“Our world is suffering from metastatic cancer. Stage 4. Racism has… been spreading, contracting, and threatening to kill the American body…” – Ibram X. Kendi, How to Be an Anti-Racist
Unfortunately, cancer has had or will have an effect on every single one of our lives. Statistically speaking in the United States, women have a 1 in 3 chance and men have a 1 in 2 chance of developing some form of cancer in their lifetime. However, did you know that certain population groups bear a disproportionate burden of both disease incidence (who is diagnosed with cancer) and mortality (who dies from cancer)? For example, the national average number of new male cancer cases per year is 480 per 100,000 men, but 515 cases per 100,000 Black men. Additionally, while there are 134 female cancer-related deaths per year per 100,000 women, that number increases to 151 deaths per 100,000 Black women. We could talk through a pretty extensive laundry list of types of cancer and different BIPOC (Black, Indigenous, and People of Color) groups that are either more likely to develop that cancer type or die from that type of cancer. We refer to this unfortunate phenomenon as a racial health disparity and, like a lot of medical issues, it gets pretty complicated when we try to untangle why this problem exists. Today, as a cancer researcher, I want to share with y’all some of what I have been learning from looking at this issue as well as hopefully encourage you to do the same kind of searching in your own sphere of influence to see where the cancer of racism has spread and how we can root it out.
One of the first ideas for us to explore when understanding the role of racism in cancer is referred to as “social determinants of health.” This concept recognizes that beyond a person’s biology and genetic family history, significant health outcomes (such as mortality, life expectancy, and how much you spend on health care) are related to the conditions of the environment that a person lives in. These conditions can range from economic stability and access to food, education, and job opportunities to a person’s physical environment and how integrated they are into their community. Because of our country’s history of oppression of Black people since 1619, when chattel slavery began in America, many Black people have lower average income, live in neighborhoods with higher poverty and crime rates, and have restricted access to health care, economic stability, and education.
One facet that has caused this disparity is the effect of housing segregation. Federal legislation in 1934 that was intended to help make housing more affordable after the Great Depression resulted in a practice known as redlining, where banks could deny mortgages to people living in “high-risk” areas—outlined in red on residential security maps—because of their high population of Black people and other minority groups. This was detrimental to communities of color, which are still feeling the effect of this discrimination today. This is seen in the lack of access to quality food, increased chronic stress due to increased crime rates and over-policing, and a disproportionate impact of environmental hazards, known as environmental racism. (Race is the most significant predictor of a person living near contaminated air, water, or soil.)
While some of the racial disparities in cancer incidence and mortality can be explained by socio-economic status (itself a by-product of a long history of limiting the access Black people have to various means for economic growth), socio-economic status cannot explain everything. Even when normalizing data by education level and socio-economic status, a number of disparities in cancer prevention, diagnosis, and treatment persist. While much of this post has discussed the systematic and structural problems that result in health disparities, here we start seeing potential effects of interpersonal actions between physicians and patients. BIPOC are grossly underrepresented in the field of medicine and medical research, which can lead to issues of miscommunication and stereotype biases between White physicians and their minority patients. Layer on top of that a history of exploitation of Black people in medical research (the story of Henrietta Lacks, the woman whose cancer cells were taken from her and used without her consent that led to major breakthroughs in cancer research, was what first got me interested in this subject in college), and it is easy to understand the high level of distrust in Black communities of the medical establishment.
Everything mentioned above just scratches the surface of the data and anecdotes around the problem of cancer racial health disparities. I personally have been trying to dive into the deep end of this subject pool because my own field of study is cancer research. Last summer, I first started thinking of the idea of including this subject matter in a cancer biology class that I would like to teach, one day, off in the future. However, when I mentioned this far-off idea to a group of friends, their response was, “why not teach that class now?” I decided to do more research and put together a workshop series which I will be teaching this spring at Georgia Tech to start the discussion in my community about the problems that exist and what we can do as scientists and engineers to alleviate the problem. If you are not in the health care field, you might be wondering, why does any of this matter to me?
As I have been reading through the entire Bible with our Ponce community, I have been struck by how great God’s heart is for the poor, the fatherless, the widow, the orphan, and the oppressed. In fact, I have started highlighting every time God talks about defending the defenseless and helping the helpless and I am amazed how often He shares His passion about this subject. Being a Christ follower means that we are being sanctified to look more like Christ every day—in this case, I would argue, this means our hearts for the oppressed should be growing as well. Every human of every race and people group bears the image of God which means every human deserves respect and dignity. I believe it is our role as believers and as the Church universal to fight for justice and equity in each of our own spheres of influence, lifting up our fellow image-bearers and paying special attention to those who historically have been oppressed.
For me, that has looked like educating myself in how my field of work has been affected by and sometimes guilty of taking away human dignity instead of promoting human flourishing. Beyond educating myself, I have felt called to the education of others and brainstorming ways to make changes in my field to be more inclusive and equitable. My challenge to you today would be to think of what small step you can take to bring Christ’s love for the downtrodden in your sphere. How has systemic or structural racism affected your neighborhood, your workplace, your family? Are there organizations that are working to reduce disparity and increase equity in your area that you can support? How can you use any position of power or privilege you have in your community to lift up those who are disadvantaged? How can you grow to know God’s heart for the poor and poor in spirit and let His heart affect your day-to-day actions? We have a long way to go, but I am praying that we could all act like “racism cancer researchers,” detecting areas of our lives where we need God’s help to treat this disease.