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Review
. 2022 Sep 21;6(1):717-728.
doi: 10.1089/heq.2022.0097. eCollection 2022.

Social Determinants of Cancer Risk Among American Indian and Alaska Native Populations: An Evidence Review and Map

Stephanie C Melkonian  1 , Jolie Crowder  2 , Emily E Adam  3   4 , Mary C White  3 , Lucy A Peipins  3
Affiliations
Review

Social Determinants of Cancer Risk Among American Indian and Alaska Native Populations: An Evidence Review and Map

Stephanie C Melkonian et al. Health Equity. .

Abstract

Objectives: To explore current literature on social determinants of health (SDOH) and cancer among American Indian and Alaska Native (AI/AN) populations.

Methods: We searched Ovid MEDLINE®, CINAHL, and PsycINFO databases for articles published during 2000 to 2020, which included terms for SDOH and cancer occurrence in AI/AN populations. We derived the data extraction elements from the PROGRESS-Plus framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Equity extension guided the evidence map.

Results: From 2180 screened articles, 297 were included. Most were observational (93.9%), employed a cross-sectional design (83.2%), were categorized as cancer occurrence and surveillance research (62%), and included no cancer-related risk factors (70.7%). Race, gender, and place were the most frequently included PROGRESS-Plus categories. Religion, relationship features, and characteristics of discrimination were least common. Only 12% of articles mentioned historical/current trauma or historical context.

Conclusions: Gaps exist in our understanding of SDOH as drivers of cancer disparities in AI/AN populations. Future studies in health equity science may incorporate historical and cultural factors into SDOH frameworks tailored for AI/AN populations.

Keywords: American Indian and Alaska Native; health equity; social determinants of health.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
PRISMA flow diagram, articles related to SDOH and cancer risk in AI/AN populations, Published 2000–2020. AI/AN, American Indian and Alaska Native; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; SDOH, social determinants of health.
FIG. 2.
FIG. 2.
Percentage of articles about SDOH and cancer in AI/AN populations reporting PROGRESS-Plus categories (N=297). Articles may have multiple topics from Progress-PLUS categories; therefore, categories are not mutually exclusive.
FIG. 3.
FIG. 3.
Evidence map of SDOH and cancer in AI/AN populations, by PROGRESS-Plus categories and outcomes. The evidence map and size of circles show density of articles (<10 articles, 10–29 articles, 30–49 articles, 50–99 articles, and 100+ articles) in each cross-section.
See this image and copyright information in PMC

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