$9.8 million NCI grant aims to combat cancer disparities

Weill Cornell Medicine and Columbia University have been awarded a $9.8 million, five-year grant from the National Cancer Institute (NCI), part of the National Institutes of Health, to help combat cancer disparities fueled by persistent poverty.

The competitive award, will engage faculty members from Weill Cornell Medicine, Columbia University Mailman School of Public Health, Columbia University School of Nursing and SUNY Downstate Health Sciences University in a collaborative effort to develop a specialized research center and spearhead two large projects in four communities of persistent poverty in New York City.

We were one of only five centers the NCI funded, and the only one in New York City and the Northeast, so we're really delighted. The NCI wanted to fund centers that came up with novel, creative, innovative ways to close health equity gaps. While we're not able to eliminate persistent poverty, we can mitigate some of its influences on cancer."

Dr. Rulla Tamimi, contact principal investigator, chief of epidemiology in the Department of Population Health Sciences and associate director of population science at the Sandra and Edward Meyer Cancer Center at Weill Cornell Medicine

The overall center will be led by a multi-principal investigator team that includes Drs. Erica Phillips from Weill Cornell Medicine, and Mary Beth Terry and Phoenix Matthews at Columbia.

"This initiative continues important collaborations across Columbia and Weill Cornell Medicine related to public health initiatives to reduce the cancer burden, which is crucial given that cancer remains the No. 1 reason for premature mortality in New York City," said Dr. Terry, a professor of epidemiology from Columbia Mailman School of Public Health and a member of the Herbert Irving Comprehensive Cancer Center.

Weill Cornell Medicine's Center for Social Capital (SoCa) will use the grant to tackle two complementary projects promoting multi-generational cancer awareness and health in South Bronx, North-Central Brooklyn, Washington Heights and Western Queens, working with many community partners.

The first project, led by Dr. Phillips, will test the effectiveness of a six-week cancer education and social justice curriculum among middle-school students at 10 New York City public schools.

The curriculum, delivered by the schools' primary science teachers, will explore cancer prevention and control from six distinct vantage points: social justice; media literacy and tobacco advertising; nutrition; cancer genetics; biotech; and risk reduction. The work will be conducted collaboratively with Columbia investigators, along with the national nonprofit Math for America, which strives to enhance STEM (science, technology, engineering, and math) instruction in NYC public schools.

"We've recognized that students, especially middle school students who at a developmental stage of wanting autonomy, are uniquely suited to be influencers," said Dr. Phillips, who is the Jack Fishman Associate Professor of Cancer Prevention, an associate professor of clinical medicine and associate director of community outreach and engagement in the Meyer Cancer Center at Weill Cornell Medicine. "If we can teach kids the science behind cancer, the social determinants that impact higher cancer rates within particular communities, we can empower them to make a difference in their own communities and households.

"We also know that poverty is multi-generational and is linked to unemployment," Dr. Phillips added. "We know the future is in STEM careers, so this project is also about enhancing the exposure kids receive to STEM-based careers so that they can be gainfully employed and leaders down the line."

The second project, led by Dr. Matthews from Columbia's School of Nursing, will implement an innovative tobacco cessation trial using federally qualified health centers and patient portal technology. The team will work directly with safety-net health care clinics to increase patient awareness of free smoking cessation treatments offered by the New York State Tobacco Quitline. Investigators will use an established patient portal to directly communicate with patients about changes they make to their smoking behaviors.

"Addressing smoking and smoking-related health inequalities among patients from economically disadvantaged backgrounds remains an important public health priority," said Dr. Matthews, who is a professor of behavioral sciences (in nursing) and a member of the Herbert Irving Comprehensive Cancer Center. "Low-income patients encounter numerous barriers to accessing affordable and effective smoking cessation treatments. This approach will build the capacity of safety-net clinics to support providers in increasing patient access to evidence-based smoking cessation counseling in a way that minimizes costs and provider burden."

Also integral to SoCa and the grant is support for early-career researchers, who will hopefully carry the torch forward to continue to advance health care equity. The grant's Career Enhancement Core, co-led by Weill Cornell Medicine's Dr. Yazmin Carrasco, will work with aspirant doctors, scientists and health care professionals who are between their undergraduate and graduate training and who hail from communities underrepresented in the field. The team will help these trainees obtain NIH diversity supplement research grants and give them access to training opportunities that will empower them to study health issues that affect their own communities. Additionally, the team will develop a capacity building program that accelerates pre-faculty investigators who are committed to cancer health disparities in impoverished communities to attain research funding and strengthening their position for academic promotion.

"At the end of the day, representation matters," said Dr. Carrasco, who is assistant dean for diversity and inclusion at Weill Cornell Graduate School of Medical Sciences and an assistant professor of education research in pharmacology at Weill Cornell Medicine. "It's so important to have individuals who come from communities impacted by cancer health disparities, from all races and backgrounds, so that we can impact innovation, creativity, enhance the rigor of science and, ultimately, influence health equity."

Other key collaborators in the grant include Dr. Jasmine McDonald, an assistant professor in the Department of Epidemiology at Columbia's Mailman School of Public Health and a member of the Herbert Irving Comprehensive Cancer Center, who will be involved in the cancer prevention curriculum as well as co-leads the Career Enhancement Core; as well as Dr. Marlene Camacho-Rivera, assistant dean for student affairs and an assistant professor in the Department of Community Health Sciences at SUNY Downstate Health Sciences University, who will develop pilot projects as part of the grant's Developmental Core. Dr. Laura Pinheiro, an assistant professor of health services research in medicine at Weill Cornell Medicine, and Dr. Jeanine Genkinger, an associate professor of epidemiology at Columbia Mailman School, will lead the center's Research and Methods Core.

"We have accumulated evidence that structural and social determinants of health impact cancer health inequities, and we now need to develop interventions that are aimed at multiple levels of influence including individual, interpersonal, community and societal," Dr. Tamimi said. "This center will allow us to do just that and cultivate the next generation of investigators who are dedicated to eliminating cancer health disparities in impoverished communities."