Objectives: Health Equity

Health Equity 1

Increase public and professional awareness about cancer-related health inequities experienced by Colorado populations.

Strategies:

• Collaborate with government agencies, academic health centers, community and faith-based organizations, and private foundations to educate the public about topics relating to health equity and cancer.
• Educate policy makers, community, and health professionals about the overall financial burden of being a cancer patient or the family member of a cancer patient.
• Promote and support health care provider, medical school and School of Public Health curricula training on cancer disparities, including strategies that providers can incorporate into their practice to address and reduce disparities.
• Identify and disseminate a set of core competencies for health professionals regarding knowledge and understanding of the contributing factors to health disparities.
• Identify and disseminate a set of core competencies for health professionals aimed at increasing cultural competence among health professionals.
• Convene a meeting of health care providers, cancer survivorship experts, researchers and programmatic staff to develop strategies to educate policy makers about the unmet needs for cancer screening and treatment for those that are uninsured and under-insured.
• Utilize existing data tools that provide group level information in funding applications to identify health inequities at the local level. An example of a data tool is the Colorado Health Disparities Profiles.

Health Equity 2

Expand culturally-relevant and patient-centered cancer health education, outreach programs, and cancer-related interventions.

Strategies:

• Develop, modify, implement and evaluate a clearinghouse of culturally, linguistically and literacy appropriate cancer education and promotion materials and resources in collaboration with relevant community-based organizations.
• Educate community members on how to access and evaluate available cancer information and resources and make appropriate to groups.
• Promote the development, dissemination, and evaluation of culturally relevant, linguistically competent cancer care guidelines to the general public via websites, portals, or other mechanisms.
• Promote and expand the use of both clinical and community health navigators in comprehensive cancer programs.
• Provide evidence-based education and promising educational practices on personal health and lifestyle behaviors that influence disease risk, including cancer risk. This education should access existing resources in the community such as families, schools and develop new resources when non-existent.
• Implement and evaluate interventions addressing lifestyle/behavioral and biological factors that increase cancer risk among disparate communities.
• Promote the use of the National Culturally and Linguistically Appropriate Services (CLAS) standards, including obligation to provide interpretation services.

Health Equity 3

Develop specific strategies to address patient access barriers across the cancer continuum for underserved communities.

Strategies:

• Disseminate the results of existing needs assessment to identify patient access needs across the cancer continuum for medically underserved populations.
• Support the adoption of Patient Navigator and Community Health Worker models for use in a variety of settings to address barriers to access, culturally therapeutic compliance, services utilization, cancer risk management and health education.
• Identify and disseminate information on available resources for medically under-served communities.
• Ensure the availability of web-based educational and support interventions and systems to communities statewide at no cost to the public. Support, expand, and promote the availability of transportation services for cancer patients, particularly in rural areas. Transportation services need to be available throughout the cancer care continuum.
• Monitor and improve transportation assistance to cancer patients throughout the state. Ensure transportation assistance throughout the cancer continuum including survivorship phase (rehabilitation phase).
• Support the development of a certified lay health education model for use in a variety of settings to address barriers to access, culturally sensitive treatment compliance support, service utilization, cancer risk management and health education.
• Maintain, promote and evaluate patient navigation systems that can facilitate optimum cancer care throughout the continuum of cancer related health services.

Health Equity 4

Develop systems and infrastructure to support the delivery of the latest, most appropriate cancer prevention, early detection, treatment, and quality of life care for underserved communities.

Strategies:

Determine and utilize resources to identify and disseminate "best practices" and "promising practices" such as Cancer Control PLANET (http://cancercontrolplanet.cancer.gov/)

Encourage the use of Patient Navigator and/or Community Health Worker training programs. Provide grant writing training and technical assistance to help disparate communities access funding streams and develop and/or access training programs.

Create, monitor and expand capacity for cancer screening, diagnostic, and treatment services in rural Colorado.

Implement increased use of mobile units in rural and under-served communities for evidenced-based cancer screening.

Extend state-of-the art cancer care to rural, frontier, and other under-served areas by expanding the use of telemedicine and reinforce a reimbursement system that facilitates expansion of telemedicine to geographically under-served areas.

Expand cancer data collection systems in the Colorado Central Cancer Registry to include socioeconomic status (e.g. level of education), disability, and primary language.

Health Equity 5

Expand the Colorado workforce to include equitable representation of individuals from groups impacted by health disparities.

Strategies:

• Support mechanisms to encourage and enable individuals from groups impacted by health inequity to enter careers related to the achievement of health equity including public health, medicine, biomedical science, behavioral sciences and health communications.
• Initiate training programs that create a diverse and culturally competent health care workforce that is representative of the Colorado community it serves.
• Support networks for college and graduate students pursuing health careers and financial incentives that will enable Native American health professionals to establish and maintain financially viable careers in rural areas.
• Increase patient education and access to participation in high quality clinical trials for low-income and uninsured or under-insured populations.
• Conduct and post an inventory of state and national resources such as federal training resources, private and local.
• Partner closely with the Colorado Public Health Association on efforts of student of color recruitment efforts for the public health education and careers.
• Encourage the growth of programs to support local development of a diverse cancer workforce at the medical, nursing, pharmacy, rehabilitation and public health schools.

Health Equity 6

Develop, implement, and evaluate public education initiatives that focus on how cancer incidence and mortality rates in Colorado directly correlate with a person's built environment (the places a person lives, works and plays), with socioeconomic status, level of education attainment, and other social determinants of health.

Strategies:

• Collect data illustrating ties to cancer incidence and mortality that are based on geographic location and poverty levels, in addition to other demographic information.
• Provide background knowledge and training to government agencies, policy makers, academic health centers, private foundations, and community and faith-based organizations on the issues surrounding environmental health inequities.
• Support community education efforts related to risk reduction measures.
• Collaborate with state agencies, community organizations, and other public health partners that promote policies to eliminate environmental health inequities.
• Align cancer control efforts with the State Tobacco Education and Prevention Partnership Strategic Plan.

Health Equity 7

Expand the development of community-driven and community-based participatory research on Colorado disparities in the cancer care continuum.

Strategies:

• Support efforts to identify key research questions, and enact (or test) strategies to eliminate health inequities, involving community members, researchers, policy makers, community agencies and state and local health care providers and public health departments.
• Encourage the dissemination of community-based participatory research cancer research, best practices and promising innovative interventions to eliminate cancer inequities.
• Involve the communities impacted by cancer inequities in the planning, implementation, analysis and dissemination of cancer research.
• Involve community organization and public health agencies in the development and dissemination of research results. Utilize existing opportunities to support linkages between research and community (i.e. CCTSI).