Center for SOcial CApital (SOCA): Promoting Multigenerational Health

社会资本中心 (SOCA)：促进多代健康

• 批准号: 10661344
• 负责人: Alicia K Matthews
• 金额: $ 208.79万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-31 至 2028-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10661344
• 关键词: Academic Medical Centers; Adult; Affect; Age; Area; Automobile Driving; Behavior; Black Populations; Cancer Burden; Cancer Center; Cancer Control; Cancer health equity; Caribbean region; Caring; Cause of Death; Censuses; Cessation of life; Cities; Collaborations; Communication; Communities; County; Disadvantaged; Discrimination; Disparity; Early Diagnosis; Early treatment; Economics; Education; Educational Curriculum; Educational process of instructing; Emotional; Enrollment; Ethnic Origin; Face; Faculty; Family; Family member; Federally Qualified Health Center; Financial Hardship; Generations; Geography; Health; Health Promotion; Health Sciences; Health education; Health system; Healthcare; Height; Hospitals; Household; Immigrant; Immigration; Incidence; Individual; Inequity; Infrastructure; Institution; Intention; Intervention; Justice; Life Expectancy; Malignant Neoplasms; Measures; Mediating; Medical center; Mission; Neighborhoods; New York; New York City; Outcome; Play; Population; Poverty; Poverty Areas; Premature Mortality; Presbyterian Church; Race; Randomized; Recording of previous events; Research; Research Methodology; Research Personnel; Resources; Role; Schools; Social Environment; Social Interaction; Social Justice; Social support; Structural Racism; Students; System; Testing; Tobacco; Training Programs; Universities; Washington; Youth; cancer education; cancer health disparity; cancer initiation; cancer risk; cancer therapy; cohesion; community organizations; design; early onset; economic impact; effectiveness testing; electronic health record system; ethnic segregation; health care service; health inequalities; junior high school; low health literacy; migration; minority communities; mortality; next generation; novel; patient navigation; patient navigator; patient portal; physical separation; poor communities; premature; prevent; programs; quitline; racial disparity; racism; residential segregation; science teacher; segregation; social; social capital; social cohesion; social determinants; social health determinants; social stigma; structural health determinants; therapy design

The overarching mission of the Center for Social Capital (SoCa) is to bring together academic institutions, community-based organizations, and a diverse group of stakeholders to reduce cancer health inequities due to persistent poverty. New York City (NYC) is a region of extremes with some of the richest and poorest living in close proximity. These extremes have profound impact on health with major inequities in life expectancy with cancer driving these differences as the number 1 and 2 cause of premature mortality and overall mortality, respectively. NYC is one of the most diverse in the U.S., with approximately 2/3 non-White, 1/3 foreign-born, and at least 1/5 living below the Federal poverty line across four counties with persistent poverty. With such diversity, come challenges with respect to implementing cancer control programs to meet the needs of all. Using a community-engaged approach, we identified the top three social determinants that exerted the greatest barriers to early detection and treatment of cancer in communities of persistent poverty were; 1) financial burden; 2) low health literacy, and 3) community/ social context (i.e., lack of social support/cohesion, stigma, discrimination). NYC has a long history of migration and immigration, which has resulted in racially/ethnically segregated communities. Residential segregation concentrates disadvantages in minority communities by limiting social, economic, and educational opportunities and resources while concentrating poverty in these communities. However, for some segments of the population, especially new immigrants, residing in a highly segregated community has positive health effects through co-ethnic social support networks also known as “ethnic enclaves” and resource availability. Hence the constructs of social capital and social cohesion may play a significant role in mediating the relationship between residential segregation and negative health outcomes, such as cancer incidence and mortality. Our mission as a Center is to reduce cancer health inequities in persistent poverty census tracts throughout NYC by promoting multi-generational health. Specifically, we aim to: Develop a rich interdisciplinary, and collaborative partnership with community organizations that will infuse stakeholder-engaged research methods and will build sustainable approaches for cancer control (Aim 1); Conduct two complementary projects that focus on novel interventions in persistent poverty communities aimed at two structural determinants of health—education and health care—in which the interventions aim to increase social capital among youth in school settings, and patient navigators in Federally Qualified Health Centers as a means to alleviate systemic inequities (Aim 2); and leverage capacity across four geographically separate groups of persistent poverty census tracts in NYC to cultivate the next generation of investigators and develop sustainable Core infrastructure to achieve cancer health equity (Aim 3).

社会资本中心 (SoCa) 的首要使命是将学术机构聚集在一起， 以社区为基础的组织和不同的利益相关者群体，以减少由于癌症导致的健康不平等 纽约市 (NYC) 是一个极端贫困地区，一些最富有和最贫穷的人都生活在其中。 这些极端情况对健康产生了深远的影响，导致预期寿命的严重不平等。 癌症导致这些差异成为过早死亡和总体死亡率的第一和第二原因， 纽约市是美国最多元化的城市之一，其中约 2/3 为非白人，1/3 为外国出生， 在四个持续贫困的县中，至少有 1/5 的人生活在联邦贫困线以下。 多样性给实施癌症控制计划以满足所有人的需求带来了挑战。 通过社区参与的方法，我们确定了影响社区发展的三大社会决定因素。 持续贫困社区的癌症早期发现和治疗的最大障碍是 1)； 经济负担；2) 健康素养低，以及 3) 社区/社会背景（即缺乏社会支持/凝聚力， （耻辱、歧视）。 纽约市有着悠久的移民和移民历史，这导致了种族/民族问题 种族隔离的社区。 居住隔离集中了少数族裔社区的劣势。 限制社会、经济和教育机会和资源，同时贫困集中在这些地区 然而，对于某些人群，尤其是新移民来说，居住在高度社区。 隔离社区通过同族社会支持网络（也称为 因此，社会资本和社会凝聚力的构建可能会发挥作用。 在调解居住隔离和负面健康结果之间的关系方面发挥着重要作用， 例如癌症发病率和死亡率。我们作为中心的使命是减少癌症健康不平等。 具体来说，我们的目标是通过促进多代人的健康来实现整个纽约市的持续贫困人口普查。 与社区组织建立丰富的跨学科合作伙伴关系，将注入 利益相关者参与的研究方法，并将建立可持续的癌症控制方法（目标 1）； 开展两个互补项目，重点关注持续贫困社区的新颖干预措施 针对健康的两个结构性决定因素——教育和医疗保健——其中干预措施旨在 增加学校环境中青少年和联邦合格健康中心患者导航员的社会资本 中心作为缓解系统性不平等的一种手段（目标 2）并利用四个地区的能力； 将纽约市的持续贫困人口普查区分开，以培养下一代调查员和 发展可持续的核心基础设施，以实现癌症健康公平（目标 3）。