New CWRU study will analyze link between neighborhoods and cancer screenings

Gillian Marshall headshot
Gillian Marshall

Can neighborhood factors influence whether older residents have access to cancer screening information and testing?

Gillian Marshall, assistant professor of social work at Case Western Reserve University’s Jack, Joseph and Morton Mandel School of Applied Social Sciences, plans to find out.

“We want to clarify assumptions that people with low incomes are less likely to receive or be recommended for cancer screenings,” she said.

Marshall will analyze data from 650 residents 65 and older in Cleveland, upstate New York and South Florida about communication experiences with their doctors.

They participated in the five-year, $1.3 million National Institutes of Health/National Cancer Institute study “Health Care Partners in Cancer Prevention and Care among the Aged.”

In the study, half the participants were randomly selected to participate in “Speak Up,” an intervention to improve doctor-patient communication through verbal and written information with instructional films at centers operated by the federally funded Area Agencies on Aging. The other half were encouraged to volunteer in a community project.

The researchers contacted all participants at three different points in the project: at the beginning, at two months and at 12 months. They answered questions about access to cancer screening information and tests and their experiences communicating with their doctors.

Marshall’s research project is part of a larger study led by Eva Kahana, Distinguished University Professor, professor of sociology, the Pierce T. and Elizabeth D. Robson of the Humanities and director of the Elderly Care Research Center.

Kahana’s study mainly focused on improving patient-doctor communication about cancer screening. The goal of Marshall’s new study, which received $198,666 from the National Cancer Institutes, will examine what neighborhood-wide factors help or prevent people from getting these important medical tests.

Because of health disparities in poorer neighborhoods, Marshall said she wants to find out if residents in these areas have less access to information and screenings for breast, prostate, colon or skin cancers.

The association between characteristics of neighborhoods where older people live and access to health care continues to be a growing public concern, Marshall said.

Lack of access to information widens the health gap, she said.

Tsui Chan, programmer analyst at the Mandel School’s Center on Urban Poverty and Community Development, will complete geocoded information, and Marshall and Jeong Lee, of the Elderly Care Research Center, will complete data analysis.

“Together, we hope this information will provide a new picture on who has access to health information,” Marshall said.