Paving the Way for Cancer Health Equity

Since Marcella Nunez-Smith, MD, MHS, joined the faculty at Yale in 2006, her passion and research has focused on promoting health and healthcare equity for structurally marginalized populations. She and her team advocate for people and communities facing social and economic barriers to things such as housing, education, and employment. These health and social inequities reveal themselves in many forms, but none so evident as in one extremely vulnerable population; cancer patients.

With Dr. Nunez-Smith’s recent appointment as Director of the newly formed Center for Community Engagement and Health Equity (CEHE) within Smilow Cancer Hospital and Yale Cancer Center, the mission of ensuring cancer health equity and improving outcomes with an emphasis on traditionally marginalized communities, has begun to take shape. Nationally, Dr. Nunez-Smith also serves as Chair of the COVID-19 Health Equity Task Force for the Biden-Harris administration and previously served as co-chair of the Biden-Harris Transition COVID-19 Advisory Board.

Originally from the U.S. Virgin Islands, Dr. Nunez- Smith’s leadership roles have much significance to her personally, as she saw inequities in healthcare play out firsthand. “My father had his first stroke in his 40s and was left paralyzed. I learned there was a term for what we were: an underserved community, marginalized by place and by race,” she said. As Chair of the Task Force, Dr. Nunez-Smith is working to confirm that COVID-19 testing, treatment, and vaccines are distributed equitably and is committed to making sure everyone has the information they need to make an informed decision about the vaccine. President Biden has said that her role will ensure “that fairness and equity are at the center of every part of our response.”

Realizing the opportunity she has, Dr. Nunez-Smith commented, “I could not have imagined any of this. It’s not about me. It’s never been about me. This is about the work that needs to be done. I look into the eyes of my three young children and find courage to create something better for them moving forward.”

In a study published recently by the American Association for Cancer Research, it was reported that Black Americans have the highest overall death rate from cancer of any racial or ethnic group in the nation. This is one daunting statistic the CEHE at Yale Cancer Center and Smilow Cancer Hospital seeks to change. Locally, Dr. Nunez-Smith is propelling efforts to improve the understanding of and reduce health disparities relevant to cancer care. In addition to access to quality cancer care, there is an overall lack of education and understanding of screening to overcome.

The CEHE builds on Yale Cancer Center’s longstanding commitment to high-quality, expert, and patient-centered cancer care, screening, and prevention across the state of Connecticut. The Center leverages a wide range of approaches to community-engaged research, community outreach, education, policy and advocacy, and access to clinical care. The CEHE team has spent their initial focus on creating partnerships with community-based organizations to address the barriers to accessing cancer prevention and healthcare services, and working to bring community perspectives to current cancer research projects.

Charles Fuchs, MD, MPH, Director of Yale Cancer Center and Physician-in-Chief of Smilow Cancer Hospital commented, “Working with the talented research community at YCC and SCH, I am confident the Center will push to expand cancer research that addresses the unique needs of the residents of Connecticut and will have far-reaching effects beyond our state.”

As CEHE continues to develop and expand, the team is focused on addressing the social and structural barriers to cancer prevention and care and ensuring that research from Yale Cancer Center is serving the interests of all communities. The hope is that the Center’s research and programs will not only benefit patients in New Haven, but worldwide, and improve the understanding of, and ultimately eliminate, cancer health disparities.

Reflecting back on 2020, Dr. Nunez-Smith has accomplished a lot, but also realizes there was a lot to pause and reflect on, and acknowledges the remaining work to be done. “After the experiences of this year and seeing those disparities laid bare once more, we cannot unsee it, we cannot go back to where we were. So I expect an acceleration, quite frankly.”