In March 2002, the Institute of Medicine found overwhelming evidence that racial and ethnic minorities suffer disparities in health care and concluded that the real challenge lies not in debating whether disparities exist, but in developing and implementing strategies to reduce and eliminate them. In response to this, the ASCO Task Force on Health Disparities was formed in 2003 and led by Dr. Michaele Christian. One of its first major acts was to advise the ASCO Board to include the elimination of health disparities in cancer care as part of its strategic plan. This goal remains at the core of the ASCO Vision Statement: “All cancer patients will have lifelong access to high quality, effective, affordable and compassionate care.” When ASCO says “all,” it means “all.” This commitment was further demonstrated when the disparities task force was elevated to the status of advisory group in 2006, led by Dr. Edith Perez. Since then the names of its leaders have included giants and visionaries in the field of cancer and cancer health disparities: Drs. Brawley, Raghavan, Newman, McCaskill-Stevens.
Under their leadership, the education of the ASCO membership on the realities of cancer health disparities through the Annual Meeting and Journal publications began and continues to this day. Under Dr. Derek Raghavan, ASCO put its money where its mouth is in terms of workforce diversity and funded the Diversity in Oncology Initiative. This included loan repayment for oncologists practicing in underserved areas, travel funds to the Annual Meeting for underrepresented racial and ethnic minority residents, and the funding of mentored oncologic summer clinical and research opportunities for medical students from underrepresented ethnic and minority groups. Since 2009, the medical student and resident awards have gone out to over 60 individuals from underrepresented racial and ethnic minority backgrounds and has become a model for other medical groups around the country. We continue these efforts and are developing, under the direction of Dr. Derrick Beech and the Workforce Diversity Working Group, the Diversity Mentoring Program for medical students and residents from underrepresented racial and ethnic minority groups.
In January 2013, under the leadership of ASCO President Dr. Sandra Swain, the Health Disparities Advisory Group was issued a challenge by the ASCO Board by being elevated to Committee status. I say challenge because with this elevation of status comes the recognition that we need to take our disparities efforts to the next level. It has fallen to the next generation of leaders in Dr. Beverly Moy, Dr. Sandra Wong, and myself to define and help achieve that next level. Under Dr. Moy we moved into the policy arena by laying down what we saw as the challenges in the post-Affordable Care Act world. During my tenure, we continue to focus on concrete legislative and administrative efforts to improve cancer care in the Medicaid program and to better harmonize the care of cancer patients diagnosed in Federally Qualified Community Health Centers. We are also beginning the efforts of helping to define what the next generation of health disparities research should look like. Finally, under Dr. Wong’s leadership next year, I expect we will focus even more on the interrelatedness of health equity and health quality.
We have been able to accomplish much in our last decade of efforts. Very few oncologists today are unaware of the stain of cancer health disparities in a very concrete way. I believe we have also started to move the conversation from one of frustration to one of hope about how we can reduce and eliminate cancer health disparities in this country. Future work of this committee will very likely expand that mission to match ASCO’s position as an international leader in cancer care by focusing on cancer health disparities in the developing world. As I finish my tenure as Chair of the newly minted Health Disparities Committee and ask myself the question: where would I like to see this committee 10 years from now? The answer is simple; I would like ASCO to be able to disband the committee because it has accomplished its mission.