|navigate: home: magazine: fall 1999: article|
Cancer program mpowers medically underserved rural residents|
By Kristine Lalley
For people who live in rural regions, gaining access to the latest, most valuable information regarding the treatment of cancer can be a daunting challenge. Since most major cancer research hospitals and facilities are located in urban areas, rural folks are often left to figure out the best treatment approaches on their own, frequently without the consultation of a diversity of doctors and cancer specialists or other public health service professionals. Ethnic and religious minorities and poor or uninsured families in these regions are often even more underserved and generally face significant barriers to quality care and information when confronted with cancer-related illnesses.|
At Penn State, Cooperative Extension staff and faculty from the College of Agricultural Sciences, the Pennsylvania Office of Rural Health and the College of Medicine have teamed up with several other universities across Pennsylvania and Cornell University in New York to develop ways to meet the needs of medically underserved residents of rural communities.
The Northern Appalachia Leadership Initiative on Cancer (NALIC) was created in 1992 to build local, sustainable cancer control coalitions composed of community residents and members of local health and human service organizations who work together to bring needed cancer services and education programs to families across rural Appalachia. NALIC currently serves residents of Allegheny, Indiana, Elk, Lawrence, Venango, Crawford, Forest, Clearfield, Tioga, Susquehanna, Montour, Columbia, Wyoming and Snyder counties in Pennsylvania and Chautauqua and Delaware counties in New York. New coalitions are just starting in Schuylkill and Greene counties in Pennsylvania.
NALIC also works to create partnerships on regional and state levels. It brings together representatives from four cancer centers, state cancer coalitions, the Pennsylvania and New York Departments of Health, Department of Aging and Commonwealth Libraries, Family Health Councils, the American Cancer Society, Penn State Cooperative Extension and nearly 30 other diverse organizations that collaborate to leverage necessary resources and plan cancer programs for the medically underserved in rural Pennsylvania and New York.
Through NALIC, researchers at the National Cancer Institute hope to learn more about how cancer education can be tailored to meet the special needs of the residents of rural Appalachia. Congress has requested an investigation into the ability of the National Institutes of Health, particularly the National Cancer Institute, to support research and intervention programs for ethnic minorities and the medically underserved.
The differential effects of wealth and status have been consistently linked with cancer incidence and mortality rates and must be thoroughly explored if we are to improve efforts to control cancer, Dr. Audrey Maretzki, professor of food science and nutrition at Penn State and principal investigator for the NALIC project, said.
More recently, through the leadership of Sen. Arlen Specter, R-Pa., Congress is now investigating and addressing the importance of increased funding to address the cancer needs of the rural underserved.
Legislative briefings held in Washington, D.C., last March by the Intercultural Cancer Council and applauded by the Appalachia Leadership Initiative on Cancer highlighted these needs. Sen. Diane Feinstein, D-Calif., U.S. Rep. Rick Lazio, R-N.Y., Rural Health Caucus Committee Chair Mike McIntyre, D-N.C., and other lawmakers are drafting legislation to better serve the cancer needs of ethnic minorities and rural populations.
We are at a very critical time in cancer outreach, said Ann Ward, project manager for NALIC. Finally, projects like NALIC are receiving national exposure, and needed research funding is being addressed by our legislators. Despite funding challenges, the coalitions have been phenomenally productive over the past six years, carrying out hundreds of cancer-related activities, using primarily volunteer and community-based energy. Building the quality of life of our rural families and their communities has always been our primary goal. NALIC has shown that community health lies within reach when citizens, their leaders, members of the health care community and many other organizations work together as partners to define the root causes and solutions to cancer. Nearly 200 community organizations and hundreds of volunteers have invested time and energy into coalition efforts over the past six years.
Ward added that one major factor in NALICs success is the involvement of diverse and widely dispersed individuals.
Cancer survivors, teachers, bankers, nurses, Cooperative Extension agents, youth and just about everybody else is involved in taking action against cancer.
After all, a major goal of the initiative is to build and sustain a network of many different people who come together united for one purpose: to beat cancer.
In Pennsylvania, the Department of Health is putting in place a local partnership model for community health called the State Health Implementation Program (SHIP). NALIC is an excellent and successful working model of such a vision for the management of public health education.
Given the hundreds of NALIC partners and Penn States outreach mission, we are very well positioned to be a valuable asset to the future of public health in our state, Ward said.
In fact, during the last six years, the number of activities implemented by NALIC coalitions has increased from nine in its first year of operation to 790 today.
In 1994, 61 percent of activities were related to breast or cervical cancer, but as coalitions have successfully established these programs in their communities, they are now turning their efforts to colorectal, skin and tobacco-related cancers.
Many of the NALIC coalitions have found that it is easier to attract an audience and instill community-level health goals by conducting cancer programs at the communitys most frequented locationschurches, work sites and community centers.
In the six years since NALIC was funded, the leadership initiatives 13 cancer coalitions have had a significant impact on the health systems in their communities, Ward said. In every case, the coalitions accomplishments have involved hundreds of partners who have worked together to increase the publics awareness of cancer, provide educational programs to reduce risk factors and organize screenings for early detection with a focus on the medically underserved.
Ward sees this outreach project as ultimately helping people improve the quality of their lives when faced with cancer.
We know from experience that communities cannot develop economically and families cannot grow to their capacity if health care concerns exhaust their energy and resources. NALIC is a model of personal empowerment and leadership development that has increased the overall potential of rural communities to address a disease of great emotional and economic cost.
For more information on the Northern Appalachia Leadership Initiative on Cancer, contact:
Ann Ward, Project Manager