Socially based inequities in breast cancer care: intersections of the social determinants of health and the cancer care continuum
Bibliographic record
Abstract
Rapid advances in the field of medical imaging, drug development and genomics have paved the way for revolutions in the way breast cancer in treated and managed, such that the five-year survival for breast cancer in Canada averages 88%. Despite advances in treatment and overall survival, vast disparities by material advantage or disadvantage occur across the entire breast cancer care continuum. As a result, individuals lower down the socioeconomic ladder are more likely to have cancer diagnosed at a later stage, and have less availability to basic resources such as nutritious food and prescription drug coverage. In Canada, increasing austerity measures have resulted in higher levels of income inequality, deepening poverty, homelessness and growing precarious working conditions. The purpose of this paper is to describe the ramifications of spending cuts, and social structural inequality on the cancer care trajectory. By using the example of breast cancer care, this paper serves to advance the discussion of what it means to consider the intersections of power, resources and opportunities in creating gendered social inequality, and the implications of such ‘structures of constraint for women experiencing cancer. Through this illustration we are able to conceptualise that the foundations of health equity are built upon social equity, and one cannot be achieved without the other.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".