Predictive Model and Social Determinants-Based Interventions for Aggressive Prostate Cancer Among African American Males

Among several definitions, health disparity can be described as a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage; or as racial or ethnic differences in the quality of health care that are not due to access-related factors or clinical needs, preferences, and appropriateness of intervention. Unfortunately, Blacks/African Americans (AAs) are disproportionately impacted by disparity patterns in life expectancy, mortality, and demographics. These disparity patterns are reflected across the five key domains of the Healthy People 2020 social determinants of health (SDOH):

1) Economic Stability
2) Education
3) Social and Community Context
4) Health and Healthcare
5) Neighborhood and Built Environment

Cancer & Underrepresented Minorities

Cancer is a major public health problem worldwide and is the second leading cause of death in the United States prior to the coronavirus pandemic. It is the 4th leading cause of morbidity and the 2nd leading cause of mortality in the Greater Houston Community (GHC) with a disproportionate overall impact on underrepresented minorities (URMs).

The GHC contains 9 Texas counties which consists of 37.3% Hispanic/Latino, 36.1% White, 16.9% Black/African American (AA), 7.8% Asian, and 1.9% other ethnic groups and is considered one of the most ethnically diverse metropolitan regions in the nation, consisting largely of URMs.

In the United States, the incidence of prostate cancer (PCa) is highest among AA males (168.8 per 100,000) compared to Whites (95.3 per 100,000) and clinically advanced-stage PCa and aggressive PCA (aPCa) occur most frequently in AAs (12.3%) compared to Hispanics (10.5%) and non-Hispanic Whites (6.3%). In Harris county, mortality rate due to PCa is 34.9% which is 15.5% higher among AA males when compared to Whites, Hispanics or Asian/Pacific Islanders causing 19.4 Deaths per 100,000 males.