Most of us have never heard the phrase 'health inequalities' until it suddenly exploded in its use over the last year, describing a range of circumstances in which health outcomes and the delivery of healthcare are inequitably distributed across communities, population groups and the nation.
Covid exposed the inequality of health outcomes across regions, towns and even neighbourhoods and made many of us focus on the underlying determinants of good health. A wide consensus has developed on the need to address these health inequalities, and the government has recently established a new department to focus exclusively on it.
But for those affected by prostate cancer, health inequalities have been with us for a lot longer than Covid. Not everyone gets prostate cancer or is even at risk of getting it. There are, of course, obvious inequalities in risk factors that underly develop the disease – being a man for starters and after that one’s age.
But did you know that if you’re a black man, you have twice the likelihood of developing prostate cancer?
That’s right – while 1 in 8 men in total will develop prostate cancer, 1 in 4 black men will. That’s a significant inequality. Cancer Research UK provides a breakdown of how prostate cancer incidence is distributed across the UK.
Also, did you know that if you’re 70 or over, you may not get offered the same treatment as if you were younger?
Inequalities in prostate cancer care exist across geography, too – sometimes described as a postcode lottery. So how can we address these inequalities in outcomes and access to prostate cancer care?
With regard to black men, research is being undertaken to understand the biological and physiologic and genetic roots of this inequality. But it’s also important to look at access to care within the black community, and to understand if this differs from other communities. We’ve spoken with several men about this over the last year who have described personal and community-wide experiences that are different from the experience of non-black men.
We continue to support many individuals and organisations that are raising awareness and campaigning for more research on prostate cancer in black men and improving access to screening within black communities. In terms of age, we embrace the changing attitudes to ageing that we see partially driven by living longer and the very question about what constitutes age.
As the science underlying our understanding of ageing continues to advance, we hope to see more personalised treatments emerging for older men with prostate cancer based on their overall health and quality of life and not simply their biological age.
As for the postcode lottery, all men have the right to access the care they want regardless of their geographical location. Educating and informing men about treatment options and encouraging second opinions will help them to exercise this right. We aim to help men develop their individual health advocacy and believe that knowledge and transparency are paramount to accessing the best healthcare available to them.
Have you been affected by health inequalities? We’d love to hear from you.