The following is an extended version of the article that appears in our June 2023 issue.
Sir James Thornhill’s artwork on a mobile health van envisions joy in a cancer-free future.
Cancer knows no demographic boundaries, but numbers show that how we treat the disease, how we heal and whether we recover are often impacted by a complex brew of ethnic, socioeconomic and environmental conditions.
Factors affecting health care outcomes include a host of systemic inequities influenced by years of racism. Differences in housing, income, education, access to care and screenings for early detection of cancers, tobacco use, access to recreation and exercise, mental health and diet impact health care outcomes for different people and groups.
African Americans have the highest cancer mortality rate in the nation, even though the differences between cancer mortality rates of Black and white people in the United States have halved since the turn of the present century, according to the American Association for Cancer Research.
Disparity in overall cancer mortality between Black and white populations has narrowed by half during the last two decades, from 26% in 2000 to 13% in 2019. Overall cancer mortality rates show a 32% drop from 1992 to 2019. The number of cancer survivors more than doubled in that time frame, according to the cancer research association.
But the gap remains. For example, cancer death rates are 14% higher for Black people than white people in Virginia, according to information from Massey Cancer Center.
Health care providers are seeking to close that gap. One such effort in Richmond is set to begin in June, as two mobile health vans from Massey will take services to the area’s underserved communities.
The Massey on the Move vans are scheduled to start service later this month, bringing health care to cancer hot spots across the commonwealth in communities with higher-than-average rates of cancer and deaths from the disease.
Vanessa B. Sheppard, Ph.D.
“It’s tailored to the needs in the community,” according to Vanessa B. Sheppard., Ph.D. She is associate director for outreach and engagement and health disparities research at VCU Massey Cancer Center and VCU School of Medicine’s associate vice president for public health and public health strategic initiatives. She also heads Massey’s Office of Health Equity and Disparities Research, which is leading the mobile care initiative.
Target areas for the outreach vans include the Tri-Cities of Colonial Heights, Hopewell and Petersburg; Portsmouth in Hampton Roads; Brunswick County and Lawrenceville in Southside Virginia; and Martinsville in south central Virginia. “These communities are where we see higher disparities when it comes to screenable cancer,” Sheppard says.
Education, screening and risk reduction are key in mitigating the gap in the difference in cancer survival rates and outcomes, so those are a focus for the vans. Sheppard says the vehicles will provide one-on-one outreach services that emphasize health education. Access to health screenings is a priority, as is help in navigating cancer screening and cancer care. The Massey mobile units will partner with existing local resources to coordinate people with care.
She notes that Massey will work in Petersburg with partners such as the Healthy Living and Learning Center, a program at the Petersburg Public Library that seeks to provide healthy lifestyle options to residents. Petersburg will be the first stop for the vans.
“It’s about Massey working with the community, specifically around cancer,” Sheppard says.
Massey on the Move was funded through a $300,000 grant from the social justice grants initiative of the Dominion Energy Charitable Foundation. A $150,000 Bank of America grant was used for educational materials, which will provide information on topics such as healthy living and wellness and on cancer prevention and screening. The Jenkins Foundation and the Shelton Short Trust also provided funding for the project.
Artwork by Hamilton Glass on a mobile health van centers around movement and energy.
The mobile health centers have distinctive looks, courtesy of Richmond artists Hamilton Glass and Sir James Thornhill. According to Massey, the designs reflect its goals to reduce inequities in health care and improve outcomes for diverse groups in treating cancer.
“When you see the vans, they’re really bringing hope and well-being to the community,” Sheppard says. “This is something I wanted to do and be able to deploy our message across a broader area.”
Glass says that his design centers around movement and energy. It features different types of people, races and ages, smiling and joyous. He also took inspiration from strands of DNA, represented in different colors streaming through the piece, “something to pull you closer to it,” he says.
Thornhill says in a Massey release that he found inspiration for his design of people of various ages and groups dancing, twirling and moving in the overall concept of motion, moving toward a cancer-free future. “They represent all of us. And the key is that they all — that we all — embrace the power of information and get screened, and stay educated, and do what we all can and must do to help put cancer at bay,” he says.
The American Association for Cancer Research notes in its report that eliminating racial disparities in lung, colorectal, breast and prostate cancers could save the nation $2.3 billion annually.
The cancer research association also notes that equitable access to standard care and treatments can close the outcome gap between ethnic and racial groups. “In fact, researchers have shown that racial and ethnic minority patients respond better to treatments against many cancers compared to white patients and have better outcomes when offered similar access to standard and quality care,” according to its 2022 disparities progress report.
Cancer by the Numbers
47,100: Estimated new cancer cases in Virginia in 2023
15,800: Estimated cancer deaths in Virginia in 2023
47 million: Black population in the United States
111,990: Projected new cancer diagnoses in Black men for 2022
36,340: Projected cancer deaths in Black men
112,090: Projected new cancer diagnoses in Black women for 2022
37,250: Projected cancer deaths in Black women
Cancer Incidences and Outcomes
The new cancer diagnosis rate is 6% higher in Black men in the United States compared with white men; the death rate from cancer is 19% higher in Black men than in white men.
Black women have an 8% lower cancer incidence rate than white women, but a 12% higher mortality rate.
Regarding breast cancer, the overall incidence rate is slightly lower in Black women than in white women, but the mortality rate for breast cancer is 40% higher in Black women than in white women.
Prostate cancer: The most common cancer diagnoses in Black men at 37% of all new cancer diagnoses. Prostate cancer is twice as likely to lead to death in Black men than in white men.
Breast cancer: The most common cancer diagnosis in Black women, accounting for 32% of all new cancers in that group.
Lung and colorectal cancers: Second most common cancer in Black men (11%-12%) and third in Black women (9%).
Lung cancer is the No. 1 cause of cancer deaths in Black men and the No. 2 cause of cancer deaths in Black women. Lung cancer is also the leading cause of cancer-related mortality in Black men and the second-leading cause of cancer deaths in Black women.
Colorectal cancer rates are 15% higher in Black people than in white people; Black people have the highest rate of colorectal cancer of any ethnic group in the nation.
Sources: American Association for Cancer Research, 2022 disparities progress report, American Cancer Society
