African Americans and Environmental Cancers: Sharing Histories to Build Trust

说明(申请人提供)：本提案回应(09)健康差距的广泛挑战领域和具体挑战主题：通过环境公共卫生方面的能力建设在研究人员和社区之间建立信任(09-ES-101*)。 在美国所有种族和民族中，非裔美国人的总体癌症死亡率最高，生存时间最短。这些差距在美国南部更加突出。例如，美国高加索女性的乳腺癌死亡率为23.0(每10万人中)，而非裔美国女性的死亡率为34.3。北卡罗来纳州白人和非洲裔美国女性的乳腺癌死亡率分别为27.2和38.0；在我们的研究地区达勒姆县，白人和非裔美国人的乳腺癌死亡率分别为27.5和42.0。造成这些不平等的原因很复杂，但至少在一定程度上是由收入、教育、营养和获得医疗保健方面的差距引起的。这些因素都增加了接触环境致癌物质的可能性，这可能导致非裔美国人癌症死亡率增加。 这项提议的中心目标是促进姐妹网络和杜克大学之间的伙伴关系，以解决社区对环境因素导致高危非裔美国家庭癌症健康差距的关切。我们的具体目标是：1)建立一个团队和一个框架，以了解北卡罗来纳州达勒姆县的社区动态，因为它们与癌症的环境贡献者作为健康终点有关；2)部署社区卫生工作者，盘点300个高危非裔美国家庭的暴露、饮食、居住和社会历史；以及3)发展针对癌症健康终点的以家庭为基础的环境公共卫生行动模式。 该项目利用并促进了杜克大学和姐妹网络公司三角分会之间的持续关系。该提案汇集了肿瘤学家、环境科学家、地理学家、患者导航员和社区组织的专业知识。这一方法有望解决当地和其他地理区域有关乳腺癌和其他癌症的环境公共卫生问题。此外，该提案将通过倾听、学习和推广的合作模式，在非裔美国人社区和医疗保健系统之间建立信任。拟议的工作反映了S公爵致力于与社区合作，将知识服务于社会，并在环境健康科学和医疗保健系统中培养强大的跨学科研究项目。

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.