Today [June 26], the Biden-Harris Administration awarded $50 million to launch the Persistent Poverty Initiative, an initiative to alleviate the cumulative effects of persistent poverty on cancer outcomes by building research capacity, fostering cancer prevention research, and promoting the implementation of community-based programs.

The Persistent Poverty Initiative is the first major program to address the structural and institutional factors of persistent poverty in the context of cancer. It is coordinated by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH). These awards create five new Centers for Cancer Control Research in Persistent Poverty Areas that will advance key priorities of the Administration’s Cancer Moonshot — to reduce inequities in the structural drivers of cancer and prevent more cancers before they start by reducing tobacco use and making sure everyone has access to healthy food.

Persistent poverty areas are defined as those where, for the past 30 years, 20% or more of the population has lived below the federal poverty line. People who live in such areas have a higher incidence of cancer, experience delays in cancer diagnosis and treatment, and are more likely to die from cancer than people who do not live in poverty. However, there has been limited research on how to improve cancer outcomes in persistent poverty areas.

“Persistent poverty is a place-based and community phenomenon that reflects a failure of the structures and institutions in society, including health care,” said Shobha Srinivasan, PhD, senior advisor for health disparities and health equity in NCI’s Division of Cancer Control and Population Sciences. “Conducting research to understand the connections between institutions — such as social, economic, and health systems — and persistent poverty is the only way to inform changes to social conditions and determinants of health that will ultimately improve overall health, cancer control, and cancer outcomes.”

Each center will work with targeted low-income communities to implement and measure the effectiveness of structural interventions for cancer control and prevention, follow-up care, and survivorship. These centers will conduct research in areas such as reducing obesity, improving nutrition, increasing physical activity, helping people quit smoking, and improving living conditions through supplemental income. In addition, the centers will help train a pipeline of early-career investigators to work with underserved communities in conducting multilevel intervention research.

“By involving the community and making the community an essential part of this effort, we are building a sustainable model,” Dr. Srinivasan said. “The idea of structural change then becomes much more built into the system.”

The launch of this Persistent Poverty Initiative complements several other Administration priorities, including its efforts to end hunger and reduce diet-related disease, and is essential toward achieving the clear goals that President Biden and the First Lady set when they reignited the Cancer Moonshot in 2022: prevent more than 4 million cancer deaths by 2047 and improve the experience of people who are touched by cancer.

The awards are spread over the next five years across all centers, pending availability of funds:

  • Acres Homes Cancer Prevention Collaboration: Led by the University of Texas MD Anderson Cancer Center, Houston, this center will work with primarily Black/African American and Hispanic communities in northwest Houston to evaluate interventions in nutrition and physical activity to help prevent obesity and obesity-related cancer.
  • The Center for Cancer Control in Persistent Poverty Areas: Led by the University of Alabama at Birmingham, this center will work with Black/African American communities in Jefferson County, Alabama, to evaluate interventions aimed at reducing cancer disparities by improving living environments and promoting healthy activities. The center will also test diet and exercise interventions for cancer survivors.
  • The Upstream Center: Led by Stanford University, Palo Alto, this center will work with Hispanic and Asian American communities in Santa Clara and Yolo Counties in northern California to assess how state programs for guaranteed basic income affect cancer outcomes. It will also test whether the earned income tax credit promotes the adoption of healthy behaviors related to reducing colorectal cancer risk.
  • The Center for Social Capital: Led by Weill Cornell Medicine and Columbia University, New York City, this center will work with Black/African American, Caribbean American, and Hispanic communities in the South Bronx, north-central Brooklyn, Washington Heights, and Western Queens in New York City to test the effectiveness of cancer education and tobacco cessation programs in promoting multigenerational health.
  • HOPE & CAIRHE 2gether: Led by the University of Utah, Salt Lake City, this center will work with primarily Hispanic communities in Utah and American Indian communities in rural areas of Montana, Oregon, South Dakota, and Wisconsin to test interventions for commercial tobacco cessation and obesity prevention.

For more information about NCI’s investments in underserved areas, visit https://cancercontrol.cancer.gov/hdhe/research-emphasis/underserved-areas.

This announcement was published by the National Institutes of Health on June 26, 2023.