"journal":{"name":"Journal of Cancer Policy","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cancer Policy","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213538324000067","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH POLICY & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Disparities in the timely diagnosis and care of cancer patients, particularly concerning geographical, racial/ethnic, and economic factors, remain a global health challenge. This study explores the multifaceted interplay between socioeconomic status, health literacy, and specific patient perceptions regarding care access and treatment options that impact cancer care in Uruguay.

Methods

Using the Cancer Health Literacy Test, Spanish Version (CHLT-30-DKspa), and a highly comprehensive questionnaire, we dissected the factors influencing the pathway to diagnosis and route of cancer care. This was done to identify delays by analyzing diverse socioeconomic and sex subgroups across multiple healthcare settings.

Results

Patients with lower income took longer to get an appointment after showing symptoms (p = 0.02) and longer to get a diagnosis after having an appointment (p = 0.037). Race/ethnicity also had a significant impact on the length of time from symptoms to first appointment (p =0.019), whereas employment status had a significant impact on patients being susceptible to diagnostic delays beyond the advocated 14-day window (p = 0.02). Higher educational levels were positively associated with increased cancer health literacy scores (p = 0.043), revealing the potential to mitigate delays through health literacy-boosting initiatives. Women had significantly higher self-reported symptom duration before seeking an intervention (p = 0.022). We also found many other significant factors effecting treatment delays and cancer health literacy.

Conclusions

While affirming the global pertinence of socioeconomic- and literacy-focused interventions in enhancing cancer care, the findings underscore a complex, gendered, and perceptually influenced healthcare navigation journey. The results highlight the urgent necessity for strategically crafted, globally relevant interventions that transcend equitable access to integrate literacy, gender sensitivity, and patient-perception alignments in pursuit of optimized global cancer care outcomes.

社会经济差异与健康素养:揭示对乌拉圭诊断和癌症护理的影响。
背景:癌症患者在及时诊断和治疗方面的差异,尤其是在地理、种族/民族和经济因素方面的差异,仍然是全球健康面临的挑战。本研究探讨了社会经济地位、健康素养以及患者对就医途径和治疗方案的具体看法之间的多方面相互作用,这些因素对乌拉圭的癌症治疗产生了影响:我们使用癌症健康素养测试西班牙语版(CHLT-30-DKspa)和一份高度全面的调查问卷,分析了影响癌症诊断和治疗途径的因素。这样做的目的是通过分析多个医疗机构中不同的社会经济和性别亚组来确定延误情况:结果:收入较低的患者在出现症状后需要更长时间才能获得预约(p = 0.02),在预约后需要更长时间才能获得诊断(p = 0.037)。种族/民族对患者从出现症状到首次就诊的时间长度也有显著影响(p =0.019),而就业状况则对患者的诊断时间可能会被延迟到所倡导的 14 天窗口期之后有显著影响(p = 0.02)。受教育程度越高,癌症健康知识得分越高,两者呈正相关(p = 0.043),这表明通过提高健康知识水平有可能减少延误。女性在寻求干预前自我报告的症状持续时间明显较长(p = 0.022)。我们还发现了许多影响治疗延误和癌症健康知识普及的其他重要因素:结论:在肯定以社会经济和扫盲为重点的干预措施在加强癌症护理方面的全球相关性的同时,研究结果强调了医疗保健导航过程的复杂性、性别性和感知性。研究结果突出表明,迫切需要从战略高度制定与全球相关的干预措施,这些干预措施应超越公平就医的范畴,将扫盲、性别敏感性和患者感知结合起来,以优化全球癌症治疗效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Cancer Policy
Journal of Cancer Policy Medicine-Health Policy
CiteScore
2.40
自引率
7.70%
发文量
47
审稿时长
65 days
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信