Reflecting on World Cancer Day, I would like to bring a lens to a small corner of the globe. Southeastern Massachusetts is a region with beautiful coastal beaches and where vibrant Native American communities still thrive while being home to some of the earliest European settlements. It is also home to the country’s earliest industries in fishing and whaling. Fisheries still draw immigrants to the region, many from Guatemala and other Central American countries. Many only speak indigenous languages, some mainly Spanish.
Once predominantly Portuguese, the immigrant population in Southeastern Massachusetts now includes large Portuguese and Creole-speaking Cape Verdean and Brazilian populations. Immigrants from Haiti live in communities surrounding Boston. Together, whether born in the region or newly arrived, these residents comprise Southeastern Massachusetts’ wonderfully diverse communities.
Southeastern MA is also a region with a range of pressing disparities in cancer occurrence and mortality, a sobering reality I learned about while working on a health equities assessment with JSI and the Massachusetts Comprehensive Cancer Prevention and Control Program. Through the assessment we identified the many socio-economic factors—low income, lack of high school education, language and literacy barriers, high rates of smoking, exposure to carcinogens in the environment and workplace—that may contribute to poor health outcomes related to cancer in these communities.
Beyond identifying contributing factors to cancer rates and barriers to care, our goal in carrying out the assessment was to offer recommendations for strategies or programmatic options (such as targeted educational outreach for underserved groups and quality improvement projects) for clinics to advance regional prevention activities, ensure appropriate screening, and improve access to culturally competent, high quality care.
During the assessment, our team held conversations with community health workers to discuss issues and strategies to improve resident health. Walking into a room full of health workers, I was struck by their deep level of commitment to their communities. The same was true of area residents and members of area health and service organizations who participated in discussions and focus groups for the project.
While Southeastern MA is clearly facing many challenges in terms of health and cancer disparities, there is social cohesion: willingness across the community to work together and contribute what they can to make these beautiful, historic communities healthier.