Cancer rates across the United States are falling, but in South Dakota, cancer remains the leading cause of death. What unique challenges does South Dakota have when it comes to cancer care that is causing the state to fall behind the rest of the country?
American Indians, other rural residents face many barriers
One of the major concerns from both health care providers and researchers is the disproportionate cancer mortality rates of Americans Indians in South Dakota. American Indians are twice as likely to die from cancer as American Indians in other states and have a 26% higher cancer mortality rate than white people living in South Dakota.
People living in rural and frontier areas — both American Indians and other population groups — are often plagued by poverty, under-resourced health care facilities and a lack of primary and specialty health care professionals, Varilek points out.
"These factors all contribute to the grievous inequities present in cancer outcomes," Varilek said.
To assess the barriers of cancer care, the research team interviewed 18 health care professionals who work closely with American Indians, frontier and rural populations. Through interviews and analysis, they were able to determine three distinct themes that constitute as barriers and challenges for those with cancer: access, time and isolation.
"The themes represent the health care professionals’ perspectives of the needs and barriers of people with cancer to whom they provide cancer care," Varilek said. "These themes also reflect the barriers health care professionals experience while providing care."
Access, time and isolation
People living in rural areas have less access to health care facilities and resources than those living in urban areas. The researchers point out that decision-making by people with cancer can be influenced by the lack of access.
"Distance is a significant barrier to accessing cancer care in the area," Varilek said. "People with cancer must travel 30-150 miles or more one way for care, which requires good weather, a reliable vehicle, financial means and a person to give them a ride if needed."
The numerous access issues lead to a population that is isolated, Varilek noted. The health care professionals identified this as the greatest challenge for people diagnosed with cancer in rural areas. Geographic isolation plays a significant role, but so does social isolation, as people are often far away from friends and family.
Need for palliative care services
As Varilek notes, an early palliative care intervention for the American Indian, rural and frontier populations in South Dakota could address the needs and help overcome the barriers to receiving cancer treatments. Currently, most of the state does not have nearby access to palliative care services as they are located in the urban areas on opposite sides of the state (Sioux Falls and Rapid City).
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Categories: South Dakota, Education, General