Episode 16: Voices for Equity: Conversations on Cancer Health Disparities
In this episode, we hear from Dr. Brian Rivers, Director of Cancer Health Equity Institute at Morehouse School of Medicine. Dr. Rivers shares the importance of the cancer health disparities research and his journey into the field. Then we hear from Dr. Tiffany Wallace, Program Director at NCI Center to Reduce Cancer Health Disparities (CRCHD) and lead for the Disparities and Equity Program (DEP). Dr. Wallace shares her career path in the field of cancer health disparities research and the programs that support it.
Listen and Subscribe to Inside Cancer Careers
Brian Rivers, Ph.D., M.P.H.
Dr. Brian Rivers is a Professor and Director of the Cancer Health Equity Institute at Morehouse School of Medicine (MSM). Dr. Rivers is nationally and internationally recognized as a leader in health disparities research and a retired member of the National Institutes of Health (NIH) National Advisory Council on Minority Health and Health Disparities (NACMHD). Dr. Rivers is an active member in the American Association for Cancer Research (AACR) community and serves in several ledership capacities. Dr. Rivers is a behavioral scientist with a broad background in implementation science and public health, with specific training and expertise in methodologies commonly used to addressing health disparitiesTo date, Dr. Rivers has secured more than $30 million in extramural funding through NIH. The goal of Dr. Rivers program of research is to contribute to advancing cancer health equity. More specifically, Dr. Rivers research portfolio has endeavored to expand the application of population-based intervention science to understand how to address cancer health disparities in clinical and community-based settings, using multi-level approaches, such as medical mobile apps and/or Community Health Workers/Patient Navigators.
Tiffany Wallace, Ph.D.
Dr. Tiffany Wallace is the Lead for the Disparities and Equity Program (DEP) at the NCI within CRCHD. In this role, she coordinates and strengthens NCI’s overall cancer disparity research activities, encompassing basic, clinical, translational, and population-based research. Additionally, Dr. Wallace oversees a portfolio of grant mechanisms promoting basic/translational cancer research and develops initiatives to stimulate research in underfunded areas. Prior to joining the CRCHD, Dr. Wallace was an Oncology Scientist at Human Genome Sciences, where she managed clinically relevant research programs and conducted preclinical development of promising cancer therapeutics. Dr. Wallace received her Ph.D. in biomedical sciences from the University of Florida in Gainesville, FL. She completed her postdoctoral training in the Laboratory of Human Carcinogenesis at NCI, where she conducted basic and translational research to identify biomarkers of aggressive prostate and breast cancer.
Show Notes
Brian Rivers, Ph.D., M.P.H.
Morehouse School of Medicine
Cancer Health Equity Institute
Cancer Moonshot
NCI's Center to Reduce Cancer Health Disparities(CRCHD)
Partnerships to Advance Cancer Health Equity (PACHE)
Intramural Continuing Umbrella of Research Experiences (iCURE)
American Association for Cancer Research (AACR) Science Education and Career Advancement Committee
AACR Cancer Disparities Progress Report
AACR Associate Membership
Tiffany Wallace, Ph.D.
NCI's Center to Reduce Cancer Health Disparities (CRCHD)
CRCHD Disparities Research
PDXNet
Specialized Programs of Research Excellence (SPOREs)
Translational Research Program
AACR Cancer Disparities Progress Report
NCI's Equity and Inclusion Program
The Context of Poverty | Division of Cancer Control and Population Sciences (DCCPS)
Your Turn Recommendations:
AACR Cancer Disparities Progress Report
Netflix Series "Live to 100: Secrets of the Blue Zones"
Book Recommendation: Oliver's Great Big Universe by Dr. Jorge Cham
Transcript
[UPBEAT MUSIC]
Oliver Bogler: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host,
Oliver Bogler: I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways people fight cancer and hear their stories. Today, we're talking to Dr. Brian Rivers of Morehouse School of Medicine, and after the break, Dr. Tiffany Wallace of the NCI. Listen through to the end of the show to hear our guests make some interesting recommendations and where we invite you to take Your turn.
One of the goals of the National Cancer Plan is to eliminate inequities by eliminating disparities in cancer risk factors, incidence, treatment side effects, and mortality by providing equitable access to prevention screening, treatment, and survivorship care. On this episode of Inside Cancer Careers, we're talking to two people engaged in this work. Our first guest is Dr. Brian Rivers, professor and director of the Cancer Health Equity Institute at Morehouse School of Medicine. Among many prominent roles, he has served as a member of the National Institutes of Health National Advisory Council on Minority Health and Health Disparities. He's a behavioral scientist with a focus on health disparities funded by the NIH and the Patient Centered Outcomes Research Institute, PCORI. Welcome, Dr. Rivers.
Brian Rivers: Thank you, Oliver. Thanks for the invitation.
Oliver Bogler: So Dr. Rivers, what are cancer health disparities and what is health disparities research?
Brian Rivers: So health disparities research basically is poised to help us examine and better understand why cancer disproportionately impacts certain populations more so than others. And so we see these differences. Now differences, that does not necessarily mean a bad thing. But when you look at it from an equity standpoint, and you see the disproportionate impact upon certain populations, the question begs itself, ‘why are these populations suffering more from cancer and the various types of cancer in comparison to some populations who are faring very well?’ This could be in terms of incidence, in terms of prevalence, or in terms of mortality. And so those are sort of epidemiological factors, if you will, that we use to monitor our progress and look at trends in the field and then decide what the approach should be to help address some of these adverse cancer outcomes that we're seeing.
Oliver Bogler: So the Cancer Health Equity Institute at Morehouse, which you lead, can you tell us a little bit about that? What are the strategic goals? What do your investigators work on?
Brian Rivers: Sure. And so the Cancer Health Equity Institute is nestled within Morehouse School of Medicine that is located in the great city of Atlanta in the great state of Georgia in the southern US corridor. It's surrounded within the Atlanta University complex, where you also have Morehouse College, Spelman College, Clark Atlanta University, and Morris Brown College. And so there's a nice ecosystem of of intellectual thought, if you will, for the furtherance of the betterment of all humanity. And so here within Morehouse School of Medicine, we pride ourselves on being able to lead in the creation and advancement of health equity toward health justice. In a similar vein, congruent with the overall vision and mission of this institution, the Cancer Health Equity Institute is purposed to help better understand those factors that are associated with adverse health outcomes among populations that are within our catchment area. And for our catchment area, it's primarily comprised of African-Americans and then Hispanics. And so we have investigators that are focused on basic science, foundational research. We have investigators that are focused on clinical research, as well as population science. So we tend to cover the entire spectrum.
