Abstract 3564: Analyzing state policies that impact cancer care access for individuals with intellectual and/or developmental disabilities
Authors: Esha Mathur, Carly Camplain, Freya Abraham, Erin Vinoski, Julie Armin
Journal: Cancer Research (2025)

Abstract Background: Almost 2 million people in the US are diagnosed with some form of cancer, with a large proportion due to environmental, occupational, or lifestyle factors. People with intellectual and/or developmental disabilities (IDD) have the same risks for cancer as the general population, and are diagnosed with cancer at similar rates to the general population; however, they may experience worse cancer-related outcomes. Studies show the life expectancy of people with IDD has improved, largely due to better health management. As this population ages , it is important to address diseases of age, like cancer. There has been little exploration into how health-promoting federal and state policies influence the cancer outcomes of people with IDD. To understand how policies may affect cancer-related experiences of those with IDD, our team is conducting in-depth analysis of state programs and Medicaid waivers of two states: Kentucky, a state that expanded Medicaid eligibility with the Affordable Care Act; and Georgia, a state that chose not to expand. Methods: We compiled every Kentucky and Georgia Medicaid waiver (vehicles states use to deliver and pay for health care services in Medicaid) and health-focused program (17 for Georgia, and 14 for Kentucky). Our team also conducted in-depth interviews with policy advocates in each state (N=4), where we gained insight into the effectiveness of these policies in practice. We thematically coded each waiver with 3 broad categories-overall health promoting, disability-specific, and cancer-specific initiatives-and with 6 social determinants of health (SDoH) categories- economic stability, education, social context, living conditions and physical environment, health care system, and food. Results: For both Georgia and Kentucky, we found that every waiver/program (100%) addressed health care access. In Georgia, waivers and programs were coded as follows: food (4, 23.5%), economic stability (1, 5.8%), living conditions/physical environment (4, 23.5%), education (0), social context (6, 35.3%). In Kentucky, waivers and programs were coded: food (3, 21.4%), economic stability (2, 14.3%), living conditions/physical environment (7, 50%), education (1, 7.1%), social context (5, 35.7%). In interviews, advocates mentioned transportation, health literacy, and provider education as major barriers to health care. Conclusions: While most Medicaid waivers address access to health care, there is a need for waivers to address the other SDoHs that create significant accessibility barriers and may affect cancer outcomes. Citation Format: Esha Mathur, Carly Camplain, Freya Abraham, Erin Vinoski, Julie Armin. Analyzing state policies that impact cancer care access for individuals with intellectual and/or developmental disabilities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3564.