20
11th Annual Health Disparities Symposium 2010
11th AnnualHealth Disparities Symposium
2010
Controversies in Cancer Science:Translating the Science into Community
Practice to Improve Health Equity
Roshan Bastani & Antronette Yancey
UCLASchool of Public Health
Jonsson Comprehensive Cancer Center
Wednesday, October 27th, 2010
2010 Symposium
*Includes nephrotic syndrome and nephrosis.
Source: Centers for Disease Control and Prevention. National Vital Statistics Reports, Vol 57, No 14. April 2009
1. Heart Disease 631,636 26.0
2. Cancer 559,888 23.1
3. Cerebrovascular diseases 137,119 5.7
4. Chronic lower respiratory diseases 124,583 5.1
5. Accidents (unintentional injuries) 121,599 5.0
6. Diabetes mellitus 72,449 3.0
7. Alzheimer disease 72,432 3.0
8. Influenza & pneumonia 56,326 2.3
9. Nephritis* 45,344 1.9
10. Septicemia 34,234 1.4
Rank Cause of DeathNo. of deaths
% of all deaths
U.S. MortalityTop 10 Causes of Death
Age Disease
35-44 Cancer
45-54 Cancer
55-64 Cancer
65-74 Cancer
75-84 Heart Disease
85+ Heart Disease
Leading Causes of DeathsUSA
Source: Centers for Disease Control and Prevention. National Vital Statistics Reports, Vol 57, No 14. April 2009
Ethnic Variation in Cancer IncidenceUSA
0
50
100
150
200
250
300
Colon Lung Breast Cervix Prostate Liver
Non-Hispanic WhiteAfrican-AmericanHispanicAsian American
Sources: National Cancer Institute. Surveillance Epidemiology and End Results (SEER). Cancer Statistics Fast Stats. 2006.
Causes of Cancer Disparities
• Probably not genetic
• Nutrition & Physical Activity
• Tobacco use
• Environmental agents
• Viruses (Hepatitis B, HPV)
• Lack of early-detection/screening
• Lack of timely and aggressive treatment
Long-Term Goal
University Community
Reduce health disparities in our diverse populations
Community-Partnered Prevention and Control Programs are Critical
Important to only implement programs that work
How do you know if a program is effective?
RESEARCH
incremental, messy, one study does not prove anything
RESEARCH
Therefore: end up with contradictory findings
Cancer Incidence Rates* Among Men US, 1975-2005
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Prostate
Lung & bronchus
Colon and rectum
Urinary bladder
Non-Hodgkin lymphoma
Rate Per 100,000
Melanoma of the skin
*Age-adjusted to the 2000 US standard population and adjusted for delays in reporting.
Source: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.
0
50
100
150
200
250
1975 1978 1981 1984 1987 1990 1993 1996 1999 2002 2005
Prostate Cancer Incidence & Mortality, US, 1975-2005
*Age-adjusted to the 2000 US standard population.
Sources: Surveillance, Epidemiology, and End Results Program, Delay-adjusted Incidence database: SEER Incidence Delay-adjusted Rates, 9 Registries, 1975-2005, National Cancer Institute, 2008.US Mortality Data 1960-2005, US Mortality Volumes 1930-1959, National Center for Health Statistics, CDC, 2008.
