Disparities in Lung Cancer: A Targeted Literature Review Examining Lung Cancer Screening, Diagnosis, Treatment, and Survival Outcomes in the United States.

BACKGROUND: Although incidence and mortality of lung cancer have been decreasing, health disparities persist among historically marginalized Black, Hispanic, and Asian populations. A targeted literature review was performed to collate the evidence of health disparities among these historically marginalized patients with lung cancer in the U.S. METHODS: Articles eligible for review included 1) indexed in PubMed®, 2) English language, 3) U.S. patients only, 4) real-world evidence studies, and 5) publications between January 1, 2018, and November 8, 2021. RESULTS: Of 94 articles meeting selection criteria, 49 publications were selected, encompassing patient data predominantly between 2004 and 2016. Black patients were shown to develop lung cancer at an earlier age and were more likely to present with advanced-stage disease compared to White patients. Black patients were less likely to be eligible for/receive lung cancer screening, genetic testing for mutations, high-cost and systemic treatments, and surgical intervention compared to White patients. Disparities were also detected in survival, where Hispanic and Asian patients had lower mortality risks compared to White patients. Literature on survival outcomes between Black and White patients was inconclusive. Disparities related to sex, rurality, social support, socioeconomic status, education level, and insurance type were observed. CONCLUSIONS: Health disparities within the lung cancer population begin with initial screening and continue through survival outcomes, with reports persisting well into the latter portion of the past decade. These findings should serve as a call to action, raising awareness of persistent and ongoing inequities, particularly for marginalized populations.

Housing plus services: supporting vulnerable families in permanent housing.

The importance of integrating services with housing to help low-income families achieve stability is gaining recognition. The variations in types of existing housing and service initiatives have produced a complex language with multiple meanings and overlapping definitions. The National Low Income Housing Coalition proposes the umbrella term housing plus services to refer to these programs. Following a review of the literature on the relationship of housing to child well-being, the article discusses and illustrates the National Low Income Housing Coalition's principles for and typology of housing plus services.

Integrating services for older adults in housing settings.

This paper draws on the work of the Housing Plus Services committee of the National Low Income Housing Coalition (to which the authors belong), constituted in 2000. The Committee is comprised of a diverse group of practitioners, administrators, policy analysts, professors, and researchers who share a commitment to the integration of services in housing settings. Committee members present their work, including the typology and principles discussed in this paper, at national conferences (NLIHC, 2005) and contribute to publications on the web (Housing Plus Services Committee, 2005a) and in print (Cohen, Mulroy, Tull, White, & Crowley, 2004), in order to disseminate the work of the NLIHC in this area and engage in dialogue with service providers, housing developers, and policy makers.

Adjustment to disability.

This article will focus on the biopsychosocial challenges encountered when an individual is disabled at an early age as well as when an individual acquires a disability later in life. Two case examples will focus on the adaptations/life choices that are necessary to adequately meet psycho/social/developmental needs and enhance individual self esteem. The case of Rita, a woman who lost her hearing at age two, highlights the importance of integrating a biopsychosocial approach to understand the multiple challenges and adaptations of individuals who are disabled at an early age. Laureen, a woman who acquired a spinal cord injury during her late teen years, described her struggles as a young adult adapting to a physical disability. Both cases highlight the importance of integrating an ecological/systems framework focusing on a biopsychosocial perspective, emphasizing the interrelationship between biological, psychological, social, technological, cultural and political factors.