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The Economics of Cancer Health Disparities

The Michigan Meeting 2010: “The Economics of Cancer Health Disparities” is led by Dr. Christopher Sonnenday, assistant professor of surgery and assistant professor of health management and policy. Other organizers are from the Comprehensive Cancer Center, Institute for Social Research, Medical School, School of Public Health, Gerald R. Ford School of Public Policy, the Ann Arbor Veterans Administration and the Michigan Institute for Clinical and Health Research.

Considerable research has been conducted at U-M on disparities in access to health care and disease outcomes, based on race, ethnicity, gender, geography and socioeconomic (SES) status. This Michigan Meeting focuses on how these disparities, and the additional stress of the current economic crisis, impact care for those with cancer, the second leading cause of death in the United States.

“A concern is that as people become more stressed financially, they are more likely to give up things that may have preventive health impact, such as cancer screening, good nutrition, control of weight and exercise,” Sonnenday says. “Furthermore, the more stressed and financially strapped that people are, the less likely they are to seek care for new problems. Shortages of time and money may cause patients to avoid seeking care for new symptoms, leading to cancers presenting at later stages when they are more difficult to treat successfully.”

Certain segments of the population are more vulnerable to economic stressors, particularly minorities, the poor and those without health insurance or with inadequate insurance, he says.

Sonnenday says the Michigan Meeting allows for an expanded collaboration with the community regarding disparities in cancer care. He describes the meeting as a multidisciplinary event, with various U-M participants in addition to representatives from the state government, local churches and community organizations, as well as collaborators from Wayne State University and the Henry Ford Medical Center.

The Michigan Meeting provides a great format to highlight work under way at the university and in the state, Sonnenday says.

“Michigan is a laboratory for the whole country in terms of the economic crisis,” he says. “We felt the impact earlier and more substantially than other parts of the country. This is an opportunity to be on the front end of efforts to change things about the health care system that may magnify disparities in care, particularly for cancer.”

The Interdisciplinary Science of Consumption

The Interdisciplinary Science of Consumption paperStephanie Preston, an assistant professor of psychology, is leading the Michigan Meeting on “The Interdisciplinary Science of Consumption.” She and her colleagues believe this conference is the first meeting between people who study the environmental aspects of consumption, scientists who study the biological evolution of how animals store and consume resources, and researchers who study how humans acquire and consume food, alcohol, money and material goods.

Preston brings together experts in marketing, finance, neuroscience, psychology, psychiatry, ecology and natural resources over their common interest of consumption to create a shared understanding of consumption that can inform novel public policy programs. “I am interested in this interdisciplinary field that does not really exist,” Preston says. “Michigan is the perfect place to host this meeting and brand this emerging field.”

Preston argues that psychologists, economists and animal researchers have much to teach each other.

“For example, there is already indirect evidence that these disparate types of decisions are related. The same neural systems are implicated in research on gambling, drug addiction and animal food hoarding, yet we do not have a good model human hoarding such as saving money in the bank, food in the pantry, or myriad items in the attic or garage,” she says.

A goal is to learn something about the basic, evolved mechanisms of these decisions that can be used to explain widespread modern problems such as addictions, over acquisition, and excessive credit card spending.

“Right now,” Preston says, "research on addiction to substances like alcohol and drugs is only distantly related to environmental consumption; it’s currently just an idea."

Preston says one important outcome of this Michigan Meeting would be the development of early education programs that better explain what happens to items when people get rid of them. She says schools do a good job of promoting such concepts as recycling, but do not accurately convey how items are created and discarded, which limits people’s ability to make informed decisions. For example, people know very little about the energy required to make and recycle common plastics.

The meeting also engages the community through a public lecture and book signing and an event directed on compulsive hoarding. A cross-listed course and a website to centralize consumption resources also will be created. Both Michigan Meetings include a graduate seminar component.