Amelie G. Ramirez, DrPH, of UT Health San Antonio is launching the new “Avanzando Equidad de Salud: Latino Cancer Health Equity Research Center” thanks to a four-year, $4.08 million grant from the American Cancer Society.
The Avanzando Equidad de Salud Center, which begins this month, is a response to the severe cancer burden facing Latinos in South Texas.
The center will unite South Texas research scholars and the community to reduce health disparities across the cancer care continuum by targeting social determinants of health that prevent Latinos from obtaining equitable care.
“Our new center will conduct a unique combination of community-engaged research, training, patient assessment and advocacy to address the social determinants of health — such as access to health care, financial strain and food insecurity — that deter Latinos from equitable access to cancer care, prevention, early detection and treatment,” said Ramirez, leader of the Salud America! Latino health equity program, and head of the Department of Population Health Sciences and the Institute for Health Promotion Research at UT Health San Antonio.
“We aim to help prevent South Texans from getting cancer, while also improving cancer outcomes, survivorship and quality of life,” Ramirez said.
Why is the Avanzando Equidad de Salud Center needed?
Nearly 5 million people — 69% of whom are Latinos — live in South Texas, which stretches from San Antonio south to the Texas-Mexico border.
Latinos here are at disproportionately greater risk of having liver cancer (64%), cervical cancer (46%), gallbladder cancer (8%), gastric cancer (4%) and pediatric leukemia (32%) than peers in the rest of Texas and the U.S., according to Ramirez’s 2018 South Texas Health Status Review.
Behind these disparities are vast inequities in the social determinants of health.
- Lack of health insurance: 30% in South Texas are uninsured; 23% in Texas.
- Care: 44.8% in South Texas don’t have a usual source of health care; 31.9% in Texas.
- Financial strain: 25% in South Texas live in poverty; 15.8% in Texas.
- Income: 22% in South Texas earned less than 150% of the federal poverty line; 14.9% in Texas.
- Education: 30% in South Texas are not high-school graduates; 16.3% in Texas.
- Language: 41% in South Texas speak Spanish as their primary language; 29.3% in Texas.
“The Avanzando Equidad de Salud Center will target these very inequities that are creating such a heavy cancer burden across South Texans,” Ramirez said.
What will the Avanzando Equidad de Salud Center do?
The Avanzando Equidad de Salud Center aims to be the driving force in South Texas and the nation for building health equity, providing equitable cancer care, decreasing the burden of cancer and improving Latino health outcomes.
The center will create a collaborative environment with the community to:
Conduct two scholar-led cancer control research projects. The center will coordinate and provide leadership, mentoring and support for these two research scholars.
- Allison Grimes, MD, assistant professor of pediatrics and investigator with the Greehey Children’s Cancer Research Institute at UT Health San Antonio, aims to increase vaccination in adolescent and young adult cancer survivors.
- Patricia Chalela, DrPH, associate professor at the Institute for Health Promotion Research at UT Health San Antonio, aims to improve breast cancer treatment adherence among Latinas.
Additional research scholar projects will be added over time.
Screen cancer patients for social determinants of health. The center will change the electronic health record at UT Health San Antonio and the Mays Cancer Center to systematically assess patients for social determinants of health. The change will automatically activate follow-up by a center navigator, who will connect the patient with needed institutional and community resources and facilitate coordinated care through partnerships with the university’s Primary Care Center and Regional Physician Network, community organizations, and Federally Qualified Health Centers.
Engage research scholars and community in education and advocacy for system and policy changes that improve health equity. For the center, Ramirez’s Salud America! Latino health equity program will apply its national communication efforts locally to create peer-modeled content and advocacy toolkits for on-the-ground system and policy changes.
Create a tailored mentoring program, webinar series and connection to local/national mentoring resources. The center will enhance the ability of the four research scholars and other early to mid-career faculty researchers at the Mays Cancer Center to understand and integrate social determinants of health assessment and health equity in their future cancer research interventions in cancer prevention, screening, treatment and survivorship.
“By increasing research, mentoring, system changes and a standardized screener to identify patients who experience issues with social determinants of health, the Mays Cancer Center will be in better position to deliver comprehensive cancer care to its patients across South Texas, creating greater health equity for all,” Ramirez said.
Who is the team behind the Avanzando Equidad de Salud Center?
