Social Determinants of Cancer Risk Among American Indian and Alaska Native Populations: An Evidence Review and Map

Stephanie C. Melkonian · Jolie Crowder · Emily E. Adam · Mary C. White · Lucy A. Peipins

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Indigenous Health, Education, and Rights Global Cancer Incidence and Screening Health disparities and outcomes

Abstract

Objectives: To explore current literature on social determinants of health (SDOH) and cancer among American Indian and Alaska Native (AI/AN) populations. Methods: , CINAHL, and PsycINFO databases for articles published during 2000 to 2020, which included terms for SDOH and cancer occurrence in AI/AN populations. We derived the data extraction elements from the PROGRESS-Plus framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Equity extension guided the evidence map. Results: From 2180 screened articles, 297 were included. Most were observational (93.9%), employed a cross-sectional design (83.2%), were categorized as cancer occurrence and surveillance research (62%), and included no cancer-related risk factors (70.7%). Race, gender, and place were the most frequently included PROGRESS-Plus categories. Religion, relationship features, and characteristics of discrimination were least common. Only 12% of articles mentioned historical/current trauma or historical context. Conclusions: Gaps exist in our understanding of SDOH as drivers of cancer disparities in AI/AN populations. Future studies in health equity science may incorporate historical and cultural factors into SDOH frameworks tailored for AI/AN populations.

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2019Racism and Health: Evidence and Needed Research 2013Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health 2011Historical Trauma Among Indigenous Peoples of the Americas: Concepts, Research, and Clinical Considerations 2012PRISMA-Equity 2012 Extension: Reporting Guidelines for Systematic Reviews with a Focus on Health Equity 2012Measures of Social Deprivation That Predict Health Care Access and Need within a Rational Area of Primary Care Service Delivery 2011Residential Segregation and Disparities in Health Care Services Utilization 2011Nonfinancial Barriers and Access to Care for U.S. Adults 2019Social Determinants of Health and Related Inequalities: Confusion and Implications

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