African Americans and Environmental Cancers: Sharing Histories to Build Trust

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DESCRIPTION (provided by applicant): This proposal responds to the (09) Health Disparities broad challenge area and the specific challenge topic: Building Trust Between Researchers and Communities Through Capacity Building in Environmental Public Health (09-ES-101*). African Americans have the highest overall cancer death rate and shortest survival of any racial and ethnic group in the US. These disparities are accentuated in the American South. For example, the US breast cancer death rate is 23.0 (per 100,000) for Caucasian women, as compared to 34.3 for African American women. The NC breast cancer death rate is 27.2 and 38.0 for Caucasian and African American women, respectively; and in our study area, Durham County, the breast cancer death rate is 27.5 for Caucasians and 42.0 for African Americans. The causes of these inequalities are complex, but arise, at least in part, from disparities in income, education, nutrition, and access to healthcare. These factors all increase the likelihood of exposure to environmental carcinogens, which may contribute to increased cancer mortality among African Americans. The central objective of this proposal is to advance the partnership between the Sisters Network and Duke to address community concerns regarding environmental contributors to cancer health disparities among high-risk African American families. Our specific aims are to: 1) develop a team and a framework for understanding the community dynamics in Durham County, NC as they relate to environmental contributors to cancer as a health endpoint; 2) deploy community health workers to inventory the exposure, diet, residential, and social history among 300 high-risk African American families; and 3) develop family-based models of environmental public health action directed at cancer health endpoints. This project leverages and promotes ongoing relationships between Duke University and the Triangle Chapter of Sisters Network, Inc. The proposal brings together the expertise of oncologists, environmental scientists, geographers, patient navigators, and community organizations. This approach holds promise for addressing environmental public health concerns regarding breast and other cancers locally and in other geographic regions. In addition, the proposal will build trust between the African American community and the health care system through a collaborative model of listening, learning, and outreach. The proposed work is reflective of Duke?s commitment to work collaboratively with the community to place knowledge in service of society and to foster strong interdisciplinary research programs in environmental health sciences and health care systems.