Center for SOcial CApital (SOCA): Promoting Multigenerational Health

The overarching mission of the Center for Social Capital (SoCa) is to bring together academic institutions, community-based organizations, and a unique group of stakeholders to improve cancer risk and outcomes. New York City (NYC) is a region of extremes with some of the richest and poorest living in close proximity. These extremes have profound impact on health with major disparities in life expectancy with cancer driving these differences as the number 1 and 2 cause of premature mortality and overall mortality, respectively. NYC is one of the most heterogenous in the U.S., with approximately 2/3 non-White, 1/3 foreign-born, and at least 1/5 living below the Federal poverty line across four counties with persistent poverty. With such a heterogenous population, come challenges with respect to implementing cancer control programs to meet the needs of all. Using a community-engaged approach, we identified the top three structural determinants that exerted the greatest barriers to early detection and treatment of cancer in communities of persistent poverty were; 1) financial burden; 2) low health literacy, and 3) community/ social context (i.e., lack of social support/cohesion, stigma, discrimination). NYC has a long history of migration and immigration, which has resulted in racially/ethnically segregated communities. Residential segregation concentrates disadvantages in minority communities by limiting social, economic, and educational opportunities and resources while concentrating poverty in these communities. However, for some segments of the population, especially new immigrants, residing in a highly segregated community has positive health effects through co-ethnic social support networks also known as “ethnic enclaves” and resource availability. Hence the constructs of social capital and social cohesion may play a significant role in mediating the relationship between residential segregation and negative health outcomes, such as cancer incidence and mortality. Our mission as a Center is to improve cancer risk and outcomes in persistent poverty census tracts throughout NYC by promoting multi-generational health. Specifically, we aim to: Develop a rich interdisciplinary, and collaborative partnership with community organizations that will infuse stakeholder-engaged research methods and will build sustainable approaches for cancer control (Aim 1); Conduct two complementary projects that focus on novel interventions in persistent poverty communities aimed at two structural determinants of health—education and health care—in which the interventions aim to increase social capital among youth in school settings, and patient navigators in Federally Qualified Health Centers as a means to alleviate disparate cancer risks and outcomes (Aim 2); and leverage capacity across four geographically separate groups of persistent poverty census tracts in NYC to cultivate the next generation of investigators and develop sustainable Core infrastructure to achieve improved cancer health outcomes (Aim 3).