Community Outreach Program

布法罗、尼亚加拉大瀑布、它们的郊区和周边乡村的历史经验和文化环境对WNYC(2)中心的使命和拟议的社区外展计划的背景非常重要。在19世纪50年代和南北战争时期，WNY是废奴运动的主要旅程点，是帮助前奴隶逃到加拿大的地下铁路的最后一站。随着航运业和工业革命的发展，布法罗在20世纪之交成为人均百万富翁最多的城市。二战期间和战后

The historical experiences and cultural environment of the cities of Buffalo, Niagara Falls, their suburbs and the surrounding rural counties is important to the context of the mission of the WNYC(2) Center and proposed Community Outreach Program. Puring the 1850's and Civil War era, WNY was a major journey point in the abolitionist movement serving as final American stops on the Underground Railroad for assisting former slaves to escape into Canada. Then with the growth of shipping and the industrial revolution, Buffalo became the home of the most millionaires per capita at the turn of the 20th century. Puring World War II and post-war boom, more African Americans from southern states moved into Buffalo for industrial jobs and then became the predominate subgroup on the Eastside creating a movement of the previous European ethnic groups from urban Buffalo into other parts of Erie and surrounding counties. These historical waves of migration resulted in what has been characterized as the "color line," referring to the hierarchical categorization of class and resources by ethnic/racial characteristics or origins that included Irish, Italian and Eastern European immigrants as "nonwhite" at the turn ofthe century.(1) By the 1980's, the City of Buffalo had lost 23% of its population, thousands of jobs and major industrial employers like Bethlehem Steel, resulting in a loss of 70% of its tax base.^ Many of these displaced workers¿White and Black- still live in Buffalo, Niagara Falls, Erie and the surrounding counties and embody both the occupational risks from past exposures as well as the economic pressures of unemployment. The resulting sociocultural dynamics are important influences on racial and economic circumstances. This economic decline resulted in social and political repercussions related to fears of class and job displacement such as delayed integration of public schools (1981); patterns for white ethnic flight of Polish, German, and Irish families; development of housing "projects" for both White and Black residents, and continued de facto segregation of neighborhoods.(2,3) A recent story in the media reported that the City of Buffalo "is the home to the emptiest neighborhood in New York State" referring to a neighborhood with the most abandoned homes. (4) The Southern Tier, including the county of Chautauqua, was primarily settled in the late 1700's by European immigrants, lending to its primarily white demographic base. In the 1800's however, with multiple stations of the Underground Railroad throughout the county, Jamestown was host to one of the first settlements of 'free colored people.(5) The first African American Episcopal Zion Church in Chautauqua County opened in Jamestown in 1882.(6) WNY is also home to a large per capita population of Hispanic/Latinos in the Punkirk area, migrating from New York City, primarily of Puerto Rican descent. There is a strong migrant presence in the area's agricultural workforce originating from Mexico. The presence of racial inequities in health and healthcare has been well documented nationally. (7) Several factors are suggested as possible causes of these inequities and resulting disparities, including, but not limited to, health care provider bias, stereotyping, and clinical uncertainty.(7 )Likewise, neighborhood dynamics including segregation, gentrification, built environment and poverty impact behavior and disease.(8) The combination of historical processes and their impact on community and environmental level variables have created significant cancer disparities in Buffalo, Niagara Falls and Chautauqua and these communities and their resources will provide the solutions. Briefly, the theoretical foundation for our Community Outreach Program plans is built upon addressing disparities at multiple levels following a Socioecological Model.(9) For example, in tobacco, RPCI will continue work at a policy level (e.g., taxes and no-smoking policies), (see Facilities and Resources) and we will enhance the community level involvement with new interventions with Block Club Associations, while working at the institutional/provider level to enhance cessation in our proposed research. (See N4.R01) The interventions to reduce disparities proposed in our Center are focused on building social capital among medically underserved residents of WNY to optimize their ability and interest in using available cancer resources and procedures'"; while expanding the experiences of the RPCI staff to improve understanding of the social and cultural context of vulnerable communities.(10) The concept of social capital as used in our Center is defined as the "benefits and challenges that accrue from participation in social networks and groups(11) and includes the positive attributes of civic engagement and norms of reciprocity and trust (as is often used in public health literature).(12)