Health care in Victoria is experienced inequitably; data shows this is overwhelmingly true for those affected by cancer. Regional residents, LGBTIQA+ communities, Aboriginal and Torres Strait Islander communities, people with low socio-economic status, and those from culturally, ethnically and linguistically diverse communities all report poorer patient outcomes than other population groups. For example, Aboriginal Victorians are nearly 2.5 times more likely to die from cancer than other Victorians while 5-year survival is higher for those in cities, compared to those residing in regional Victoria.[i]
To address inequity we have seen progress through innovative and targeted work, e.g., the development of the Aboriginal and Torres Strait Islander Optimal Care Pathway, and initiatives to improve the participation of culturally, ethnically and linguistically diverse populations in clinical trials.[ii] However, these interventions are rarely scalable and while they may provide the necessary supports for specific populations to experience improved access, treatment and care, they do not address the underlying disparities within systems of healthcare. Moreover, such initiatives are frequently developed with time limited funding, leading to challenges with sustainability.
Given the interconnected nature of cancer services and health disparities, equity initiatives must take a systemic view to change the outcomes for all populations. Taking such a view can be risky; it requires equal buy-in from multiple stakeholders, a collective understanding of the problems, and an appetite for risk and failure.
Using a collective impact model, the VCCC Alliance is developing such an approach to health equity. Working across 10 diverse organisations, the VCCC Alliance will develop a Cancer Equity Framework that: