The study, published in the journal Value in Health by Washington State University researchers, found that individuals living in majority American Indian and Alaska Native neighborhoods travel almost 40 more miles to the nearest radiation therapy facility compared to those living in neighborhoods dominated by other racial groups.
Researchers used a database listing addresses for radiation therapy facilities and calculated the distance to the closest facility for each block group — a geographic unit that includes up to 3,000 people. Using data from the 2019 American Community Survey, the researchers were able to compare travel distances by racial and ethnic composition, area deprivation, and rurality of block groups.
This is first known study to look at racial disparities in travel distances to U.S. radiation therapy facilities. The study showed that block groups with an American Indian and Alaska Native majority traveled between 26 and 103 miles to the nearest radiation therapy facility. In comparison, block groups for other majority populations ranged from 3 to 35 miles. Additionally, almost a third of Native people lived in radiation therapy deserts with greater than average travel distance to radiation therapy.
Some cancers require radiation therapy, which can only be delivered in specialized facilities by trained physicians, and the treatments can require multiple daily visits for several months. These long travel distances may lead people to choose more invasive surgeries that don’t require as frequent follow-up care, such as a mastectomy, or full breast removal, for breast cancer, according to the lead study author, Solmaz Amiri. The findings highlight the disparities between rural and urban communities, which have historically disproportionately impacted American Indians and Alaska Natives, as more than half live in small towns and rural areas.
Policymakers should consider the potential use of mobile radiation therapy facilities to help close access gaps, according to Amiri. Telehealth can also serve as a bridge to connect patients and their doctors regardless of distance. At the University of California Davis, telehealth reduced the distance traveled by 5 million miles for all patients between 1996 and 2013, researchers reported in 2017. This amounted to nearly nine years’ worth of saved travel time and $3 million in saved travel costs.