Health disparities are differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions that exist among specific population groups in the United States. These population groups may be characterized by gender, age, ethnicity, education, income, social class, disability, geographic location, or sexual orientation.
The Division of Cancer Control and Population Sciences (DCCPS) health disparities mission is to monitor the differential burden of cancer among Americans and promote and conduct research that identifies and addresses the economic, social, cultural, psychological, behavioral, and biological mechanisms contributing to these disparities across the cancer control continuum and throughout the human lifespan.
In response to this challenge, the HDWG will monitor the progress of DCCPS’
efforts to reduce health disparities and will support the following goals:
These goals are directed toward achieving the NCI mission to reduce cancer
health disparities.
DCCPS has identified a number of critical gaps in research and has worked to focus more research attention to these areas by developing special initiatives. DCCPS also has the responsibility within NCI to monitor the burden of cancer in the United States and to identify health disparities in cancer, and has developed a broad surveillance program to accomplish these goals. Major initiatives and the surveillance program are described in the table. These initiatives are organized by DCCPS Program, and Programs are organized along the cancer control continuum.
Several DCCPS initiatives that focus on health disparities cross cut other NCI priorities. These other priorities are:
Examples of Current and Planned Major Initiatives That Support Health Disparities Research
|
Description |
Years |
Long Island Breast Cancer Project |
- Examines geographic disparities in breast cancer incidence and mortality through more than 10 studies that include human population studies as well as laboratory research.
- Develops a health-related Geographic Information System (GIS) for Long Island (near completion).This GIS will provide researchers with a new tool to investigate relationships between breast cancer and the environment and to estimate exposures to environmental contamination.
|
1999-2004 |
|
Description |
Years |
Centers for Population Health and Health Disparities |
- Supports 4-5 Centers (P50s) in collaboration with other ICs.
- Encourages innovative research leading to an understanding of and reduction in cancer health disparities.
- Facilitates reciprocal collaboration among biomedical scientists, social scientists, and affected communities.
- Each Center conducts three related research projects (R01) that focus on the complex interactions of the social and physical environment, mediating behavioral factors, and biologic pathways that determine health and disease.
|
2003-2007 |
Digital Divide Pilot Projects |
- Tests strategies to increase cancer communications (particularly computer and Internet-based) in underserved communities.
- Collaborates with the Cancer Information Service (CIS), regional cancer control organizations, and the private sector.
|
1999-2000 |
Health Information National Trends Survey (HINTS) |
- Collects nationally representative data every 2 years about the American public's need for, access to, and use of cancer-related information.
- Oversamples minority populations.
- Tracks national public access to health information and provides data on changing patterns, needs, and opportunities in cancer prevention, screening, treatment, and support.
- Examines preferred information channels, sources, and information needs of diverse audiences and yields data on perceptions about cancer risks related to health hazards.
|
2002 |
|
Description |
Years |
Center for Psycho-Oncology Research Specialized Center (P50) Project |
- Conducts biomedical, behavioral, psychological, and social research on the interrelationships among biological processes, cognition, emotion, and physical health among ethno-culturally diverse survivors of breast, prostate, and AIDS-related cervical cancer.
- Supports 4 R01-level clinical trials to evaluate the efficacy of group-based Cognitive Behavioral Stress Management (CBSM) interventions, and a hormonal treatment to ameliorate adverse consequences of cancer and its treatment among ethno-culturally diverse cancer survivors.
- Assesses whether CBSM interventions can modulate the output of the sympathetic nervous system, the Hypothalamo-Pituitary-Adrenal axis, and Hypothalamic Pituitary Gonadal hormones; and normalize immunologic status in different populations.
- Supports pilot studies of CBSM intervention effects in individuals with other cancers, such as malignant melanoma.
- Develops and tests Spanish translations of interventions for breast and prostate cancer patients.
|
1999-2003 |
Minority and Underserved Cancer Survivors Supplement |
- Supports 6 pilot projects (1-year duration each) that examine survivorship issues among minority and underserved patients who have returned to their communities after completion of initial treatment, and/or their family members.
