Abstract IA30: Population-level problems require system level solutions: Using collective impact approaches to solving cancer disparities

Abstract

Abstract Disparities in cancer incidence and mortality are longstanding and tenacious. The disproportionate burden of disease is borne by racial/ethnic minority groups, as well as those living in economically depressed conditions, regardless of race/ethnicity. Although there is no physiologic or genetic link between some of these disparate populations, the similarities in the experience of cancer outcomes suggests that they may be driven by socioeconomic conditions and inequities that underpin the US health care system. Despite the multilevel nature of the drivers of disparate outcomes, public health facing solutions have largely focused on interventions aiming to change individual level health behaviors, such as risk reduction, increasing screening, and early detection. Historically, much less attention and intervention have been directed toward addressing systemic factors, either inside or outside of the health care system, that contribute. Accordingly, gaps in cancer survival have persisted over time, and in some cases those gaps have widened. More recent discourse on cancer and other health disparities has emphasized the importance of the Social Determinants of Health (SDOH); in doing so have made clear the necessity for a multilevel, multisectoral approach to eliminate these differences. “Collective impact” is one such approach. Collective impact is defined as the commitment of a group of key actors from different sectors to a common agenda for solving a specific social problem. The five conditions of a collective impact approaches include a common agenda, shared measurement systems, mutually reinforcing activities; continuous communication, and backbone support organizations. This presentation will review some successes and lessons learned from well-established collective impact activities addressing noncancer conditions at our institution. We will then explore the establishment of a collective impact approach to addressing the burden of cancer in San Francisco and other surrounding counties. We will emphasize early successes in both big “P” as well as small “p” policy realms and highlight the role of the Comprehensive Cancer Centers in supporting system-level solutions to this longstanding population-level challenge. Citation Format: Kim F. Rhoads. Population-level problems require system level solutions: Using collective impact approaches to solving cancer disparities [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA30.