Thanks for your response! CRC is an important area for health disparities work. As I mentioned to others for this assignment, it is important to recognize that CRC screening itself is not the "health disparity" but rather a disparity in process that leads in the health disparity of differences in morbidity and mortality from CRC. Keeping that distinction in mind can be helpful to keep our eye on the actual health disparity we are working on, even as we address process outcomes on the pathway. I definitely think CRC screening can be influenced by all the things you mention. I would also add in that those without access to clean and private bathrooms and who have less control over their diet may find doing FIT testing more challenging.
I love your suggestion for more flexible clinic hours etc. as a means of addressing disparities - we will talk about this more later - essentially the idea of making the system respond to the patient, as opposed to vice versa.
In terms of the cultural explanation for lack of CRC screening among Blacks, I would just urge caution whenever we apply cultural explanations. While this may in fact be something that has been found in the literature, it is important to think about this in the broader context in terms of why these "cultural" differences may exist on a structural level - e.g. medical distrust, differences in health education, etc.
Tomorrow's lecture will add lots of information about how behaviors like CRC screening are influenced by socioecological context!