Guest Editorial: Health Disparities Across the Cancer Continuum

Persistent disparities in health among racial/ethnic minority populations have stimulated interest in increasing the participation of racial/ethnic minority scientists in health disparities research. The 2002 report of the Institute of Medicine (IOM), Unequal Treatment: Confronting Racial/Ethnic Disparities in Health Care,¹ recognized the need to expand minority investigator competition and involvement in health disparities research as one of four areas of emphasis for addressing health disparities among racial/ethnic minority populations. The IOM specifically recommended that the National Cancer Institute (NCI) support training for minority investigators in health disparities research to increase their involvement in policy formulation and program design. There are several reasons to increase the number of racial/ethnic minorities who are principal investigators on both publicly and privately funded research. First, the enhanced participation and inclusion of minority scientists in primary research roles provides an opportunity to incorporate their unique perspectives, insights, and experiences towards gaining an understanding of the causes of racial/ethnic disparities in health, as well as in developing effective solutions. Second, racial/ethnic minority investigators are more likely than other investigators to focus their research on diseases and risks that disproportionately impact racial/ethnic minority populations.²

The National Institutes of Health (NIH), a major funder of health related research, has also recognized the need to increase the representation of racial/ethnic minority researchers among NIH funded principal investigators. One of the 27 Institutes and Centers that comprise the NIH, NCI has developed a number of programs designed to increase the interest and involvement of underrepresented minorities in health research.

We are pleased to present this special issue of the Journal of Health Care for the Poor and Underserved , entitled Health Disparities across the Cancer Continuum, which features the research of participants in two NCI-sponsored training activities held in 2006. The Health Disparities Research Methods Training Symposium, which was co-sponsored by the NCI Division of Cancer Control and Population Sciences, The American Legacy Foundation, the Department of Health and Human Services (DHHS) Office on Women's Health, and the Tobacco Research Network on Disparities, was a one-day training program designed to increase technical research skills and promote interest, involvement, and training of junior investigators and the participation of senior researchers in health disparities research. The 2nd Biennial Career Development Workshop to Increase Diversity in Research Funding (2nd Biennial) was jointly sponsored by the NCI Division of Cancer Control and Population Sciences, the NCI Office of Women's Health, the NCI Center to Reduce Cancer Health Disparities, the California Breast Cancer Awareness Program, the California Tobacco-Related Disease Research Program (TRDRP), and the DHHS Office on Women's Health. The 2nd Biennial was three-day workshop designed to enhance the ability of mid-career and/or transitioning investigators from racial/ethnic minority and other underrepresented groups to compete successfully for NIH funding by providing training that facilitated their professional growth and development and increased their technical and grant writing skills.

This special issue showcases the research contributions made by underrepresented minority scientists and health disparities researchers in the areas of tobacco, cancer screening, breast and prostate cancer, health risks and communication, research methodology and organizational collaboration. The Heroes and Great Ideas column highlights and celebrates the contributions made by Mr. Frank Jackson (formerly of NCI), and Dr. Richard P. Bragg from the Centers for Medicaid and Medicare Services to the training and mentoring of scientists from underrepresented minority groups.

As the title suggests, the topics in this issue span the cancer continuum and focus on research relevant to health disparities. The first three articles focus on tobacco. Tobacco-related illnesses such as cancer and cardiovascular disease are major contributors to disparities in health outcomes observed among racial/ethnic minority populations.^3,4 The first article by Yerger, Przewoznik, and Malone explores the contribution of the tobacco industry to the prevalence of smoking and use of mentholated cigarettes among urban African Americans. The authors posit that disparities in tobacco-related diseases among African Americans are a consequence not only of tobacco use behavior but also of the disproportionate distribution of conditions...