Many of these investigators are funded through the National Institutes of Health, whether it's the National Cancer Institute, the National Institute of Minority Health and Health Disparities, or NHLBI, or NIA, just to name a few. And so these investigators are exploring either within their respective domains of science or even through a transdisciplinary approach. And that's one of the approaches we foster here within the Cancer Health Equity Institute. You know, a little bit different from your NCI designated cancer centers, of which we hopefully will one day attain that designation. But you know, we tend to help foster, you know, cross collaborations across the different sciences as well as with across different disciplines, realizing that, you know, the health disparities conceptual model is multifactorial in scope, meaning it's just not one's, you know, genome that's really, you know, impacting these adverse health outcomes. Or it's not just one's place of residence or their neighborhood or their community in terms of why they're experiencing these disparities. Or it's not just you know having, you know, horrible access to quality cancer care but it's a combination of these factors and that's how we you know pride ourselves and trying to study this very complex phenomena looking at all different factors that may be associated with the adverse outcomes and then studying them collectively, but then also appreciating what we can learn individually from them as well. So we're leading in the advancement and creation of cancer health equity through translational research as well as to focus on the other domains of research as well.
Oliver Bogler: So this multidisciplinary of your research program is really interesting to me. And on the podcast, we're very interested in sort of examining all the different kinds of investigators and, you know, knowledge workers, if you will, who can contribute to the fight against cancer. So do you have everything from, sort of bench, basic biologists to economists? What other disciplines are in your teams?
Brian Rivers: So we have a wide variety of different disciplines represented. We have immunologists, we have biochemists, you know, we have cancer biologists, we have physician scientists in the lung cancer space and the OB-GYN space and the breast cancer space. And then we have population scientists, behavioral scientists, epidemiologists, policy analysts. We have individuals that are looking at legal epidemiology, looking at the role and impact of state and federal policy, which is our ultimate governance structure for society, and how they help propagate or serve as barriers and or facilitators to health access at the community level, but also within the institutional level as well, and try and address those factors. And so, a wide variety, a wide swath of multidisciplinary investigators, all purpose to come together collaboratively. It takes a lot of professional humility to come together and serve as an MPI, for example, of an R01 grant, realizing that you bring a strength that, collectively, that is much, much greater than what you can bring then individually as an investigator. And hopefully that increases the time in which we're able to better understand some of these pathways to disparities and address them to save lives. Because ultimately, at the end of the day, that's what we're trying to do, address the burden of disease, but then at the same time help save lives.
Oliver Bogler: Yeah, I mean, that sounds incredibly fascinating to …, I can imagine being part of one of those teams alongside all these different colleagues could be a really interesting way to engage with this important question. You mentioned a moment ago, a term ‘health justice’, and I wonder if you could just help us or help me understand what's the difference between health justice and health equity.
Brian Rivers: Yeah, definitely. So health equity is basically giving individuals what they need in the amount that they need it at the time that they need it. And so providing these portals of access, but really understanding what an individual needs. Health justice is basically the elimination of any structural barriers that may serve as impediments to the uptake of these discoveries once they're made, whether they're at the bench, whether they're within clinical settings, or whether they're even at the population level, such as as different screening campaigns that may even be necessitated to, you know, really help foster early detection among a population that may be suffering from a screenable cancer. And so, you know, we try and remove, you know, the barriers or we try and address the context in which we find an individual battling cancer with, but then we try and get ahead of it, realizing that some populations are at an increased risk for different cancers for one reason or the other. And so we want to be dutiful to make sure that we're addressing the context in which that individual resides and removing those structural barriers, whether they're within the community such as a free flow of information. And we saw this as a really prominent issue during COVID, where there was just not the free flow of information throughout all of society, where everyone wasn't getting the message of the importance of quarantining or the importance for the vaccine uptake. And we also realized that, you know, especially our constituents in the rural areas, you know, there's still some trust issues with science and research. As we saw vaccine hesitancy really show itself in a prominent way. We thought we were making tremendous progress, especially at the population level, but COVID really revealed some, you know, some gaps that we need to continue to address in the field.
Oliver Bogler: I wonder for our listeners who may not be thinking about health inequities on a daily basis as part of their work, whether you could share an example. For example, I know that the incidence and outcomes of cervical cancer in rural Georgia in African Americans and Hispanic women is different from that of people in the city. Or another example, I would just love for you to tell us a little bit about what that looks like at the human level.
Brian Rivers: Yeah, I mean, that's a great example within and of itself. If I was to utilize an example that I'm very familiar with and we are currently funded to address is prostate cancer disparities. For example, we see African-American men are more likely to be diagnosed with prostate cancer than any other racial and ethnic group in this country. And we also know that African-Americans are more likely to die from prostate cancer in comparison to other groups. And the question begs itself, why?
We know that when this disease is found early, survival rates are incredible. Ten-year survival rates are close to 100 percent. And so, you know, it's incumbent upon us to figure out why are individuals still presenting with advanced stage disease? Are they not getting the screening message? Do they not have access to screening? What role does fear of diagnosis play? What role does fear of the health system play? And what role does fear of cancer in general play?
And then if you're residing in a rural area, you know, what type of health system do you have available to you to help foster early detection? And if you need to address, you know, an adverse screening outcome, you know, what kind of help is in place to help you navigate the complexities associated with understanding your cancer diagnosis, but then deciding what treatment is best for me? So with prostate cancer, for example, there's a number of options, depending on stage and and grade of disease, that one has to consider as it relates to treatment. You know, this is not an easy decision by any stretch of the imagination. We've come to develop informed decision aids, shared decision aids. We foster multi-level models that's inclusive of a patient navigation model, utilizing iterations of that, to all evaluate the role and impact of these different strategies to help individuals navigate their way across a cancer continuum. It's challenging in urban areas. It's even more challenging in our rural areas, individuals who elect to go on a radiation therapy. Some individuals in our rural areas have to travel up to three hours each way to Atlanta just for quality care. I mean, that's not going to be easy.
Oliver Bogler: And many times, right, in the course of radiation therapy, it's not just one time, right?
Brian Rivers: It's not just one time. Oftentimes, it could be three, four times a week over a six, eight week period, which is extremely taxing for someone who perhaps may not have the employment flexibility to have that much time off from work. For example, if someone's working in retail and their duty is to work a cash register, that is a very, very difficult task. And that should not impact your treatment decision. You should not compromise your treatment decision based on, well, the distance is just too far. And I know it's quality care, and it's probably the best care that I could receive, but I'm going to have to settle or compromise because of the social determinants that I'm facing as it relates to accessing these cancer care services. And so that's just one example of how we utilize or how we understand the complexities of an issue, but then how we utilize a transdisciplinary approach to help engage.
So currently we have and we're working with our geneticists. with our population scientists, such as the behavioral scientists, as well as our outreach workers, our navigators, and others, you know, to really help build out a strategy that not only addresses the individual, making sure that they are well-informed and well-equipped, but then also addressing the context where we utilize iterations of the navigation model to help them overcome the context and really access these services. And so it is a multilevel approach again, realizing the complexities that often are associated with many of the disparities that we see. I think we learned over the last 10 years that, yes, knowledge is important. Impacting one's knowledge, attitudes, and beliefs is extremely important. But at the same time, if we really want to see behavior change, if we really want to see individuals take advantage of screening or really interface with the health care system in a way that produces better outcomes, then its going to really necessitate an approach that takes into consideration how one navigates their environment.
