By Timothy Watts, M.P.H., Diversity and Inclusion Specialist, Office of Equity & Inclusion
The warm, quiet evening was punctuated by the sound of one lonely ice cube striking the inside of my thermos as I plunged through the double glass doors. I had consumed the last of my water as we proceeded toward the question and answer portion of the health education class, and I had been too emotionally drained to refill the container afterward. Carefully loading my projector, computer and locked case of documents into my car, I breathed a deep sigh as I reflected on the testimonials of some of the cancer survivors:
“All of the pamphlets and forms were only in English.”
“It’s hard to get time off from work, and I did not feel welcome when I went [to the clinic].”
“I felt like I had to choose between going to the doctor or paying rent.”
Their words hummed in my head as I closed the trunk and prepared to drive the 101 down California’s Central Coast. This evening’s class had gone like many before, but I knew this session would linger in my mind because I felt a great pang of empathy for the people who had been brave enough to share with the group. I felt empathy not only because they were so gracious with their time and energy, but because many of the challenges they experienced in seeking cancer screenings or treatment were challenges shared by my own mother, who is an immigrant and who also does not speak English as a first language.
As we collectively reflect upon National Hispanic Heritage Month, my mind takes me back to memories from my time serving as a health educator with the Every Woman Counts (EWC) program. In this role, I had the great privilege of working with a wide variety of populations, and one of the communities I found myself working with frequently was that of new immigrants and indigenous people from Central America.
Inequities in health outcomes in these populations are palpable. Between 2015 and 2019, “five-year survival rates for all cancers and all stages of cancer combined was lower among Hispanic/Latine patients than among non-Hispanic Whites (65.5 vs. 68.2 percent, respectively). Hispanic/Latine individuals also had lower survival rates for breast, bladder, lung, non-Hodgkin lymphoma, oropharyngeal, prostate, and thyroid cancers. For most of these cancer sites, Hispanic/Latine individuals were also more likely to be diagnosed at later stages,” according to the California Cancer Registry.
Reflecting on that particular session from a few years ago, I remember the people who shared their stories. That evening’s class was held in a shelter that primarily served people experiencing homelessness and many participants self-identified as Hispanic/Latine on their participant forms. Our class discussed breast and cervical cancer screening recommendations, apprehension about healthcare providers, frustrations around condescension in healthcare settings, and many other topics. There was also dialogue surrounding domineering partners, social and familial stigma about mammograms and the HPV vaccine, the importance of the advice of matriarchs and curanderas, and the shared culture and community that anchored these individuals. It was their community that brought them together on many nights (including this one), where they discussed barriers to their health and the ways they could learn from one another to navigate them.
I see these lessons mirrored in some of NCI’s work. For example, they are present in initiatives such as the NCI Equity and Inclusion Program (EIP), where the Enhancing Research to Address Cancer Health Disparities working group is charged to “identify and prioritize research recommendations to elucidate causes and factors that influence cancer disparities and informing strategies/interventions to eradicate them.” CCR’s commitment to inclusion also displays intentionality in reducing barriers to participation in clinical trials, increasing access for communities where this sort of participation may have been overly cumbersome or even impossible. While these initiatives are not a panacea for the aforementioned inequities, they signal to me an earnestness to pursue better outcomes for communities who have been underserved historically.
Monthly observances are not the only opportunity to mutually celebrate a group, culture or cause, but they offer us a time to direct a concerted focus in a day and age where focus can be hard to come by. National Hispanic Heritage Month reminds me of the incredible work of my colleagues from this community, of the gaps in health equity our work compels us to close, and of the opportunity we have every day to acknowledge and celebrate the different communities and perspectives that enable us to be thoughtful and inclusive in our work.
Aligned is a blog written by the Center for Cancer Research's (CCR) Office of Equity and Inclusion discussing diversity, equity, inclusion and accessibility (DEIA) and highlighting various ways we can all be more involved in creating a more diverse scientific workforce. Learn more about CCR's commitment to inclusion.
