Shaping Solutions: Partnership Helps Bridge Health Gaps

Web Extra! Hear Tuskegee scientist Adelia Bovell-Benjamin, Ph.D., discuss nutrition, culture at cancer.

Edward Partridge, M.D., and Timothy Turner, Ph.D., are men of science. But when they met a few years ago at a conference in New Orleans, the conversation quickly turned to geography.            

Dr. Partridge, now director of the UAB Comprehensive Cancer Center, already had received funding to develop a partnership with Atlanta’s Morehouse School of Medicine. Dr. Turner, a Tuskegee University biologist and now deputy director of its National Center for Bioethics in Research and Health Care, was interested in joining the collaboration.            

“I took out a napkin and drew a triangle of this possible three-way partnership,” Dr. Partridge says. “We realized that Birmingham, Atlanta, and Tuskegee are equidistant. And if you look at the African-American population in the United States, the highest concentration forms a crescent that starts in North Carolina and goes to eastern Texas. Our triangle sat in the middle of that crescent.”

That’s when Dr. Partridge and Dr. Turner realized just how important the partnership could be. “We’ve known for about a decade and a half that health disparities exist, and we know some of the reasons they exist,” Dr. Partridge says. “In cancer, there are differences in education and cancer-awareness levels between served and underserved individuals. There are differences in ability to access care and in the quality of care once you gain access. And there are small, but real, biological differences based on genetics.            

“We need to understand how we can make modifications in these areas—awareness, access, quality of care, and biological differences—and how we can make a positive impact on the ultimate detection and treatment of cancer.”            
That is the goal behind the Morehouse/Tuskegee/UAB Cancer Center Partnership. The National Cancer Institute first funded the partnership in 2001, and in late 2007, renewed funding another five years.            

“The purpose of the partnership is to increase the research capabilities of the minority-serving institutions so they can be more competitive for extramural funding,” Dr. Partridge says, “and to enhance the capability of the majority-serving institution to conduct cancer health-disparity research.”            

The partnership focuses on four areas—research, career development for junior investigators, cancer education, and community outreach. Specific initiatives include a summer education program in cancer biology, health disparities, genetics and bioethics for students at all three campuses; a grant-writing program for young scholars at Morehouse; a yearlong training program for junior faculty at the three campuses; a UAB navigator program to help underserved patients overcome barriers to participation in clinical trials; and new undergraduate courses at Tuskegee geared toward cancer biology and health disparities.            

Mona Fouad, M.D., director of UAB’s Minority Health and Research Center and co-principal investigator for the partnership with Dr. Partridge, says the arrangement builds on each partner’s assets while developing a culture of collaboration. “UAB is a research-oriented institution providing a wonderful infrastructure for investigators,” Dr. Fouad says. “Morehouse is part of the Georgia Cancer Coalition and promotes cancer screening and treatment. And Tuskegee has strengths in its undergraduate programs, plus the areas of cultural competency and rural health.”            

Among those strengths is Tuskegee’s Healthy Lifestyle Program. Vivian Carter, Ph.D., a Tuskegee sociology professor, led an effort to recruit nine team leaders and two nurses who promote the benefits of exercise and nutrition. “The main goal is to get the community involved in reducing cancer and the risk of cancer,” Dr. Carter says. “This is not about individuals, but about the larger community. We recruited people who are involved in the community, and we want them to infuse this knowledge throughout the area.”            

“I’ve been walking and encouraging people to walk,” says team leader Irene Taylor. “We have about eight women in our group right now, and our oldest member is 82. She leads the pack, and I say, ‘When I grow old I want to be just like you.’” Other exercise activities include water aerobics, floor aerobics, and even tai chi.            

Johnnie Cook, who has more than 30 years of nursing experience, enjoys spreading the nutrition gospel. She laughs when she recalls walking up to strangers in the grocery store and gently encouraging them not to buy pork products. “I say, ‘Don’t eat the pig,’” Ms. Cook says. “I’ve seen what fat can do to you. I’ve seen how it clogs your heart and leaves a waxy substance in your arteries. Our nutrition program has taught us to modify our diets, and we want to help others do the same thing.”            

People like Ms. Cook and Ms. Taylor are critical to the success of Healthy Lifestyle, says Dr. Carter. “For many of them, this is like a ministry. It cannot come from the campus; it has to come from the community. Our job is to equip them with the tools they need to feel confident and comfortable in putting forth the message.”            

That’s the kind of connection the Morehouse/Tuskegee/UAB Partnership is designed to foster. Such efforts could make a dramatic impact over the next 10 years, Dr. Partridge says.            

“There should be no difference in the ultimate cancer outcome, whether you are white or black, rich or poor, insured or uninsured. We’re not even close to that as a nation right now, and that’s morally and ethically unacceptable—in addition to being very expensive.            

“First, every citizen needs access to care. Second, we need to elevate the importance of cancer prevention. We put most of our emphasis on treatment, but we either don’t pay for or undervalue prevention and early detection. We also undervalue research in prevention and behavioral change.            

“We know enough already to prevent 70 percent of the deaths we have from cancer,” he says. “We just don’t apply what we know.”