County-Level Structural Racism Indices and Racial Disparities in Lung Cancer Care
By
Jacquelyne J. Gaddy
Do H. Lee
Jeph Herrin
James B. Yu
Craig E. Pollack
Lorraine T. Dean
Geoff B. Dougherty
Maureen E. Canavan
Pamela R. Soulos
Cary P. Gross
May 20, 2026
Clinical Scorecard: Structural Racism Metrics at the County Level and Their Impact on Racial Inequities in Lung Cancer Treatment
At a Glance
Category Detail
Condition Non-small cell lung cancer (NSCLC) Key Mechanisms Structural racism metrics including the Structural Racism Effect Index (SREI) and County Structural Racism (CSR) index. Target Population Non-Hispanic Black and non-Hispanic White Medicare beneficiaries diagnosed with NSCLC. Care Setting Cross-sectional study using SEER-Medicare data.
Key Highlights
Black patients are less likely to be diagnosed with localized NSCLC and to receive appropriate treatment compared to White patients. Structural racism metrics like SREI and CSR are linked to disparities in lung cancer care. The CSR index measures racial dissimilarity across multiple domains including housing and healthcare. Guideline-Based Recommendations
Diagnosis
Utilize NCCN guidelines for staging and treatment evaluation. Management
Ensure stage-appropriate evaluation and treatment for NSCLC patients. Monitoring & Follow-up
Monitor disparities in care based on structural racism metrics. Risks
Consider socioeconomic disadvantages and structural racism when assessing patient outcomes. Patient & Prescribing Data
Medicare beneficiaries aged over 67 years diagnosed with NSCLC from 2013 to 2019.
Patients with localized disease (T1-3AN1) may be considered for curative treatment.
Clinical Best Practices
Incorporate structural racism metrics in cancer care assessments. Focus on reducing disparities in treatment and outcomes for Black patients. Related Resources & Content