Oliver Bogler: So many points of failure between a person getting screened or a patient getting treatment.
Brian Rivers: And we realize, and I think the architects of the Cancer Moonshot Initiative realize the value of screening, realizing that we can really make some significant reductions in cancer mortality if we got people screened. And we know COVID really delayed screening for so many individuals as the health systems overran with COVID patients. And so for two years, and some say three, that individuals have delayed key cancer screenings. You know, guideline appropriate screenings for a variety of reasons. And so, you know, some individuals are projecting that we may see an uptick in advanced stage disease as a result. And so if we're seeing that just in the general population, just imagine a population that has historically experienced disparities. I think those disparities will just be amplified.
Oliver Bogler: Dr. Rivers, you are part of a PACHE program. That's a program from our NCI Center to Reduce Cancer Health Disparities. It stands for Partnerships in Advanced Cancer Health Equity. We'll be talking to Tiffany Wallace from CRCHD after the break. Your PACHE is with Morehouse, of course, Tuskegee University and the University of Alabama Birmingham O'Neill Comprehensive Cancer Center. Can you tell us a little bit about the work that you do with this grant.
Brian Rivers: No, absolutely. And again, I just want to applaud Dr. Sanya Springfield, the visionary behind this initiative, the tremendous staff at the Center to Reduced Cancer Health Disparities, my good friend and colleague Tiffany Wallace. I'm just going to say it's been great.
PACHE - Partnerships to Advance Cancer Health Equity - has been probably an initiative that was really intended in a neat way to help raise the tide for all individuals. It brought in institutions that historically were not really considered or envisioned in the National Cancer Act. And so 50 years ago, it was a great mission. It was a great vision by the leaders at the time, you know, to foster and pass the National Cancer Act. And we know that really gave rise and coordination and structure to our cancer infrastructure here in the United States. It helped birth the NCI designated cancer centers, state cancer registries, just to name a few. And so it really helped us better understand and address the issues that cancer brought with it. But there was unevenness in terms of which institutions were awarded NCI designation and why. And we're still working on that. As you know, there's been many additions to the P30 application, which basically gives an institution that designation of NCI, meaning that they're really doing a tremendous job in addressing cancer from prevention, through diagnosis, treatment, and then survivorship as well. So it's really a testament to the type of research as well as the type of care delivery that these institutions are delivering to their constituents. So - awesome program. But then realizing that some individuals in some states didn't even have an NCI designated cancer center, let alone a cancer center. And then there was some institutions that, you know, had tremendous, tremendous reach into populations that were suffering disproportionately from cancer, whether it was breast cancer in African American women or, you know, some Asian populations and liver cancer or, you know, individuals in rural areas that just couldn't access proper screening services.
And so the idea I thought, which was an excellent idea by Sanya Springfield and her colleagues, was to help formulate a partnership. where you have these NCI designated cancer centers across the country. But what if we fostered a relationship with them, with minority serving institutions or historically Black colleges and universities? And we know that these institutions have tremendous outreach into the community, given the demographics of the student population of most of these institutions. These are the ones who we want to train and then hopefully go back into their respective communities and have a tremendous impact, based on the skill acquisition, received within the halls of academia. And so the program fosters this relationship. So we are a triad, and we're one of the oldest partnerships in the country. I think we've been trending to year 17. So much so, though, we're starting to now better understand the impact. And the true reduction in cancer-related mortality that we've had in the deep South, our data is that robust now. And we're continuing to learn. And that's one thing I've learned throughout my career, is that you just have to be a life learner. Because so many things are changing. Our understanding is changing. How we address cancer, our approach is all changing.
And so now I find myself working with individuals from the National Bioethics Center at Tuskegee, realizing that now I'm in the southern US corridor, an area that is, you know, is very familiar with injustices in research, right? And so, you know, utilizing, you know, a bioethics lens to approach disparities is something that was new to me upon entering into this partnership. So I currently serve as, you know, one of the PIs. I'm the contact principal investigator at Morehouse School of Medicine for our PACHE. As you mentioned, it's with Tuskegee, then O'Neill Conference of Cancer Center at UAB. And we're really trying to address a lot of the issues that we see in some of the poorest regions of the country, which is considered the Black belt region, which spans from Mississippi to Alabama and Georgia, and primarily rural areas, high areas of persistent poverty. I know NCI just came out with an initiative. I was fortunate enough to be on that study panel reviewing that particular initiative. And so, you know, these are individuals that are in the context with depleted resources.
But many of our HBCUs and our minority-serving institutions have outreach into these different areas because that's where the students are coming from as well as that's where a lot of community education, community outreach takes place as well. So it's only natural that the partnerships that connect you know with these schools to help foster you know more robust research, more diverse participants in research, strategic outreach that really addresses the needs within one's respective catchment area; help understand the data trends so the epidemiological trends along the lines of incidence and prevalence and mortality; and use that data at the state level to help inform state policy that then dictates the state cancer plan and or funding allocations, but even more so really help NCI better understand sort of the uniqueness of the catchment area in which you're working, then allow for the tailoring and targeting of your approach to really help address cancer within and of itself among all individuals, but then really detailing a strategic approach to those populations, that may be suffering disproportionately from cancer, whether it's prostate, whether it's breast, whether it's cervical, whether it's lung, whether it's ovarian, just to name a few.
So the partnership has really been just a tremendous asset for my career. I started in a PACHE, I was trained through a PACHE, and now to find myself in a leadership position is such an honor and a privilege that I really don't take lightly, but I really consider this golden opportunity to really make a difference and to really help advance the science.
Oliver Bogler: I want to return to one of your leadership roles as Director of the Institute for Cancer Health Equity at Morehouse. What is your vision for the Institute? Where is it going?
Brian Rivers: And so we are actively recruiting nationally. We've been able to secure some tremendous talent over the last year. I really applaud the efforts of our President and CEO, Dr. Valerie Montgomery Rice, who was a trainee of Dr. Springfield's in the iCURE program. And she gave her first training grant, or research training grant. And so, you know, she's still in that vein of really trying to, you know, address, you know, a lot of the disparities that we see in cancer.
I really applaud the work of our new dean from the University of Florida, Adrian Tyndall, all of his efforts and how he's been able to attract, you know, some new talent, especially in the cancer space. And so ultimately in three to five, maybe seven years, we hope to be, you know, the first NCI designated cancer center on the campus of an HBCU that's uniquely poised to address cancer health equity leading towards health justice. And this should be reflected in how we train our learners of tomorrow, whether they're our biomedical students or whether they're our medical students or our physician assistants or our public health students. It should be reflected in terms of Morehouse Health Care or how we deliver care to the community. And it should also be reflected in our research pillar in terms of the type of research that we conduct. We don't feel that we are competing with other centers but we are finding that niche that, you know, we have the talent, we have the bandwidth and we have the institutional support and structure to really advance health equity across all pillars. Learn ... the academia, clinical, as well as research. And so hopefully, you know, we will see that vision actualized. I know it's going to take a lot of work [laughs], but we've been working at this for quite some time and, you know, I've really been socializing this idea with many of my colleagues in the field and there's tremendous support. I'm just realizing we're nestled and just the need. Realizing that African Americans continue to experience the highest cancer-related mortality for most cancers. Even though a lot of cancer-related mortalities are on the decline for all populations, we're still seeing a disproportionate impact of certain cancers among African Americans. We think, given the heterogeneity of African Americans that we have here in Atlanta and the state of Georgia, that we have some unique contributions that we can render toward advancing science for all individuals, both nationally as well as globally.
