Addressing Health in Areas Characterized by Persistent Poverty

David W. Wetter, PhD

The Center for Health Outcomes and Population Equity (HOPE) at Huntsman Cancer Institute and the University of Utah (the U), in partnership with the Montana State University Center for American Indian and Rural Health Equity (CAIRHE), received a grant for Cancer Control in Persistent Poverty Areas from the National Cancer Institute (NCI), part of the National Institutes of Health. The new grant is part of the National Cancer Moonshot, led by the Biden-Harris Administration, and it will bring together the expertise of the Center for HOPE and CAIRHE to expand their impact through two initiatives that address poverty as a fundamental cause of cancer-related inequities.

The grant falls under the Persistent Poverty Initiative, started by the NCI. Their goal is to empower institutions, clinics, communities, and tribes to collaborate and develop a cancer prevention and control research program that focuses and serves people living in persistent poverty. They aim to provide resources and support for this collaborative effort.

“The poverty level for a family of four is an income of $30,000 a year or less,” explains David W. Wetter, PhD, senior director of cancer health equity science and director of the Center for HOPE at Huntsman Cancer Institute, and a Jon M. and Karen Huntsman Presidential Professor in the Department of Population Health Sciences at the U. “Unfortunately, people living in poverty have a far greater likelihood of getting almost every type of cancer, and it’s critical to eliminate this inequity if we are meaningful reduce the pain and suffering due to cancer.” Alexandra Adams, MD, PhD, director of CAIRHE at Montana State University and co-PI for the grant notes that the inequities for Native American communities are especially severe.

Chelsey Schlechter, MPH, PhD, researcher at Huntsman Cancer Institute and assistant professor of population health sciences at the U, will lead a project in Utah that addresses the social determinants of health and tobacco usage. Social determinants of health are factors that put a person at a higher risk of getting cancer such as being born into poverty, uninsured, have unstable housing, or a lack of education. Wetter says that tobacco usage, which greatly increases the risk of getting cancer, has become heavily concentrated in areas where people are experiencing poverty and are medically uninsured.

Emily Tomayko, PhD, RD, Assistant Professor in Health and Human Development and CAIRHE researcher at MSU will lead a project addressing the social determinants of health and addressing obesity prevention to lower cancer risk in Native American populations across four states. The project uses a culturally tailored family-based wellness program based on two randomized clinical trials by Drs. Tomayko and Adams developed in partnership with 8 tribes nationally.

“We have Montana experts involved in our Center for HOPE tobacco use project and Utah experts involved in the CAIRHE obesity project,” says Wetter. “Because of these collaborations, it gives us the opportunity to have a much greater impact with respect to reducing health inequities.”

Together, these initiatives are called HOPE and CAIRHE 2gether (HC2). According to experts at NCI, the long-term goal of H2C will be to build capacity to foster cancer prevention, conduct research and promote the implementation of programs and practices throughout areas of persistent poverty to reduce the effects of cancer-related disparities.

“HOPE and CAIRHE 2gether is not only funding incredibly exciting research but is so much more given it establishes the foundation for a new partnership to address health inequities across Montana and Utah, as well as additional states,” says Neli Ulrich, PhD, chief scientific officer and executive director of the Comprehensive Cancer Center at Huntsman Cancer Institute. “The populations living in persistent poverty addressed by HC2 include large proportions of Latinos and Native Americans, as well as rural and frontier areas. These populations face major challenges in cancer prevention and care. Doctors Wetter and Adams have brought together an exceptional team, and we are thrilled about this important new partnership with Montana State University.”

In addition to the grant to study Cancer Control in Persistent Poverty Areas, the study is also supported by the NCI including P30 CA042014 and Huntsman Cancer Foundation.