Studying poverty’s impact on cancer

In Northern California, an estimated 1.4 million people live in persistent poverty census tracts. The National Cancer Institute (NCI) defines persistent poverty census tracts as having 20% or more residents living in poverty throughout 1990, 2000, and 2010. 

Living in these conditions can have detrimental effects on an individual's health and even contribute to the development of aggressive cancers since these patients face significant barriers to healthcare access and standard-of-care treatment. Improving their prognosis is a multi-faceted endeavor requiring multisector involvement. 

Last year, in an effort to advance the Biden-Harris Administration’s Cancer Moonshot initiative, the NCI awarded nearly $10 million to launch the UPSTREAM Research Center, a collaborative project between three centers: Stanford University, UC San Francisco, and UC Davis. 

“The idea was to move the needle and understand what kinds of things related to persistent poverty and impact cancer in all different ways,” said Melissa Bondy, PhD, Stanford Medicine Discovery Professor, professor of epidemiology and population health, and associate director for the Stanford Cancer Institute Population Sciences Program. For Bondy, collaboration was the natural next step for tackling this issue. 

“It takes a village to do our research. Everyone was on board and excited, and it expands our catchment area to all of Northern California, which is a really big deal.” 

The center investigates how regular income supplementation for impoverished people in several Northern California communities affects their overall health and cancer risk.

UPSTREAM has several strategic aims: (1) evaluating the impact of income-based interventions in demographically diverse persistent poverty areas in Northern California, (2) implementing innovative and collaborative cancer prevention and control programs in our catchment areas and across the Persistent Poverty Centers Network, a group of research centers that work to improve cancer outcomes in low-income communities, and (3) building a collaborative community of residents in persistent poverty areas to co-create programs to address the fundamental impacts of living in these areas. 

Pilot grants

Additionally, the UPSTREAM Research Center provides young researchers the opportunity to further their research careers through pilot grants and projects. In 2024, the center released its third round of requests for pilot proposals, jump-starting research aimed at reducing cancer inequities due to structural and social determinants of health, including systemic racism, poverty, income inequality, climate change, food insecurity, social isolation, and housing insecurity. 

“We’re getting really great pilot projects and training some incredible people,” Bondy said. 

T32 training grant 

In 2024, Stanford’s Department of Epidemiology & Population Health and the Stanford Cancer Institute launched an innovative new NCI-funded predoctoral T32 training program in cancer genetic epidemiology that aims to bridge the gaps between traditionally disparate cancer research fields with multi-disciplinary education and holistic professional development. The training program is led by John Witte, PhD, co-leader of the Stanford Cancer Institute Population Sciences Program, and Bondy.

While traditional training programs have focused mainly on specific disciplinary pathways, this program offers a distinctive training experience that unites insights across diverse fields of inquiry. The program will support five students a year, and graduates will have expertise in cancer research, epidemiology, genetics, omics, biostatistics, and disparities. Much of the program is centered in the Stanford Cancer Institute Population Sciences Program. 

“We are honored that the National Cancer Institute has recognized the need for training across the fields represented by this new program. We have developed a comprehensive program that will include a number of new courses, seminars, internships, and community outreach experiences. Key aspects of the program include leveraging big data with novel approaches and working with understudied populations to understand the causes of cancer,” Witte said. “Our graduates will be able to serve as the hub linking together teams comprising basic scientists, clinical scientists, and population scientists.” 

Students will be trained with the concept of “cells to society,” the complex interplay between biological, social, and environmental factors that shape health outcomes at the micro and macro levels. With this approach, the Stanford Cancer Institute recognizes that health is not solely determined by genetics or individual behaviors but is influenced by the social and environmental contexts in which individuals live, work, and interact. Students will benefit beyond the opportunities in the Epidemiology & Population Health graduate program by receiving access to activities, programs, pilot funding, and training resources within the Stanford Cancer Institute.

By Kai Zheng

#CancerRisk #CancerPrevention #HealthEquity