Oliver Bogler: Sounds like an exciting time in your institute and at Morehouse in general. We'll be sure to put some links in the show notes so people can easily find your institute and maybe there's a job that they can apply for. You never know.
Brian Rivers: Absolutely. We've taken all comers, you know, especially those with NIH funding.
Oliver Bogler: There you go. So Dr. Rivers, I want to pivot slightly to another role. So we work together on the Science, Education and Career Advancement Committee for the American Association for Cancer Research. You chair that committee. You've also chaired AACR's Minorities in Cancer Research Council. And I wonder what role does AACR, a big association of over 50,000 cancer research professionals, what role does this organization play in the work of cancer health disparities and also in promoting the diversity of our cancer research workforce?
Brian Rivers: Yeah, yeah, I mean, excellent topics, Oliver. You know, I just can't say enough about Dr. Marge Foti, the CEO of AACR, the American Association for Cancer Research. She has been tremendous to the field in terms of, and globally, just not in the field domestically, but also globally as well. She has really fostered approaches that helps toward the prevention of cancer. But then also, if you you should find yourself with a diagnosis of cancer, the best treatment that one can have through providing platforms for scientists and others to come and opine and share best practices and strategies, recent discoveries, different approaches toward disparities. She's been a leader in that regard. I mean, AACR was the first professional organization to really have a meeting uniquely focused on cancer health disparities, on understanding the science of cancer health disparities among racial and ethnic minorities. And that cancer, man, that conference, we just celebrated 16 years of that conference being in existence. And it's growing by leaps and bounds. Outside of the annual meeting, it's the second most popular conference that AACR actually hosts. And they host quite a few conferences. And so I applaud Marge for just her vision and just providing opportunities. She's always evolving. Another thing that, you know, in positions of leadership within that organization that I've been able to really be a part of was the inaugural Cancer Disparities Progress Report, which is produced every other year. The parent progress report is produced annually, and the cancer disparities progress report is produced every other year.
So this is a tool that many of us use in the field. This is a tool that goes to Congress to help shape federal policy. But then we also use it at the state level as well. And it's really just a report card to really provide an assessment of the progress that we're making. Because we do want to celebrate progress. We don't want to always have a conversation from a deficit, but also from the assets, realizing that we've put a tremendous amount of resources toward this issue and that we're seeing the impact of that investment of resources. And so that's what the progress report really demonstrates, the progress that we’ve made, but then the directions we need to attenuate to going forward. Marge has held several focus groups that many of us were a part of that really helped address some of the key factors that we know are in the field, such as clinical trial participation among diverse individuals. We had a think tank, if you will, in 2018 that brought together leaders from around the world to really help develop strategies and a plan to increase diverse representation in clinical trials. I wasn’t a part of a similar think tank, which really gave rise to the Cancer Disparities Conference, but many of my colleagues were.
So to find myself in leadership positions now, I think, is extremely meaningful. It's a monumental task before us, I think you know very well. I mean, we serve on the Science, Education, and Career Advancement Committee. And that's the other side. The research is extremely important. And we really foster that NIH-funded research, of course, within the Cancer Health Equity Institute here at Morehouse School of Medicine. But workforce diversity is also germane to our approach, as well. And working through AACR, we're able to attenuate that, through Science Ed and the Career Advancement Committee that we serve on. Whether it's high school students, whether it's, you know, undergraduate students, whether it's graduate students at the master or doctoral level, whether it's individuals that are postdoctoral fellows or folks in their residency, that organization provides such a unique platform for training and for networking, especially for those that are pursuing careers within academic or government settings. It really helps foster the professional development one needs to really be successful in the field. And so I definitely enjoy my time. Again, I consider these leadership positions an honor and privilege. And then I know the calling that we have upon us as a committee to make sure that we're meeting the needs of those individuals that are coming behind us and that will be leaders one day in the field as well.
Oliver Bogler: Yeah, and I'll just mention that AACR has an associate membership level, which is designed for people in those different career, early career stages that you mentioned, students, graduate students, very affordable and gives you access to this tremendous network. I want to turn to your own path. You know, we're a career focused podcast. I'm always interested in, you know, what made you want to do the thing you do today when you look back even, you know, to your early years, what sparked your interest in science and in cancer health disparities ultimately.
Brian Rivers: Yeah, absolutely. So, you know, originally I'm from Buffalo, New York. Parents transitioned to Atlanta. Dad was in corporate America in the financial sector. So that's what got us down into the South. A lot of families are still in upstate New York. And so when we moved here, it was a bit of a culture shock. Things were different, to say the least. And my mom is an educator as well. And so she's been a primary school teacher for 40 plus years. And so there was always this fostering of education. I always just had a knack and interest in science. I don't know if that stemmed from my interest in the Encyclopedia Brown books and I love mysteries and trying to solve the mystery before the end of the book. And so always looking at a problem and trying to find solutions for the problem has always been a knack and I think science parallels nicely with that. My love for mystery books and mystery movies and science where you identify a problem but then you have to research and find a solution. So growing up I had chemistry sets and microscopes. I mean I loved the science fairs. I built solar, you know, ovens back in the 80s where I was out manipulating, you know. I did the traditional volcano understanding, you know, chemical reactions with baking soda. I mean, I just, you know, love science and, you know, just, I was able to foster that through high school. I went to a magnet high school, was focused on engineering. My initial focus was biomedical engineering. I went to Frederick Douglas High School, a public school here in Atlanta.
From there I transitioned to Vanderbilt University in Nashville, Tennessee. I was a biology major, and my exposure just opened up tremendously at Vandy. I mean, I had tremendous exposure here in Atlanta through high school, as well as elementary, but Vanderbilt just opened my eyes up to the world and saw the possibilities that were endless. And how I framed and looked at careers totally changed.
And I began to do more volunteering as a result, because I was intrigued by better understanding these different careers that historically I had not been exposed to. And so I moved from engineering, of course, biomedical engineering, more into just pure biology. And it was fascinating. And botany was wonderful. We would go out in the woods and learn what plants you can eat and what insects you can eat. And it was just fascinating. I really enjoyed it.
Oliver Bogler: Very cool.
Brian Rivers: So I began to volunteer. I volunteered at Meharry Medical College and TSU and Fisk and through the church that I was attending at the time within Nashville and just got exposed to public health. And then I started seeing how some populations are faring.
