Bridging cancer health inequities

The Stanford Cancer Institute Office of Cancer Health Equity team

The Stanford Cancer Institute Office of Cancer Health Equity team

The Stanford Cancer Institute Office of Cancer Health Equity (SCI-OCHE) is dedicated to fostering and strengthening partnerships that improve research, education, and community outreach and engagement to reduce the cancer burden and cancer disparities. 

Dinah Trevil, MPA, executive director of SCI-OCHE, and Alyce Adams, PhD, Stanford Medicine Innovation Professor and associate director of SCI-OCHE, spoke about SCI-OCHE’s efforts and their inaugural SCI Bridging the Gap Health Equity Symposium, which brought together university, community, and industry leaders to discuss issues and opportunities in addressing cancer health inequities.

2024 SCI Bridging the Gap Health Equity Symposium

The symposium brought together diverse perspectives and experiences to discuss pressing cancer health equity issues. Panelists represented Stanford University and Stanford Medicine leadership, industry, such as Genentech and Pfizer, community partners, non-profits and local government representatives, and cancer patient advocates and survivors.

Trevil recounts an exciting panel discussion on health equity and AI that highlighted both AI's concerns and benefits, including its potential to benefit research and community engagement through data analytics. 

She says, “The general consensus was that AI can be a valuable tool for health equity, but there needs to be consideration that the gap is not widened for communities that don’t have equitable access to these technologies. There was also consensus on the need to be transparent in our use of AI and to establish a clear understanding of how the data is going to be used, especially involving the community. There was also a larger conversation about collecting more data and ensuring the data is representative of the community.”

Participants in the health policy panel outlined important things to consider when engaging policymakers, specifically the necessity of telling stories about the impact of cancer and lack of healthcare access on individual community members’ lives. Sharing these stories puts a human face on the problem that may not be conveyed by just sharing statistics on the community burden and potential policy impact. The panel also discussed the need for collective action in shifting policy, with one panelist sharing her experience of leveraging broad community action to get an initiative on the ballot for a local election. 

Trevil describes the event’s community panel, which consisted of community members whose lives have been affected by cancer and who have worked directly with cancer patients, as being particularly impactful. She notes that one panelist, Juanita Waugh who is part of the SCI-OCHE Community Advisory Board, accompanies cancer patients to their appointments, advocates on their behalf, and helps them navigate the diagnosis, insurance issues, transportation, and other challenges and barriers to accessing treatment. 

Working with researchers to reduce the cancer burden in local communities

SCI-OCHE regularly conducts research with community members, partners, and stakeholders to develop pilot grants, fund different research and community projects, and inform outreach strategies to address community needs. Additionally, they survey Stanford research program managers to identify and launch collaborative research projects. 

Trevil says, “We make sure to stick to the framework of getting priorities from the community and helping that inform our work. We circle back to the community to make sure they’re involved throughout the process and collaborate with researchers to inform some of the research programs and research questions they’ll be focusing on.”

An example of their multi-faceted efforts is a partnership with the Stanford Human-Centered AI Institute on a National Cancer Institute-funded patient-driven algorithm in neuropathy and a project using machine learning to anticipate the equity effects of specific strategies within health systems to reduce out-of-pocket costs. Additionally, SCI-OCHE is organizing smaller events to facilitate conversations between community members and Stanford researchers in AI, health policy, and population health, as well as consulting community partners, to discuss how to better engage communities and patients with AI implementation.

Adams says, “The idea is to use AI to leverage data and identify opportunities to address inequities. We’re also trying to understand how patients might inform not just the development of AI but generative AI and help us identify opportunities for interventions and what components of AI regulation and policies patients should be engaged in so their voices can be heard and integrated into policy development. Additionally, when these programs are implemented, how can we leverage patients’ wisdom, knowledge, and priorities to help us think about that implementation phase.”

SCI-OCHE recently played a major role in developing and funding the Upstream Research Grants, a collaboration between Stanford, UC San Francisco, and UC Davis that focuses on persistent poverty areas and rural communities in northern California. SCI-OCHE has continued to collaborate closely with the other cancer centers’ community outreach teams to ensure community engagement.

Finally, SCI-OCHE held webinars with several Stanford research programs and community partners to discuss financial toxicity. A priority issue for the SCI-OCHE Community Advisory Board, financial toxicity occurs when a cancer patient suffers financial hardship as a result of their diagnosis and treatment. These webinars led to collaborations between researchers and Community Advisory Board members to develop and obtain a supplement to the Stanford Cancer Institute’s Cancer Center Support Grant to study the complex factors influencing community health programs, particularly medical financial assistance as a strategy to reduce financial toxicity. 

Empowering communities to leverage health equity data

As a part of Stanford Medicine’s Racial Equity to Advance Community of Health (REACH) Initiative SCI-OCHE worked with Stanford researchers, undergraduate students, and students enrolled in the Stanford Cancer Institute’s Historically Black Medical Colleges (HBMC) summer program, a research program connecting HBMC students with Stanford cancer faculty members, to develop a data dashboard as a resource for researchers and the community. 

The dashboard has neighborhood-specific data on cancer incidence and mortality, so both researchers and community organizations can use this data to support their work. For example, community organizations can use it to identify cancers with a high community burden and increase education and awareness of screening options. Additionally, the dashboard can connect how funds are allocated in a community with the community’s health outcomes, such as medical financial assistance’s effects on cancer health equity, and examine national datasets to identify additional research areas that may benefit the local community.

Currently, SCI-OCHE is planning sessions that pair researchers with community partners to discuss how researchers have used the dashboard and how community organizations can use the tool to engage the community and address their community’s cancer burden.

Trevil says, “That’s one of the main ways that we can really engage the community because we want them to have ownership of the data, input simple criteria, and use that information to create an infographic they can distribute in their community or discuss the importance of screening for these cancers at health fairs or other events and community gatherings, such as religious congregations.”

Building capacity in the community to promote change

SCI-OCHE partners with many organizations to provide important services and resources in the local community. One of those partnerships is with the Bay Area Health Advisory Council, which provides more than 400 free mammograms at its annual community event. SCI-OCHE refers members with abnormal mammograms to local providers for follow-up through a partnership with the city of San Mateo. 

The Clinical & Translational Science Association (CTSA) and SCI-OCHE co-sponsor a health equity ambassadors program that facilitates collaboration with nine community health organizations. Community partners wanted to focus on climate change because they were concerned about migrant farmworkers’ increased cancer risk. To assist in this effort, SCI-OCHE recruited and trained community partners to build community capacity to conduct research. These community members provided educational climate change presentations and storytelling activities in six different languages for community members.

Trevil notes that building community capacity is one of SCI-OCHE’s most notable achievements. 

She says, “There has to be a recognition of the strength of community-based organizations and the important work that’s being done within these organizations. We have to recognize that we can’t do it all on our own. We have these great partners that are doing the work. We value these partnerships and try to find innovative ways to build that capacity  to continue to address the cancer burden and health equity in the community.”

January 2025
By Katie Shumake

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