Strengthening data systems: Exploring racism as a distal determinant of treatment completion among Aboriginal and Torres Strait Islander people — The Association Specialists
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  3. Strengthening data systems: Exploring racism as a distal determinant of treatment completion among Aboriginal and Torres Strait Islander people

Strengthening data systems: Exploring racism as a distal determinant of treatment completion among Aboriginal and Torres Strait Islander people (24212)

Rebecca Murray 1 , Ray Lovett 1 , Kate Anderson 1 , Abbey Diaz 1 , Stephanie Wheeler 1
  1. Australian National University, Acton, NSW, Australia

Background: Racism is a significant determinant of health, yet it is rarely captured in routine health data collections,  including clinical cancer data systems. Current surveillance frameworks prioritise proximal (downstream) predictors such as financial strain, while distal (upstream) exposures limit the capacity of health systems to respond to inequities. This study examines the prevalence of racism in healthcare among Aboriginal and Torres Strait Islander people undergoing cancer treatment, and its association with treatment completion.

Methods: Aboriginal and Torres Strait Islander participant age 18 years and over from the national Kulay Kalingka cancer experience study (n=588) were include. Exposure to racism in healthcare exposure was measured using two survey questions: 1) a 10-item scale of experiences of discrimination in the healthcare setting and 2) whether discrimination was self-attributed to Indigenous identity. Racism was then categorised as no racism (no discrimination or discrimination not attributed to Indigenous identity) or any racism (a little to a lot of discrimination attributed to Indigenous identity). Treatment completion was self-reported for all broad types of biomedical anticancer treatments. Generalised linear models with a log link and robust standard error were used to estimate prevalence ratios, adjusting for age, gender, education, remoteness and financial situation, and cancer type. Analysis is currently underwater.

Results: Aboriginal and Torres Strait Islander participants (n=588, xx% women) were on averaged aged xx at diagnosis (median xx, range xx-xx) with breast (n=xx, xx%), melanoma (n=xx, xx%), xxxx (n=xx, xx%), and other cancer types. Results will be presented.

Conclusion: Findings from this study may help inform future work exploring the casual relationship between racism and cancer care and outcomes. It is expected to inform the development of data systems that capture, monitor and report on racism within healthcare to strengthen Indigenous Data Governance, health system accountability and surveillance of healthcare inequities.