It really came to a head when I volunteered in the VUMC, Vanderbilt University Medical Center, ER, and the type of accidents and tragedies that were coming in… many were because of just poor management of disease or undiagnosed disease. And it was just striking. It was an alarming phenomenon that was happening. So I graduated, Vandy, came back, pursued a master's in public health. I got exposure through public health in Nashville. So I was at Morehouse School of Medicine, second class of their, at the time, brand new public health program. And the miles are further widening. I was part of some NIH grants that took me across the entire state of Georgia. I was part of the Governor's Honors Program. And again, just seeing just the need outside of Atlanta that existed as it relates to health and wellness. And even from a prevention side, you know, really, you know, struck a chord with me. And so I ended up, you know, doing a genogram, if you will, in one of my classes. And the task was to go and do sort of a mapping of your family history, but detailing their health history. And if you could get the information, detail what one particular relative died from, or as a result of.
So doing that, I started seeing this common thread of cancer in the family. I was like, wow. And then I saw prostate cancer. It's like, ‘Huh, what is that?’ I was a biology major. I didn't really focus on the prostate gland that much in biology and anatomy. And so doing more research led me to discover that certain populations are disproportionately impacted by prostate cancer. And there's still so many unanswered questions in terms of the why.
So I ended up doing a thesis on prostate cancer while I was enrolled in the public health program. And it was just an epidemiological study, just looking at knowledge, attitudes, and beliefs toward prostate cancer screening. And lo and behold, so many people had never heard of prostate cancer, let alone a prostate gland, let alone prostate screening. Wow, this is incredible. These are like life-saving guidelines that you should be familiar with. Are you interfacing with your health care provider on a regular basis? And so did the thesis and then ended up getting recruited over to a PhD program at UAB, University of Alabama at Birmingham School of Public Health. I was in the Department of Health Behavior. Again, got tremendous exposure to the Black belt, but I was actually down in Selma doing focus groups. Selma, Alabama, a very, very historical place, but I was down there doing focus groups, working on a grant at the time. Dr. Mona Fouad was the PI of analyzing the gap between Black and whites as it relates to prostate cancer. So I did some focus groups with providers, trying to understand, again, barriers and facilitators. Got recruited out early of my PhD program, working with my mentor, Dr. Lee Green. He was recruited to Texas, so he ended up … and recruited me to Texas A&M where I got involved in HDEART, a health disparities consortium that was led by Lovell Jones and others, and again, really, really took off in the disparity space. I think right around the time David Satcher passed some national legislation as Surgeon General during Bill Clinton's administration that really gave rise to a center at NIH for to study this phenomenon called health disparities, which was still very new.
Again, we knew the outcomes of the Heckler report during Reagan's administration about the excessive deaths that take place among Blacks and other minority populations. But there was just the Office of Minority Health, I think, at the time that had been developed to help address some of those issues that were in the Heckler Report. But then David Satcher came on board and passed a key legislation that really helped inform some infrastructure at NIH to further develop and stand up. It was just an incredible time of free flow, John Ruffin and others, Sanya Springfield, other leaders at NIH, you know, really began to put RFAs out. And I really saw a path forward for me as a career because prior to, I was told that could be an add-on, health disparities research, but that cannot be your main stay. And we do not know if you choose the academic route, if that will suffice for tenure and promotion. Got recruited out of finished up the PhD and got into a postdoc out there in Texas, then got recruited to Moffitt Cancer Center, where I was on the faculty in the Department of Health Outcomes and Behavior under the leadership of Paul Jacobsen and Tom Sellers. Bill Dalton was the CEO at the time. And just sitting down talking with all of them was just incredible. Their passion, their drive, their innovativeness, and just their approach to addressing cancer from a prevention framework as well as from a control and treatment framework was just incredible. And so I was on the faculty there for about… at least 11 years before I got recruited to Morehouse School of Medicine where I met Dr. Valerie Montgomery Rice serving on the National Advisory Council for NIMHD. And from there, you know, she laid out her vision, and this was about 2014, you know, we really need a cancer center to help galvanize resources and talent to really address the complexities. And she was so tired of hearing all of the disparities that she knew as a physician could be prevented that were resulting in people dying from the disease. And so, you know, that was my track.
That was my trajectory of how I got here to where I am today and my understanding of the field from a research perspective, but even more so a workforce diversity perspective. I think that both have to go in alignment if we really want to see a change in the field.
Oliver Bogler: You've really seen a tremendous change then, positive change in your area of interest, right?
Brian Rivers: Absolutely.
Oliver Bogler: I mean, it didn't exist in the way that it does today, even 20 years ago. And well, that's phenomenal. Thank you for sharing that. I wonder then in that context, what advice you might give to people listening who are maybe just exploring or beginning to understand what health disparities research is. And if they're interested in this, what could they start by doing?
Brian Rivers: I mean, there's tremendous resources at the National Institutes of Health, NCI in particular. There's a number of programs that individuals could be a part of at any stage they are, whether it's high school, whether it's undergrad, whether it's grad. Your Center, Oliver, the Center to Reduce Cancer Health Disparities, the iCURE program, all of these are programs to help foster insight into having a career in cancer, whether it's at the bench, whether it's at the bedside. whether it's at the community or even a policy level. So you have to reach out and get involved. I will strongly encourage individuals to network at conferences. Oftentimes we're so intrigued by the location of the meeting. We go in, we have our presentation, whether it's a poster or a podium, but we fail to really take advantage of the context of the meeting where we're networking, where we're meeting program officers. Instead of sending those emails trying to get them to respond, many of the program officers at NIH, especially NCI, attend meetings and are there for multiple days. And so I would strongly encourage individuals to value the strength of networking and identifying, through networking, mentors. And you shouldn't just have one. I'm a strong believer, and I've always been trained, that you should have a mentoring team of at least five to seven individuals. Some you talk to monthly. Some you may talk to once or twice a year. And everyone serves a different role. One could be, you know, your scientific editor. One could help you sort of envision, you know, and strategize, and others could just be for professional development. Whatever role that particular person plays, it's good to have them part of a team because the field is changing so fast. And, you know...there's a strong need to foster team science. And no one wins, you know, just, you know, ‘I'm the Lone Ranger and I'm gonna go out and cure cancer tomorrow’. But it really takes collaboration, it takes partnering, and it takes, you know, a certain level of humility to really help address these issues. And so that would be my advice, you know, take advantage of conferences or any public gathering of, you know, thought leaders, such as yourself, Oliver, that can really help shape your path going forward.
Oliver Bogler: Well thank you very much Dr. Rivers for sharing all this great information and your own path with us.
Brian Rivers: Well, thank you for having me. I really enjoyed the conversation.
Oliver Bogler: Stick around after the break, we'll be talking to Dr. Tiffany Wallace of the NCI's Center to Reduce Cancer Health Disparities.
[music]
Oliver Bogler: The NCI wants to hear from you about what we are doing to support early career cancer investigators.
We have released a new Request for Information or RFI.
It is entitled Inviting Comments and Suggestions on the National Cancer Institute’s Support of Early Career, Mentored Cancer Researchers and Trainees.
NCI is committed to supporting the training and development of the next generation of the cancer research workforce. We are seeking input on our existing approaches and your ideas for innovations we might explore - all designed to improve how we support you.
