Center for SOcial CApital (SOCA): Promoting Multigenerational Health

社会资本中心（SoCa）的首要使命是汇集学术机构， 以社区为基础的组织，以及不同的利益相关者群体，以减少癌症健康不公平， 持续贫困。纽约市（NYC）是一个极端的地区，一些最富有和最贫穷的人生活在 近距离这些极端情况对健康产生了深远的影响， 癌症导致这些差异成为过早死亡和总体死亡的第一和第二大原因， 分别纽约市是美国最多元化的城市之一，大约三分之二的非白人，三分之一的外国出生， 在持续贫困的四个县中，至少有五分之一的人生活在联邦贫困线以下。与这些 多样性，在实施癌症控制计划以满足所有人的需求方面带来了挑战。 使用社区参与的方法，我们确定了三大社会决定因素， 在持续贫困的社区，癌症早期发现和治疗的最大障碍是：1） 经济负担; 2）健康素养低，以及3）社区/社会背景（即，缺乏社会支持/凝聚力， 歧视）。 纽约市有着悠久的移民和移民历史，这导致了种族/民族上的差异。 隔离的社区居住隔离集中了少数族裔社区的不利条件， 限制社会，经济和教育机会和资源，同时将贫困集中在这些领域 社区.然而，对于某些人口阶层，特别是新移民，居住在一个高度 隔离社区通过同种族社会支持网络（也称为 "族裔飞地"和资源的可获得性。因此，社会资本和社会凝聚力的结构可以发挥作用， 在调解居住隔离和负面健康结果之间的关系方面发挥了重要作用， 例如癌症发病率和死亡率。我们的使命作为一个中心是减少癌症健康的不公平， 通过促进多代人健康，在纽约市各地开展持续的贫困人口普查。具体来说，我们的目标是 与社区组织建立丰富的跨学科合作伙伴关系， 研究人员参与的研究方法，并将建立可持续的癌症控制方法（目标1）; 开展两个互补项目，重点是在持续贫困社区采取新的干预措施 针对健康的两个结构性决定因素-教育和保健-干预措施旨在 在学校环境中增加年轻人的社会资本，在联邦合格卫生保健中增加病人导航员 中心作为缓解系统性不平等的手段（目标2）;并利用四个地理区域的能力 将纽约市持续贫困的人口普查区分开，培养下一代调查人员， 发展可持续的核心基础设施，以实现癌症健康公平（目标3）。

The overarching mission of the Center for Social Capital (SoCa) is to bring together academic institutions, community-based organizations, and a diverse group of stakeholders to reduce cancer health inequities due to persistent poverty. New York City (NYC) is a region of extremes with some of the richest and poorest living in close proximity. These extremes have profound impact on health with major inequities in life expectancy with cancer driving these differences as the number 1 and 2 cause of premature mortality and overall mortality, respectively. NYC is one of the most diverse in the U.S., with approximately 2/3 non-White, 1/3 foreign-born, and at least 1/5 living below the Federal poverty line across four counties with persistent poverty. With such diversity, come challenges with respect to implementing cancer control programs to meet the needs of all. Using a community-engaged approach, we identified the top three social determinants that exerted the greatest barriers to early detection and treatment of cancer in communities of persistent poverty were; 1) financial burden; 2) low health literacy, and 3) community/ social context (i.e., lack of social support/cohesion, stigma, discrimination). NYC has a long history of migration and immigration, which has resulted in racially/ethnically segregated communities. Residential segregation concentrates disadvantages in minority communities by limiting social, economic, and educational opportunities and resources while concentrating poverty in these communities. However, for some segments of the population, especially new immigrants, residing in a highly segregated community has positive health effects through co-ethnic social support networks also known as “ethnic enclaves” and resource availability. Hence the constructs of social capital and social cohesion may play a significant role in mediating the relationship between residential segregation and negative health outcomes, such as cancer incidence and mortality. Our mission as a Center is to reduce cancer health inequities in persistent poverty census tracts throughout NYC by promoting multi-generational health. Specifically, we aim to: Develop a rich interdisciplinary, and collaborative partnership with community organizations that will infuse stakeholder-engaged research methods and will build sustainable approaches for cancer control (Aim 1); Conduct two complementary projects that focus on novel interventions in persistent poverty communities aimed at two structural determinants of health—education and health care—in which the interventions aim to increase social capital among youth in school settings, and patient navigators in Federally Qualified Health Centers as a means to alleviate systemic inequities (Aim 2); and leverage capacity across four geographically separate groups of persistent poverty census tracts in NYC to cultivate the next generation of investigators and develop sustainable Core infrastructure to achieve cancer health equity (Aim 3).