Rate Per 100,000
Incidence
Mortality
UCLA Partnerships: Enhance Health Equity
UCLA Investigators
Roshan Bastani, PhDAntronette Yancey, MD, MPH
Beth Glenn, PhDRitesh Mistry, PhD
Annette Maxwell, DrPHWilliam McCarthy, PhDBarbara Berman, PhDCatherine Crespi, PhDAlek Sripipatana, PhD
Project Staff
Jennifer Tsui, MPHRoena VegaKathleen Yu
2004-20092009-2014
LAC-DPH InvestigatorsPaul Simon, MD, MPH Rita Singhal, MD, MPH
Community PartnersAmerican Cancer Society
Asian Pacific Healthcare VentureCabrillo Economic Development Corp
California Food Policy AdvocatesClínica Romero
Herald Cancer AssociationLA County Department of Public Health
North East Valley Health Corp
Partnered for ProgressPacoima Beautiful
SaathSpecial Service for Groups
Tri-County Cancer DetectionT.H.E. Clinic
Venice Family ClinicWorksite Wellness LA
UCLA Partnerships: Enhance Health Equity
Phillip Koeffler, MD
2009-2014Partnership to Eliminate Health DisparitiesCharles Drew University & UCLA Cancer Center
Cancer Outreach Program
UCLA Drew
Roshan Bastani, PhD
Annette Maxwell, DrPH
Roberto Vargas, MD
Keith Norris, MD
David Martins, MD
Mohsen Bazargan, PhD
Loretta Jones, MA
Nell Forge, PhD
Colorectal Cancer Screening in Primary Care Practice
UCLA Drew
Roshan Bastani, PhD
Michael Rodriguez, PhD
Mohsen Bazargan, PhD
Chizobam Ani, MD, MPH
Kenneth Wolf, PhD
• Research• Community outreach• Training next generation of scientists
Jaydutt V. Vadgama, PhD
UCLA Kaiser Permanente Center for Health Equity
• Conduct community-partnered intervention research to mitigate disparities
• Technical assistance, leadership development, community engagement
2004
2009
Co-Directors: Roshan Bastani & Antronette Yancey
Associate Director: Hector Rodriguez
Project Director: Alek Sripipatana
Special thanks to Kaiser PermanenteKaiser Permanente Southern California
Benjamin K. Chu, MD, MPH, MACP
Diana Bontá, RN, DrPH
Angela Coron, MPH
Patrick Burkhardt
Center Advisory BoardTony Kuo, MD, MSHS
Aliza Lifshitz, MD
Anne Staveren, MD
Zul Surani, MPH(c)
Thank YouSymposium Planning Committee
UCLABeth Glenn
Joyce Guinyard Alison HerrmannJammie Hopkins
Yvonne HungCathy Lang
Annette MaxwellWilliam McCarthy
Ritesh Mistry Alek Sripipatana
Jennifer TsuiRoena VegaKathleen Yu
Community Partners Kaiser Permanente
Linda Aragon June English
Brian MontañoAlbert PachecoMarlene RamosVeronica PadillaSylvia Rodriguez
Debra RosenRita SinghalZul Surani
Mae SwobodaEric Wat
Patrick BurkhardtTim Nguyen
Nilushka MelnickMaria Carrasco
Dr. Yancey’s 20-Year Journey
Mahatma Gandhi:
First they ignore you,
then they laugh at you,
then they fight you,
then you win!
Dr. Yancey goes to Washington!
Just out from UC Press this month!
"In Instant Recess, Dr. Yancey provides the tools to get America moving, in a very accessible style with the scientific research to back it up…”
--Sen. Tom Harkin (D-IA), Chairman, Senate HELP Committee
“Dr. Yancey writes on a topic about which she is both passionate and knowledgeable. Instant Recess is scientifically valid and culturally sensitive. It is doable in just about any setting. It could get America moving again.”
--David Satcher, MD, PhD, 16th Surgeon General of the US
Part personal memoir, part public health manifesto, and part poetry, Yancey’s warmth and enthusiasm shine through this book. I’m betting that she can convince anyone that moving more is not only good for health, but easy and lots of fun to do.”
--Marion Nestle, PhD, Food Politics
“Instant Recess is a necessary part of a complex solution to our society’s epidemic of inactivity. It can work equally well in the corporate boardroom, school classroom, or for fans at a sporting event for that matter. It is a great place to start if we don’t want to leave anyone behind. I’m all for breaking our national inertia with a musical beat and a smile on our face.”
--Dave Winfield, National Baseball Hall of Fame 2001
Praise for Instant Recess