We invite suggestions and comments on all the career stages we support from middle school, high school, undergraduate and graduate studies through postdoc and fellowship to early research independence.
NCI is interested in your opinion on how our grant awards are structured and positioned and whether they could be improved to meet the needs of a diverse cancer research workforce.
Your feedback on this matter would be greatly appreciated.
Responses are due by December 29, 2023.
We’ll put a link in the show notes, but for questions, please contact nci_earlycareer_rfi@mail.nih.gov.
We look forward to hearing from you.
[music]
Oliver Bogler: Okay, and we're back. It's a pleasure to welcome Dr. Tiffany Wallace, a colleague from the NCI. Welcome, Tiffany.
Tiffany Wallace: It's a pleasure to be here.
Oliver Bogler: Dr. Wallace is a program director in NCI's Center to Reduce Cancer Health Disparities, where she serves as the lead for the Disparities and Equity Program, DEP, and works to coordinate and strengthen NCI's overall cancer disparity research portfolio, encompassing basic, clinical, translational, and population-based research. Before the break, we spoke to Dr. Rivers about his work in health disparities. So let's jump right into NCI's engagement. Tiffany, what is the DEP, and how does it address this field?
Tiffany Wallace: So the center that I work in, the Center to Reduce Cancer Health Disparities, has a really large mission and it's split between two areas. The first is promoting cancer health disparities research and the second is to focus on diversity training and workforce diversity. So my role within the DEP is focused on that first part of promoting disparities research.
As an aside, this program is going to be evolving into a full-fledged branch soon. So I'm very excited about that. But our charge is really to develop and advance research programs that address cancer health disparities and to promote health equity. And so in addition to building our own research initiatives, a huge part of what we do is to work collaboratively across all of the divisions, offices, and centers at NCI. We're interested in research that spans all research disciplines. So from basic to pop[ulation] science to clinical and across the whole continuum of cancer. So from prevention through diagnosis and treatment, survivorship and beyond. And so really collaborating and coordinating across NCIs is very key to what we do.
Oliver Bogler: You mentioned a moment ago the word branch. That's a little bit of NIH lingo. That's like a department, right?
Tiffany Wallace: Yes, right now it's a little bit more of an informal program and it'll be a little bit more of a formal branch soon.
Oliver Bogler: So early on in our podcast, we had a couple of program officers on the show. And so we've talked about how program officers interact with grants portfolios. But I want to make sure I understand the way your group, soon to be a branch, interacts with all these other groups of program officers in the divisions and centers you mentioned. So are you holding those grants or are you working together with those folks to hold the grants in those divisions?
Tiffany Wallace: Well, a combination. So, you know, our program certainly holds our own programs and research and we manage those grants. And then we work together collaboratively across the divisions. They hold the grant, but we certainly work to help make sure the initiatives have considered health disparities research and, you know, to help manage the product of the research.
Oliver Bogler: So why is NCI interested in health disparities research?
Tiffany Wallace: Health disparities are in a huge area. I think this is a bit of an evolving field. It's still relatively early, and there's a lot to be accomplished. But I do think that it's something that, whether or not we can eliminate completely, we certainly have the power to significantly reduce health disparities. And so we're making progress. We have a lot more to go, but it's such an important issue that affects so many people in society.
Oliver Bogler: So you've already alluded to the sort of breadth of your portfolio and the portfolio across the NCI and the challenges facing people engaged in this work, right? I mean, there are some significant systemic challenges. How do you measure progress and what does that look like?
Tiffany Wallace: Well, that's a difficult question. You know, certainly we can look at small benchmarks. We can look at the amount of research we're supporting and see the impact of the publications coming out. You know, I think really measuring progress is going to see that the rates of cancer incidence and the poor outcomes that we're seeing disproportionately across populations is where we're really going to be able to measure success. We see some incremental and sustained progress in this, but like I mentioned before, there's so much more that we have to accomplish before we really can even start to say we've made an impact.
Oliver Bogler: So as you think about the portfolio, what are the main areas of engagement right now that are most important, that you feel are going to make the most impact?
Tiffany Wallace: Well, I think, you know, so much of what research that's been done in this area has been done largely in silos. So basic researchers have been focusing on biology and, you know, other population focus has been looking more at the epidemiological data and then community-based and engaged research is looking, you know, specifically at the community. I think to see progress, you know, we really need to be better intersecting these factors that contribute to disparities and take a more complex approach to what we're doing.
We're making investments across all different areas, as I mentioned, different disciplines, so basic biology, population science, clinical, and we're making some significant advancements in these areas. What I think what we really are trying to focus more on now is embracing the complexity of health disparities, where we're better trying to incorporate some biological aspects with social science aspects, with more clinical aspects, and put them all together with a real eye on including the community in the development of these research proposals. So I think that's where we're heading and where we're going to see some real improvements.
Oliver Bogler: Your mechanisms, your portfolio consists of research, academic folks, learning and researching and understanding mechanisms and underlying factors and so on. How do you then take that information and make sure that it transforms how healthcare is delivered or the outcomes in the community?
Tiffany Wallace: Yeah, I mean, our goal, I think, is to collect as much information to understand what the causes are for health disparities and to try out some implementation science and see what sort of interventions can be useful. But I think that, you know, all we can do is provide the information. We don't control policies. But, you know, we have to hope that what we're finding out provides enough information that we can start changing some of the policies that might be at the root cause of some of these disparities. And so we continue to make progress and hope that it makes an impact.
Oliver Bogler: NCI is also increasing its investment in this portfolio, has been for the last several years, I'm sure that's going on across the country. What's your impression of the trends in cancer health disparities research, say over the last five or 10 years?
Tiffany Wallace: As I alluded to before, I think the trends are really starting to see these multidisciplinary approaches, these large kind of system science approaches where we're really trying to get different disciplines interacting and speaking with each other. So we know that biology is not a driver of disparities, but perhaps is a contributor. We know that largely the drivers are social determinants of health and impacts from environment. But getting these different aspects of science to interact and to really make the big picture clearer, I think that's where we're heading.
Oliver Bogler: And if I could ask you to project maybe five or ten years into the future, where do you think we'll be?
Tiffany Wallace: I think we'll have moved beyond identifying what the disparities are. Maybe we'll be a little bit further in developing some sustainable interventions and starting to have a better understanding of the root causes and aiming our interventions more at not just fixing the problem we see but getting to interventions that could perhaps stop the problem from starting.
Oliver Bogler: That sounds exciting and I hope it comes true.
Tiffany Wallace: Me too, you know, I don't know, five years is a short time. Maybe a little bit further out, but it's the direction I think we're all hoping to head.
Oliver Bogler: So I understand you also oversee a portfolio of grant mechanisms promoting basic and translational cancer research and initiatives to stimulate research in underfunded areas. Can you tell us a little bit about that work?
