CADCA Publisher December 7, 2017

Addressing Rural Cancer Health Disparities – A Geographic Health Equity Alliance Publication

On Thursday, November 16, 2017, CADCA’s Geographic Health Equity Alliance (GHEA) posted a blog entitled Rural Caregiving in the United States.  Written by one of GHEA’s key partners, Chandylen Nightingale, Ph.D. – an Assistant Professor at Wake Forest School of Medicine who conducts behavioral research in cancer survivorship – the blog provided an account of the nearly 40 million people providing informal (unpaid) care for adult family members or friends in the United States.  Individuals providing informal care are considered caregivers.   This blog serves as a follow-up to Nightingale’s write-up.

GHEA focuses its partnership development goals and provision of training and technical assistance on tobacco and cancer related public health phenomena, including cancer survivorship.  Defined by the National Cancer Institute, cancer survivorship focuses on the health and life of a person with cancer post treatment until the end of life.  It covers the physical, psychosocial, and economic issues of cancer, beyond the diagnosis and treatment phases.  Caregivers are considered part of the cancer survivorship experience. 

In Rural Caregiving in the United States, Nightingale discussed the role of a typical caregiver.  Such an individual is often tasked with providing emotional support to the care-recipient – such as a cancer survivor – navigating the complex healthcare system, and providing hands-on medical care, often with little or no training.  Caregivers consider multi-level factors in providing support to relatives and friends, oftentimes influencing the care recipients’ health behaviors and outcomes.  In the case of cancer survivors, GHEA has an available resource that may be useful to caregivers and their extensive network.

Caregivers residing in or supporting loved ones living in rural areas face greater difficulty in providing the best possible care.  Rural disparities in cancer survivorship are observed for many different reasons, such as access to cancer related knowledge and difficulty understanding cancer-related information.  Evidence based practices and promising strategies are available to help address such gaps – with caregivers being well positioned to execute such interventions.  Entitled Addressing Rural Cancer Health Disparities – A Geographic Health Equity Alliance Rural Cancer Disparities Publication, GHEA provides a geographic health equity model that can be applied to better identify contributors to rural health disparities in cancer and tobacco use, as well as ideas on how to implement the most appropriate place-based promising practices.

The publication is based on a model describing and categorizing multi-level factors influencing health behaviors and outcomes.  Cancer survivors, as well as their caregivers can use this model to both understand how health in their community is being influenced and determine which factors may be the best targets for improving the provision of care.  GHEA has identified five inter-connected “levels” of influence on geographically based disparities in the cancer continuum – which includes cancer survivorship.  Starting with the most fundamental, these five levels include biology, individual characteristics, social context, physical context and ends with the political and economic environment.  Importantly, factors at one level are often closely linked with other levels.  To learn more about the publication and how it can be used to support caregivers and cancer survivors  click here to download the full version.  If you prefer hard copies of the publication, contact Relja Ugrinic at

As Director of CADCA’s Geographic Health Equity Alliance (GHEA) – a national network – Keith A. Vensey, MBA, MPH oversees the operations and management of GHEA’s focus on advancing tobacco control and cancer prevention in populations experiencing geographically based health disparities. In providing training and technical assistance to CADCA affiliated coalitions, state tobacco and cancer programs, national organizations, community-based organizations and other pertinent partners, Vensey and his team drive enhancements in the quality and performance of specific public health programs, public health data and information systems as well as public health practices and services. Particularly, Vensey’s work aims to 1) enhance public health competencies and skills to educate and communicate support for evidence-based tobacco use and cancer prevention environmental approaches, 2) convene public health partners and promote implementation of health system interventions among other objectives and 3) build support for public health services and practice strategies to improve relationships between the communities at large and the public health and healthcare professionals who serve them.

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