Health Equity

Left to right: Dr. Erica Phillips (M.S. ’03) and Dr. Yazmin Carrasco

Dr. Erica Phillips (M.S. ’03) is a co-principal investigator for the Center for Social Capital (SoCa) and Multigenerational Health — a specialized research center funded by a $9.8 million, five-year grant from the National Cancer Institute (NCI) designed to help combat cancer disparities fueled by persistent poverty — and the lead investigator for the Cancer Risk Education in Schools for Youth and Families (CARES4You) study.

Dr. Yazmin Carrasco co-leads the career enhancement core of the Center for Social Capital.

What is community-engaged research?

Dr. Phillips: Community-engaged or community-based participatory research has existed for decades as an approach that has focused predominantly on addressing health inequities. It requires you to work collaboratively with the community to address issues most relevant to them by listening, responding and incorporating what community members say and want from the study you conduct. It’s the reason I went into medicine in the first place: to address differences in communities related to health and answer big questions around what we know are pervasive disparities in health outcomes.

How the work of the Center for Social Capital addresses health disparities

Dr. Phillips: Prior to the COVID-19 pandemic, we began working on understanding the needs around cancer prevention and control in neighborhoods served by the Sandra and Edward Meyer Cancer Center and NewYork-Presbyterian. We started with neighborhoods with disproportionally higher amounts of new cases and death from cancers that can be detected early, such as breast, cervical and colon. We held a series of community roundtables and surveyed around 2,500 residents about how they understood their cancer risk and the obstacles to cancer prevention and control. One thing we found was that some people hear the word “cancer” and think “death” — even as the science advances. We hope to change that cycle of thinking by focusing on the science of cancer.

When we hosted a community conversation to present our findings, one of the resounding themes from community members was that we need to start younger — middle school — with education and interventions that would embed cancer risk reduction information in the school system.

Our current work challenges us to consider how we, as academic researchers, will respond to our community members’ needs. Our team is thinking about how to get middle school students in our target communities interested in the science of cancer and the many STEM-based careers that impact cancer. How do we strengthen under-resourced schools where the STEM pipeline starts? How do we channel students’ energy into understanding how their environment and public policies can contribute to cancer risk and activate their desire to be influencers around these policies? How can we get them to communicate what they learn in the classroom to the adult caregivers in their households?

Dr. Carrasco: The SoCa Center’s Career Enhancement Core has several programs. One provides experiential and employable skills to college-level, post-baccalaureate and masters’ students from underrepresented groups within persistent poverty areas or insider researchers (researchers who are members of a community where research is being conducted) to enter clinical research coordinators positions, a role that involves managing and coordinating the daily activities of clinical studies. It’s a career path that is not well known outside of academic research but provides an entry and retention point into the scientific ecosystem. We hope to provide a path to social mobility to members of the communities with a greater cancer burden and in turn, engage the lived experiences of these insider researchers to meaningfully diversify the clinical research workforce to promote inclusive research.

We will also develop infrastructure to facilitate the use of NIH diversity supplements to fund hands-on research experiences in biomedical fields for underrepresented students to expand their career choices, and ultimately, expand the diversity of the biomedical workforce.

Why representation matters

Dr. Carrasco: You cannot be what you cannot see, right? We hope the Career Enhancement Core will provide an opportunity for people to see themselves in the people who are doing the research, who take part in asking the questions and who have a say in the questions being asked.

At the end of the day, it’s about engaging with those innate cultural norms and societal structures that individuals bring from their communities, so they can influence the health-related decisions being made in their own community. We hope the clinical research coordinator program will not only impact the diversity of clinical studies and participants in those studies, but also the diversity of the biomedical workforce to ultimately advance health equity.

Dr. Phillips: Getting kids excited about the science of cancer and having them think about all the STEM-based careers that are often unfilled by people like themselves is so important because often the only kind of STEM-based careers students consider are becoming doctors or nurses. And there are so many untapped professions. It’s also about creating that pipeline a lot earlier to connect to the pipeline that Dr. Carrasco and colleagues are building. If we start these conversations in high school and college, even that’s still too late. Our project is targeting middle school because that’s what our community members advised.

The numbers of individuals from underrepresented backgrounds in the biomedical workforce is still pretty small. This work is about creating social capital.