Tiffany Wallace: Yeah, so when I started my role in the center, I took over a program that's been around for, you know, quite some time. It started in 2010, and that's focused on basic research in health disparities. This is a collaboration with DCB, Division of Cancer Biology and DCP, Division of Cancer Prevention. It's really focused on understanding the biological contributors of disparities, a focus on more of the mechanistically focused studies.
What's been interesting though is that since this started in 2010, we've really seen this program grow and evolve with the field. As I mentioned, we understand biology is likely not a driver of disparities, but maybe just one contributor. And so it's been great to see that many of the proposals coming in and being funded have more of a focus looking at these social determinants and the environment and investigating how these factors are getting under the skin, influencing biology, not just looking at germline risk factors. We have some other programs with more of a focus on translational research. So this has been two programs I'm very proud of that I started working on early in my role in CRCHD. I really had an interest to see some basic research findings translate better into the clinic or, you know, relate to public health. And so through some very strategic collaborations, mostly with the Division of Cancer Treatment and Diagnosis, we had these two programs start up about in 2018. The first is the PDXNet, right? This is a network that was designed to advance precision medicine research efforts.
Oliver Bogler: What's a PDX, sorry, for our audience?
Tiffany Wallace: A patient-derived xenograft. And so this is a patient, a cancer model that's derived directly from patient tissue. And the network in general is designed to do this collaborative development of these patient-derived models and then use these models, kind of like a little mini clinical trial in animals, to test these therapeutic agents that are very targeted.
Oliver Bogler: Because the PDX models are much more faithful to the human disease, right?
Tiffany Wallace: Exactly, they've gone much further than a traditional cell line and they incorporate some of the heterogeneity that you see in the tumors and they're kind of shown here in the animal model. And so the goal of this network is really to help us with a prioritization and a rationale for what sorts of agents should be going into early phase trials. And what we did is we joined this network and we fund a few of these centers that have a real focus on developing models from underserved or underrepresented populations to increase representation of these models that better reflect the community. And also they're asking research questions on why do we see some therapeutic outcome disparities and better understand what might be going on there. So I'm super excited that we just got reissued and it's starting a new round of research and it's been very productive.
Another area that we've been working on are with the SPOREs, the research, Specialized Programs Of Research Excellence. For this, we've collaborated closely with the Translational Research Program, which is the home of the SPOREs. If you're familiar with this program, they've been around for over 30 years, and the hallmark of it is translational research. And so most people, when they know of a SPORE, these are large prestigious grants, they're organized by the organ site. So you might know a breast SPORE or prostate cancer SPORE. But they also encourage programs to focus in on more thematic areas, so like addressing health disparities. But despite disparities being a real priority area for the SPOREs, we haven't had a SPORE with a focus in on health disparities. And so we started a planning grant opportunity to help these investigative teams get more competitive in making an application focused in on addressing health disparities. In total we were able to fund 12 planning grants, and they span so many different cancer sites and different populations, and we're super excited to see where they go.
Oliver Bogler: That's a lot. So traditional SPORE, I used to be part of a brain tumor SPORE before I came to NCI. Traditional SPOREs are groups of projects that are all translational, as you said, and they're trying to head to the clinic, right? Or they're connected to the clinic. And the idea is that the project sort of mature out of the SPOREs as they become clinical trials and new projects come in. Is that the same way that you're constructing the health disparity SPORE?
Tiffany Wallace: Exactly, yes. They have the same requirements and they're doing early phase clinical trials to try to address these research questions. Now, we haven't had a full SPORE come in even yet with these planning grants to date, but the TRP is leading a new RFA and hopefully we're going to see more. These are going to be just like a regular SPORE, but using a cooperative agreement mechanism and to see some of these research questions related to health disparities and minority health be investigated in this program.
Oliver Bogler: And that's the Translational Research Program that's going to issue a request for applications just to expand on those acronyms.
Tiffany Wallace: Yes, acronyms, I'm sorry, I speak federal.
Oliver Bogler: Not at all. Yes, it's part of our DNA, which is deoxyribonucleic acid, in case you're wondering. Fantastic, thank you very much. Those are also, that sounds like a great new program as well. Excited to see what happens there.
You have many roles at NCI, Tiffany. You also serve as the co-chair of a working group that's part of NCI's Equity and Inclusion Program. The working group is called Enhancing Research to Address Cancer Health Disparities. Obviously, something near and dear to your heart. You work with Dr. James Doroshow and Dr. Worta McCaskill-Stevens on that. I wonder, what is the focus of that group or obviously the title is suggested, but what have you been up to with that working group?
Tiffany Wallace: Yeah, this working group is very overlapping with the work that I do in depth that we talked about. I couldn't have been luckier than to be teamed up with Dr. James Doroshow and Dr. Worta McCaskill-Stevens. I mean, they're just notable names and such impact in the field. Some of what we've done has been focusing on soliciting input from various thought leaders and community members about, you know, what recommendations they have for helping us to advance the field of disparities and promote health equity. And we've had some other activities more focused on supporting research in the area that we thought were very important, things like how we could better increase clinical trial diversity and how we could advance persistent poverty research agenda, which is a big focus right now within the NCI. So we have a bunch of other activities in the works, looking a little bit more maybe broadly at some policies that we could consider. Trying to encourage more investigators that aren't doing disparities research to still use an equity lens when they're putting their proposals together. So we're doing a lot of different activities that kinda all go in a different direction.
Oliver Bogler: I'd like to talk about your own path, your own career a little bit. Always fascinated to learn how people got into science. So what sparked your initial interest in science broadly?
Tiffany Wallace: Well, I've always been a bit of a science nerd. I think we all share that in common. This goes back to elementary school, so it's not surprising that I chose to pursue this in graduate school. I did my initial graduate studies focusing really on signal transduction work, cardiovascular, really far removed from anything clinically relevant or, you know, public health related. So for my post-doc, I really wanted to come and make it a little more personal, go into cancer research. I think everybody in, you know, by now has been touched by cancer in some way, and you know, I had that through some family members, and so I was really lucky to join the lab here at NCI with Dr. Stefan Ambs in the Laboratory of Human Carcinogenesis where he was, you know, combining basic research interests that I had, but with more of a molecular epidemiology slant to look at aggressive markers for prostate cancer and breast cancer. And so we had this great case control cohort and it was really wonderful to be able to look at these differences that we were seeing by ancestry and understanding why some patients were more at risk of prostate cancer and aggressive disease than others.
So it really sparked my passion for understanding what the causes were and it's really been the end of the story for me. I've just been growing and focusing in this field since then.
Oliver Bogler: So there is this saying that I've heard before, which is that when you think about your health outcomes, your zip code is more important than your genetic code. So it sounds to me like you almost moved from the genetic code to the zip code between your post-doc and what you're doing today. Is that fair?
Tiffany Wallace: Yeah, I mean, I think I firmly have one foot in genetic and the other in the zip code area. I realize how important both of those aspects are and really kind of combining it, I think, is really key.
Oliver Bogler: So what though triggered, you know, you were doing your postdoc, you were interested in biomarkers, what then made you wish to transition both in terms of your role and what you do day to day, and also in that shift in focus, if you will, from genetic to zip.