- Fosters collaborations between cancer centers and community organizations.
|
2001 |
Overcoming Barriers to Treatment Adherence In Minorities and Persons Living in Poverty |
- Supports 2 projects that examine issues related to adherence to prescribed medical and healthy-lifestyle regimens among diverse ethnic and/or low-income populations.
|
2001-2005 |
Long Term Cancer Survivors Research Initiative |
- Supports 15 research grants examining questions related to physiological or psychosocial outcomes, and/or interventions that may promote positive outcomes, among long-term (5 years posttreatment) cancer survivors.
- Examines the relationship between treatment and late effects among ethno-culturally diverse long-term cancer survivors (8 of 15 projects funded under this initiative).
|
1998-2003 |
|
Description |
Years |
Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) |
- Establishes a national consortium of competitively selected research teams focusing on colorectal and lung cancers to collaborate on large observational cohort studies of newly diagnosed cancer patients.
- Analyzes disparities in the delivery of quality cancer care.
- Examines factors such as the clinical or nonclinical characteristics of patients; provider knowledge, attitudes, and practices; and health system factors that also may be related to quality of cancer care.
|
2001-2005 |
Breast Cancer Surveillance Consortium |
- Evaluates performance of mammography services in community settings with diverse populations by linking data on mammography practice to data on cancer outcomes in either cancer registries or pathology laboratories.
- Expands monitoring of disparities in mammography-related outcomes through a large sample drawn from diverse geographic and practice settings.
- Identifies health disparities as a special focus of investigation.
- Assesses the understanding of breast cancer screening practices in the United States through an assessment of the accuracy, cost, and quality of screening programs and estimates the quantitative population effect of mammography screening on various outcomes.
|
1994-2001 |
HMO Cancer Research Network (CRN) |
- Develops a population laboratory, blending diverse populations and research expertise of various HMO plans.
- Encourages the expansion of collaborative cancer research among health care provider organizations that are oriented to community care and have access to large, stable, and diverse patient populations.
- Takes advantage of existing integrated databases that can provide patient-level information.
- Six plans have 20% or more non-white racial/ethnic enrollees and four of these have SEER cancer registries with rapid ascertainment systems.
- Studies late-stage breast and invasive cervical cancer patients to identify factors that affect advanced disease.
|
1999-2002 |
|
Description |
Years |
Surveillance Epidemiology and End Results (SEER) Program |
- Maintains 18 cancer registries, covering 26% of the U.S. population (23% of the African-American, 40% of the Hispanic, 45% of the American Indian/Alaska Native [AI/AN], and 53% of the Asian/Pacific Islander populations in the U.S.).
- Supports new registries to increase the oversampling of minority/ethnic groups, rural populations, and states with high cancer mortality.
- Enhances data systems to improve racial/ethnic classification and to measure cancer disparities by socioeconomic factors through linkage with other databases.
- Collaborates with other registries and organizations to set standards; improve coding systems; and interpret, report, and disseminate data.
- Provides access to SEER data and common statistical analyses through a public Web site(http://seer.cancer.gov).
- Supports efforts to improve the methods for derivation of statistics, such as cancer prevalence and survival, to increase their usability and meaningfulness.
|
Annual |
The Network for Cancer Control Research Among American Indian/Alaska Native Populations |
- Exchanges information on cancer control research; improves community links to the NCI, CIS, and ACS.
- Increases the number of AI/AN researchers, scientists, and medical students involved in cancer control activities in AI/AN communities.
- Develops curricula and mentors students in the Native Researchers' Cancer Control Training Program, increasing the research skills of young Native investigators.
- Convenes national conferences on "Cancer in Indian Country."
- Established the Native CIRCLE:Cancer Information Resource Center and Learning Exchange for individuals involved in the education, care, and treatment of AI/AN.
