{"doi":"10.1016/j.jaad.2022.05.070","title":"A health equity framework to address racial and ethnic disparities in melanoma","abstract":"Capsule Summary•Health disparities exist with regards to melanoma diagnosis and outcomes in ethnic minorities and social determinants of health (SDOH) play a large role.•We propose a health care equity framework, and solutions that directly address SDOH using a multi-level approach. These solutions can be adopted by dermatologists and other stakeholders. •Health disparities exist with regards to melanoma diagnosis and outcomes in ethnic minorities and social determinants of health (SDOH) play a large role.•We propose a health care equity framework, and solutions that directly address SDOH using a multi-level approach. These solutions can be adopted by dermatologists and other stakeholders. Although melanoma is rare among racial and ethnic minority groups, patients from these groups are 2 to 3 times more likely to die from melanoma than their non-Hispanic White counterparts.1Reyes-Ortiz C.A. Goodwin J.S. Freeman J.L. Kuo Y.F. Socioeconomic status and survival in older patients with melanoma.J Am Geriatr Soc. 2006; 54: 1758-1764Crossref PubMed Scopus (68) Google Scholar,2Qian Y. Johannet P. Sawyers A. Yu J. Osman I. Zhong J. The ongoing racial disparities in melanoma: an analysis of the Surveillance, Epidemiology, and End Results database (1975-2016).J Am Acad Dermatol. 2021; 84: 1585-1593Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar Compared with non-Hispanic White populations, racial and ethnic minority groups are less knowledgeable about the appearance of melanoma, less likely to be aware of the importance of skin self-examinations, and less likely to have received skin examinations from their provider.3Harvey V.M. Patel H. Sandhu S. Wallington S.F. Hinds G. Social determinants of racial and ethnic disparities in cutaneous melanoma outcomes.Cancer Control. 2014; 21: 343-349Crossref PubMed Scopus (44) Google Scholar The cascading effect of inadequate melanoma health literacy, misunderstood personal risk (ie, low risk does not equal to no risk), and delayed receipt of medical care may explain the greater burden of thicker primary tumors and more advanced stage at initial diagnosis in these patient populations.2Qian Y. Johannet P. Sawyers A. Yu J. Osman I. Zhong J. The ongoing racial disparities in melanoma: an analysis of the Surveillance, Epidemiology, and End Results database (1975-2016).J Am Acad Dermatol. 2021; 84: 1585-1593Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar,4Pollitt R.A. Clarke C.A. Swetter S.M. Peng D.H. Zadnick J. Cockburn M. The expanding melanoma burden in California hispanics: importance of socioeconomic distribution, histologic subtype, and anatomic location.Cancer. 2011; 117: 152-161Crossref PubMed Scopus (74) Google Scholar Knowledge and access to care are the 2 social determinants of health (SDOH) that shape outcomes of many diseases, including melanoma (Table I).3Harvey V.M. Patel H. Sandhu S. Wallington S.F. Hinds G. Social determinants of racial and ethnic disparities in cutaneous melanoma outcomes.Cancer Control. 2014; 21: 343-349Crossref PubMed Scopus (44) Google Scholar However, the American Academy of Dermatology message, “If you find a spot on your skin that could be skin cancer, it’s time to see a dermatologist” demonstrates a blind spot with respect to SDOH. It assumes that all individuals have similar skin cancer knowledge and access to dermatologic care.Table ISocial determinants of health∗Standard categories from the U.S. Department of Health and Human Services. that may affect melanoma careEducation access and quality∗Standard categories from the U.S. Department of Health and Human Services.Economic stabilitySocial and community contextNeighborhood and built environmentHealth care access and qualityKnowledge of skin cancer riskIncome levelCultural beliefs and attitudes toward cancerAbility to protect oneself from sunAccess to primary careEducation levelEmployment opportunitiesLanguageAccess to transportationAccess to specialty careLiteracy skillsFo","journal":"Journal of the American Academy of Dermatology","year":2022,"id":285257,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9509,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":414511,"name":"Azizi Seixas","orcid":"0000-0003-0843-2679","position":1,"is_corresponding":false},{"id":963449,"name":"Prince Adotama","orcid":"0000-0003-3092-1524","position":2,"is_corresponding":false},{"id":963450,"name":"Victoria Foster","orcid":"0000-0002-9391-245X","position":3,"is_corresponding":false},{"id":402148,"name":"Simona C. Kwon","orcid":"0000-0003-2398-704X","position":4,"is_corresponding":false},{"id":963451,"name":"Vivienne Li","orcid":"0009-0009-0224-4491","position":5,"is_corresponding":false},{"id":388178,"name":"Ann Y. Lee","orcid":"0000-0002-8143-2635","position":6,"is_corresponding":false},{"id":711308,"name":"Jennifer Stein","orcid":"0000-0002-0962-4982","position":7,"is_corresponding":false},{"id":345304,"name":"David Polsky","orcid":"0000-0001-9554-5289","position":8,"is_corresponding":false},{"id":711299,"name":"Avani Kolla","orcid":"0000-0002-4071-6092","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-19T00:29:40.826853Z","pmid":"35970385","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}