Tiffany Wallace: Well, the focus from genetics to zip just happened organically. I don't think you can be working in the field of health disparities and not have appreciation for all the competing and complex factors that contribute to disparities. And so while my training and my passion is still very much in the more genetics side of things, I would only be able to take the field so far without kind of expanding. And so as part of the new branch, you know, we're going to be hiring and looking for program officers to join with unique and complementary expertise so we can, you know, work to get a better view of exactly what's happening and how we could better tackle these hard issues and hard problems.
Oliver Bogler: And then I guess that's the same reason then that you moved from a sort of right on the interface of research to being in a program role, you wanted to broaden your impact, I imagine.
Tiffany Wallace: Yeah, I mean I guess nothing's as simple as that. I knew from the very beginning I wanted to go into industry. I wanted to work at a biopharmaceutical company and I did do just that. After my post-doc I went into a company, Human Genome Sciences. They have since been bought out by GlaxoSmithKline. I really loved it there to be honest with you. So it goes to show no one's career path is a straight line, right? It always takes its turns. But, you know, I definitely, I missed working in the field of disparities and I had twins at the same time as my company got bought out and it made me do some soul searching. And coming back into the government felt like the right change for me and focusing back in on health disparities just seemed like a really nice organic fit for what I wanted to accomplish.
Oliver Bogler: And an exciting time in the field with all that's going on.
Tiffany Wallace: Yeah, I mean it continues to get more and more attention, which is just wonderful.
Oliver Bogler: So then lastly, people listening to our conversation wondering maybe how they could become engaged in health disparities research or how they could even just add that lens to their own work. What's your advice to our listeners?
Tiffany Wallace: Well, if you're interested in doing disparities research, I wholly encourage you to go for it. You know, all research should be rewarding, but I think doing this line of work just is truly special. You know, there's a real need for making an impact in this space, and we have a long way to go. I think, as I mentioned, we're kind of at the early stages of this field, and a lot more to learn and grow.
If I were to give advice, it would be to be open to having diverse training experiences as you're getting more in tune with this area. Lean into the different disciplines and really seek out collaborations outside of your comfort zone or what would seem traditional for you to do. We really need data scientists working with basic researchers and staying in tune with the social scientists and really prioritizing and incorporating the community into all the research. And so I guess that would be the path forward is, you know, don't stay too focused. Keep an open mind.
Oliver Bogler: And what might some resources be that our listeners could access? We talked to Dr. Rivers in the first part of the show, and he, of course, heads an institute at Morehouse. So if you're at Morehouse, just go connect with him. But what about elsewhere or online things that you might recommend?
Tiffany Wallace: Well, if you're just getting into this field or you really wanna look at the state of the science, I think tuning in, if you're not familiar with it, AACR does a Cancer Disparities Progress Report. They publish this every two years. The first one started in 2020, and it's really a really comprehensive review of the field. And what I really like is they put some explicitly stated call to action recommendations in there that are just so important, and they intermingle it with stories from patient advocates, so it makes it very special.
If you already know that you're into this field, you're looking for collaborators, then going to the AACR Disparities Meeting, they have one every year focused only on the science of health disparities. They just had the 16th one earlier this month. It's one I go to every year, and it's a great place for establishing some collaborations and hearing about the exciting things.
But it's a hot area. If you're interested in this, you can get a seminar on it probably weekly here on really interesting topics. Persistent Poverty just started a new seminar series that's open to the public that I definitely recommend checking out. So…
Oliver Bogler: Those are some great recommendations. We'll put links in the show notes as always. Well, thank you very much, Tiffany, for coming and sharing your insights and your experience. Thank you.
Tiffany Wallace: Oh, absolutely. It was a pleasure. Thank you for the invitation.
[music]
Oliver Bogler: Now it's time for a segment we call Your Turn, because it's a chance for our listeners to send in recommendations that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast or a talk or anything that you found inspirational or amusing or interesting. You can send those to us at NCIICC@nih.gov. Record a voice memo and send it along. We may just play it on an upcoming episode. Now I'd like to invite our guests to take their turn. Let's start with you, Dr. Rivers.
Brian Rivers: OK, so my recommendation will be for everyone to familiarize yourself with the American Association for Cancer Research Cancer Disparities Progress Report. Again, this report is produced every other year. And it really helps explore issues and provides an action plan, if you will, toward addressing health disparities and advancing health equity. So it's a tremendous document. It covers many of the cancers. It covers workforce diversity. Covers research, care delivery, recent advances in the field. It just really gives you a nice comprehensive overview of where we are in the field and what needs to happen. And it really helps attenuate and highlight a lot of the great funding that NCI has put forth toward helping us better understand cancer, most importantly, eliminate cancer. And so I strongly encourage everyone, if you haven't, familiarize yourself with the AACR Cancer Disparities Progress Report. Please do. You will not regret it.
Oliver Bogler: It's a great recommendation, a great way to start learning about this field and what's going on. Thank you for that.
Brian Rivers: Thank you, Oliver.
Oliver Bogler: Tiffany, what's your recommendation?
Tiffany Wallace: Okay, I thought about this a little bit. I stream a fair amount of TV series to unwind with my husband and just relax. And, you know, one that I really like, I'm watching it currently, I'm only two episodes in, so you know, more to come, is this documentary that's called Live to 100. I don't know if you heard about it, Secrets of the Blue Zones. So.
Oliver Bogler: I have not heard of this, no? Interesting.
Tiffany Wallace: No, it's very interesting. So they've done all this work previously to identify these areas they call blue zones that have higher frequency of people living over 100. And they're trying to understand what gives people in these areas longer longevity. A lot of what they're finding is what you would think, links to diet and exercise. But some of it's a little bit more interesting.
Some differences on lifestyle or social circles or philosophies and it's always good to hear some recommendations on how to improve your health and my kids even like it at 11 years old so I would recommend it.
Oliver Bogler: For sure. That's cool. Okay, thanks. We'll dig that out and put a link in it into the show notes as well. I'd like to make a recommendation as well. It's for a new book from Dr. Jorge Cham, who's I think famous for his PhD comics, piled higher and deeper. A lot of people are familiar with those. And actually, I think in our very first episode, we had a recommendation for them. He's got a new book and it's called Oliver's Universe. So, I'm naturally drawn to it, of course, because the protagonist has such a great name, but it's also because it's funny, it's enjoyable, and it talks about science in a way that young people of all ages can enjoy. If you have a middle schooler in your life and are looking for a way to get them thinking about STEM, take a look at this great new book, Oliver in the Comics is 11, so that gives you an idea of the age focus. So we'll put a link to that one as well. And if you're listening and you want to send a recommendation in, please do so as well.
That’s all we have time for on today’s episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.
We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at NCIICC@nih.gov.
Inside Cancer Careers is a collaboration between NCI’s Office of Communications and Public Liaison and the Center for Cancer Training.
It is produced by Angela Jones and Astrid Masfar.
Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won’t miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.
If you have questions about cancer or comments about this podcast, email us at NCIinfo@nih.gov or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.
We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.