|
Annual |
Staff Name/
Contact Information |
Areas of Interest |
Shobha Srinivasan
Health Disparities
Research Coordinator
sriniva2@mail.nih.gov
301-435-6614 |
- Social determinants of health
- Policy and social justice
- Health care access and utilization
- Immigrant populations
|
Tanya Agurs-Collins
collinsta@mail.nih.gov
301-594-6637
|
- Racial differences in biological and lifestyle factors that influence hormone-dependent cancers
- Behavioral genetics, gene-environment interactions, and obesity risk
- Diet and obesity risk in minority populations
|
Catherine Alfano
alfanoc@mail.nih.gov
301-402-1450 |
- Biopsychosocial determinants of cancer survivorship disparities
- Social ecological model of health behavior change
- Policies affecting outcomes in cancer survivors
- Social justice
|
Neeraj Arora
aroran@mail.nih.gov
301-594-6653 |
- Patient-centered care
- Patient-clinician communication
- Assessment of patient experiences of care, quality of care
|
Audie Atienza
atienzaa@mail.nih.gov
301-402-8426 |
- Behavioral medicine
- Aging
- Real-time measures and health informatics
|
Rachel Ballard-Barbash
barbashr@mail.nih.gov
301-402-4366 |
- Diet, weight, and physical activity
- Breast cancer screening and treatment
|
David Berrigan
berrigad@mail.nih.gov
301-451-4301 |
- Acculturation and health behaviors
- Built environment and physical activity
- Understanding race/ethnic responses to survey questions
- Measurement of physical activity
|
Kelly Blake
kelly.blake@nih.gov
301-402-8425
|
- Communication inequality
- Knowledge gaps
- Social epidemiology
- Social determinants of health
- Social policy
|
Michele Bloch
blochm@mail.nih.gov
301-402-5284 |
- Tobacco control and prevention for women and girls
- Tobacco use in developing (low- and middle-income) nations, especially among women and girls
|
Nancy Breen
breenn@mail.nih.gov
301-496-4675 |
- Social determinants of health and health care disparities
- Cancer screening
- Cancer control surveillance systems
|
Erica Breslau
breslaue@mail.nih.gov
301-435-2839 |
- Remedying health disparities in breast, cervical, and colorectal cancers
- Dissemination of evidence-based cancer screening interventions
- Health literacy
- Social networks
- System science
|
Martin Brown
mbrown@mail.nih.gov
301-496-5716 |
- Implications of health disparities for cost-effectiveness analysis of cancer control interventions
- Relationship between health care delivery organizational
structure and patterns of care
|
Wen-ying Sylvia Chou
chouws@mail.nih.gov
301-435-2842 |
- Immigrant health (health and immigration reform)
- Health and human rights
- Mixed methods and systems approach
- Health literacy
- Global burden of disease
|
Veronica Chollette
cholletv@mail.nih.gov
301-435-2837 |
|
Steven Clauser
clausers@mail.nih.gov
301-451-4402 |
- Health-related quality of life in patients with cancer and cancer survivors
- Clinical quality performance measurement and improvement
- Provider surveys of the use of evidence-based interventions
in cancer prevention, early detection, and treatment
|
Kathy Cronin
cronink@mail.nih.gov
301-435-2792 |
- Developing health objectives
- Measuring health disparities
- Monitoring health outcomes
|
Rao Divi (Mahesh)
divir@exchange.nih.gov
301-443-5539 |
- Molecular analysis/phenotyping
- Exposomic and metabolomic differences
- Effect of exposures on epigenome
- Infection and inflammation
|
Michelle Dunn
dunnm3@mail.nih.gov
301-594-6557 |
- Statistical methodologies applied to health disparities research
|
Brenda Edwards
edwardsb@mail.nih.gov
301-496-8506 |
- Surveillance research on measures of social and economic differences in cancer patterns (incidence, mortality, survival, outcomes)
|
Gary Ellison
ellisong@mail.nih.gov
301-402-1853 |
- Occupational and environmental risks for cancer
- Social determinants of health
- Epidemiology of prostate cancer
|
Eric “Rocky” Feuer
feuerr@mail.nih.gov
301-496-5029 |
- Impact of reducing health disparities on population incidence and mortality trends
- Geographic health disparities
|
Bradford Hesse
hesseb@mail.nih.gov
301-594-9904 |
- Health communication
- Public health informatics
