Effects of Social and Economic Deprivation on Cancer Mortality

Social determinants of healthFurther reading

The three primary types of epigenetic changes observed in cancer include DNA and ribonucleic acid methylation, histone modification, which can be further specified as acetylation, methylation, or phosphorylation, and the expression of non-coding RNA1. Any of these epigenetic alterations have the potential to inhibit tumor-suppressor mechanisms and/or directly activate oncogenesis.

Local and federal governments, institutions, as well as other organizations, regulations, and processes, encompass societal systems that have the power to control, allocate, withhold, and/or distribute resources and hazards for health. Some examples of health resources include food, shelter, safety, sanitation, civic participation, education, employment, law enforcement, and transportation.

Black adults in the general U.S. population have double the poverty and unemployment rates as compared to White adults, both of which are SDH that independently increase the risk of cancer mortality. Private insurance has a significant protective effect against being diagnosed with advanced cancer. Nevertheless, the REGARDS study found that a greater number of SDH in the same individual increases their risk of cancer mortality, with this effect persisting in individuals 65 years of age and older who are eligible for Medicare, which is a federal health insurance option for the elderly in the United States5.

A high-calorie diet that is rich in fat and red meat intake, for example, increases the risk of colorectal, prostate, and breast cancer, whereas dietary patterns like the Mediterranean diet, which is associated with high consumption of fresh fruits and vegetables, whole grains, and limited meat, have been shown to be protective against cancer onset.

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