Addressing Cancer Disparities in Appalachia

“For people struggling to make ends meet, the last thing on their minds is health care,” said Electra Paskett, who has devoted her 30-year career to addressing cancer disparities experienced by underserved groups in the United States. “The question we want to answer is how to reach them,” she said.

Electra’s efforts to address cancer disparities through science and community partnerships, which NCI has supported over the last two decades, have led to important improvements in cancer screening and care in rural and low-income populations where cancer rates have remained stubbornly high. Populations in the Ohio Appalachian region and inner-city African Americans, in particular, have benefited from her studies.

In the Appalachian areas of Ohio, Kentucky, Pennsylvania, Virginia, and West Virginia, the rates of lung, cervical, and colorectal cancer incidence and mortality are higher than anywhere else in the United States. “It’s all about figuring out why,” said Electra. To identify the causes of these disparities and develop ways to reduce them, she conducts research to develop and test interventions.

Her approach includes partnership building with local clinicians and public health officials and, most importantly, with members of the community. “The people who live there in those communities know what strategies work best for them,” explained Electra. This community-based participatory research approach means she often takes road trips into the heart of Appalachian country.

In these less-populous areas, she meets with locals, listens to their stories, and asks for their perspectives on how to address their higher-than-average cancer incidence and mortality rates. With their assistance, Electra has successfully pinpointed public health flaws and gaps.

Her research has tested such initiatives as working with local churches to promote healthy eating and exercise, conducting outreach to parents and clinicians to improve rates of HPV vaccinations among adolescent girls, and implementing mammogram vans to make breast cancer screening more accessible. By working with communities and implementing culturally sensitive strategies, Electra has found that people will be more proactive about their health needs and even adopt healthier behaviors, such as regular cancer screenings, when appropriate programs and incentives are put into place.