The Avanzando Equidad de Salud Center will be headquartered at UT Health San Antonio, a Hispanic-Serving Institution, in alignment with its Mays Cancer Center, a National Cancer Institute (NCI)-Designated Cancer Center with a priority focus on Latinos.
“We welcome the center as an opportunity to further elevate UT Health San Antonio’s culturally, regionally and contextually tailored cancer education, prevention, diagnosis and treatment by increasingly targeting the social determinants of health that drive health disparities in South Texas,” said Robert Hromas, MD, dean of the Joe R. and Teresa Lozano Long School of Medicine at UT Health San Antonio.
Heading the Avanzando Equidad de Salud Center is Ramirez.
Ramirez has conducted pioneering research over three decades to reduce Latino health disparities and drive action around health equity. She has led a 20-year NCI-funded multi-site research and training network on Latino cancer (Redes En Acción) and leads a national communication program to build advocacy for system and policy changes for Latinos (Salud America!).
Ramirez also is leader of the Mays Cancer Center’s Community Outreach and Engagement team. The team has led Latino-centric successes to promote human papillomavirus (HPV) vaccination and cancer screening, create innovative smartphone apps to reduce smoking and promote cancer treatment adherence, and increase accrual of Latino patients into cancer clinical trials.
Ramirez will work closely with the Mays Cancer Center and a diverse Community Advisory Board to engage the community across all center activities toward achieving health equity.
These members will help scholars with community-responsive research, guide efforts toward local policy and system changes, engage in inclusive mentoring and training efforts, and catalyze community partnerships to address patients’ social determinants of health needs:
- Amanda Ramirez, Cancer Survivor and Founder of Mandy’s Fight
- Sandi Stanford, Patient Survivor and Advocate at the Alamo Breast Cancer Foundation
- Jennifer Puryear, BS, Cancer Control Strategic Partnerships Manager, American Cancer Society South Region Research Liaison
- Donna Rankin, BS, Cancer Control Strategic Partnerships Manager, American Cancer Society San Antonio
- Julie Bazan, MHA, CHW, Director of the Mid Rio Grande Border Area Health Education Center (AHEC)
- Belinda Flores, RN, Director of the South Coastal AHEC
- Brenda Hoffman, MA, LPC, CHW, Director of the Southwest Border AHEC
- Janna Lesser, PhD, RN, FAAN, Director of the South Texas AHEC
- Armando Lopez, MPH, Director of the Lower Rio Grande Valley AHEC
- Paula Winkler, MEd, Director of the South Central AHEC
- Jose Zapata, Jr., MSS, Manager of Academic Programs at South Texas AHEC
- Jennifer Knoulton, RN, Vice President of Regional Operations at Methodist Healthcare Ministries of South Texas
- Fernando Martinez, PhD, Community Health Worker Program Coordinator at Northwest Vista College
- Erine Ercoline, MBA, Executive Director of ThriveWell
- Elizabeth Lutz, MBA, Executive Director of the Health Collaborative, Bexar County Community Health Leadership
- Mary Jimenez, BBA, Vice President of Strategic Account Management at Caris Life Sciences.
- Carlos V. Rodriguez, Health Equity Manager, City of San Antonio Metropolitan Health District
- Dolores Garcia, BS, Project Coordinator for Community Outreach and Engagement, Mays Cancer Center, UT Health San Antonio
- Susan Padalecki, PhD, Associate Professor of Urology and Cellular and Structural Biology, and Associate Director for Research Administration, Mays Cancer Center, UT Health San Antonio
“With this level of community engagement, we expect the Avanzando Equidad de Salud Center to not only improve cancer care and outcomes for Latinos and all people in South Texas, but also to advance a new generation of scholars and researchers concerned with cancer health equity,” Ramirez said.
Ramirez expressed her thanks to the American Cancer Society for supporting establishment of the Avanzando Equidad de Salud Center.
The new center is one of 89 extramural discovery science grants funded through a $54.3 million investment by the American Cancer Society.
“We are proud to announce these new grant awardees and their research projects,” said William Dahut, MD, chief scientific officer at the American Cancer Society, in a news release. “It’s very exciting, as we will fund studies that will increase our understanding of genetics and cancer risk and explore better ways to find, treat and survive cancer, focusing on equity and optimizing quality of life for cancer survivors.”