- Patient-centered support environments
|
Annette Kaufman
kaufmana@mail.nih.gov
301-451-6829 |
- Youth and young adult tobacco use
- Tobacco and health disparities
- Risk perception and policy
|
Sue Krebs-Smith
krebssms@mail.nih.gov
301-496-4766 |
- Risk factor monitoring, with an emphasis on diet, weight, and physical activity
|
Damali Martin
martinda@mail.nih.gov
301-451-1956 |
- Disparities in cancer incidence and survival
- Gene-environment interactions in breast and prostate cancer
- Tumor biology microenvironment
|
Paige McDonald
mcdonalp@mail.nih.gov
301-435-5037 |
- Mechanisms and interactions of psychosocial and behavioral factors, neural and endocrine function, and immune system processes
|
Robin McKinnon
mckinnonr@mail.nih.gov
301-594-3599 |
- Policy research related to diet, activity, and weight
- Economics of obesity
- Measurement of the food and built environments
- Underserved populations
- Intersection between sustainable and healthy design
|
Glen Morgan
gmorgan@nih.gov
301-496-8585 |
- Smoking cessation
- Smoking and negative affect
- Tobacco use etiology
|
Rick Moser
moserr@mail.nih.gov
301-496-0273 |
|
Wendy Nelson
nelsonw@mail.nih.gov
301-435-4590 |
- Decision making
- Decision support
- Numeracy
- Literacy
- Risk perception
- Ethics
|
Mark Parascandola
Paramark@mail.nih.gov
301-451-4587 |
- Tobacco use among Alaska Natives
- Smokeless tobacco use
- International tobacco control
|
Frank Perna
pernafm@mail.nih.gov
301-451-9477 |
- Physical activity intervention design and selection of mediators
- Exercise effects on fitness, physiological outcomes, and psychosocial outcomes
- Physical activity and nutrition policies affecting schools and school-aged children
|
Irene Prabhu Das
prabhudasi@mail.nih.gov
301-451-5803 |
- Cancer screening and followup of abnormal screening results
- Health literacy and patient-provider communication
- Low-income (SES) groups, ethnic minority women
|
Britt Reid
reidbr@mail.nih.gov
301-435-4914 |
- Household air pollution from solid fuel combustion
- Climate change and vulnerable populations
|
Sheri Schully
schullys@mail.nih.gov
301-435-4911 |
- Epidemiologic and genetics research
- Gene-environment interactions
- Risk factors
|
Ashley Wilder Smith
smithas@mail.nih.gov
301-451-1843 |
- Health and lifestyle behaviors
- Health-related quality of life
- Adolescent and young adult cancer survivors
- Quality of care and health services of young cancer survivors
|
David Stinchcomb
stinchcd@mail.nih.gov
301-594-7251 |
- Social determinants of health
- Socio-economic status and health disparities
- Use of geographic analysis methods in disparities research
- Use of SEER data in disparities research
|
Joseph Su
sulj@mail.nih.gov
301-443-8066 |
- Dietary pattern and cancer
- Exposure to modifiable cancer risk factors
- Links between diet/environment and epigenetics
- Diet and gene interaction on carcinogenesis
- Environmental pollutants in diet and cancer
|
Judith Swan
swanj@mail.nih.gov
301-435-4958 |
- Cancer rates in Native American populations
|
Stephen Taplin
taplins@mail.nih.gov
301-402-1483 |
- Cancer screening implementation through Federally Qualified Health Centers (FQHCs)
- Delivery and quality of breast cancer screening
- Multilevel contextual influences on cancer care
- Cancer care and primary care
|
Zaria Tatalovich
tatalovichzp@mail.nih.gov
301-435-2171 |
- Geo-spatial modeling, analysis, and visualization
- Environmental exposures
- Built environment
- Contextual environments
- Disease patterns
|
Mukesh Verma
vermam@mail.nih.gov
301 594 7344 |
- Genetic and epigenetic susceptibility differences between ethnic populations
- Ethnic differences in HPV strain types/infection prevalence
- Biomarkers of risk assessment in ethnic populations
|
Debbie Winn
winnde@mail.nih.gov
301-594-9499 |
- Methods of cancer surveillance among indigenous populations
- Ethnic and cultural differences in cancer risks
- Geographic variations in cancer risks
|
Krista Zanetti
zanettik@mail.nih.gov
301-496-7250 |
- Biological determinants of health disparities
- Genetic susceptibility to cancer risk
- Disparities in cancer incidence and survival
|