Inequality still costing lives in Cancer services

An in-depth survey of GPs finds that public patients may have to wait up to 25 times as long as private patients for tests to diagnose cancer. This two-tier system kills. This adds to the existing inequalities in cancer already made visible by previous research here and here. While it is good this stuff comes to light it is unfortunate that the continuous nature of this problem will all too easily be lost again in episodic media reporting and campaigners will continue to be obsessed with the biological existence of the disease while overlooking the additional crucial and deadly social elements.

Other findings point to potential inequality of access based on social networks, which 1 in 5 GPs believe exists. They perceive certain doctors as having greater pull for getting their patients bumped up on waiting lists for CT scans and MRIs through their established connections elsewhere in the health service. This sort of pull reminds me of the penalty points scandals and the clientelism and brokerage that has(possibly still does) existed in Irish politics. If the GPs’ suspicions are correct it serves as a reminder of how inequality isn’t just economic but – as Bourdieu has demonstrated– social, cultural and status-based as well as deadly.

Inequality Kills: According to Reports on Cancer in Ireland

Good to see an article in the Irish Times addressing the relationship between inequality and cancer in Ireland according to two recent reports. The article lists several of these reports’ findings :

  • “people living in more deprived areas experience a poorer survival from cancer than those who live in more affluent parts of Ireland.”
  • “breast cancer patients from the most deprived areas were about 30 per cent more likely to die from their cancer than patients from the least deprived areas, having allowed for differences in patients’ age.”
  • “those from more deprived backgrounds were more likely to present late with advanced stage cancers. In addition, they were more likely to present with symptoms rather than through screening and were less likely to have breast-conserving surgery.”
  •  “death rates from cancer in some of the poorest parts of Dublin were more than twice as high as rates in more affluent areas.”
  • “Some of these disparities are due to the difficulties accessing healthcare experienced by the poorest in society”

Unfortunately the article is quite small, far from the symbolism of front page significance, and all too easily forgotten. I fear the class-based, social justice and social environment features behind such cancer rates will become lost again in mainstream media’s tendency towards ‘episodic’ reporting. For an illustrative example see this previous post which highlights how a statement, about poorer people being up to 70% more likely to get some cancers, gets lost in a new report’s classless assessment. Such easy returns to class-invisibility with regard to the reporting of cancer rates is perhaps aided by the media’s bias towards the middle-class experience along with a narrow dependency on a panel of go-to experts wherein the individualising mainstream economist is dominant – although for “softer” social and more lifestyle related issues the individualizing psychologist becomes the consecrated ‘public intellectual’. This narrowness of expertise in public debate and policy-related decision-making is something I will return to in a future post.

The Classless View of Cancer in Ireland

A report has been released by the Irish Cancer Registry which predicts a doubling of cancer incidences by 2040. I find it interesting how quickly class invisibility re-emerges in regards to cancer in Ireland. If you remember in September last year the headline to emerge from the annual Irish Cancer Society Charles Cully Lecture in Dublin was that poorer people are up to 70% more likely to get some cancers. This produced a brief ripple with some minor coverage in a few newspapers and featured as a topic in radio one’s Drivetime. As far as I can tell the class aspect of cancer appears to have become lost again from the articles that I have read (a)(b)(c). Additionally, RTE Radio 1 show News at One failed to mention class when discussing the report with Dr Harry Comber from the Irish Cancer Registry.

Of course the media seem merely to be repeating the core predictions of a report in which class does not feature. This behaviour is typical of the journalistic practice of episodic framing: i.e.  “case study or event-oriented” depictions of “public issues in terms of Continue reading