Recently, as part of the Obama administration’s campaign to cure cancer, Vice President Joe Biden and former New York mayor Michael Bloomberg announced $125 million in grant funding to found the Bloomberg-Kimmel Institute for Cancer Immunotherapy at Johns Hopkins. Their commitment to “rid the world of this disease” is commendable, but we cannot stop at biomedical innovation. Advanced medical technologies only treat cancer, and they do so just for those with access to these life-saving resources. If we are to end “cancer as we know it,” prevention must be our top priority. And we cannot prevent cancer unless we address its social and environmental causes.
Cancer is inextricably linked to social determinants of health, conditions such as neighborhood location, air and water quality, wealth and employment, literacy and educational attainment, and access to healthy food and exercise spaces.
For instance, a large body of scientific evidence links cancer to air, water and land pollution. The most socially and economically marginalized in society are disproportionately exposed to these hazards.
Social determinants also influence behavioral risk. According to the CDC, smoking is more prevalent among groups with low income and education levels. These groups are also less likely to try to quit smoking and to have access to smoking cessation resources.
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Lastly, social determinants drive disparities in cancer treatment and mortality. The National Cancer Institute cites low socioeconomic status, lack of health insurance, barriers to accessing health services, and the absence of primary care providers as factors that contribute to lower screening and treatment rates, and therefore higher mortality, among black men and women.
Advances in immunotherapy offer promising new developments to cure cancer when it occurs. But they do little, if anything, to change the conditions that lead to cancer, nor do they ensure that those most vulnerable – and most impacted – have equitable access to preventative and curative resources.
We must reduce exposure to known carcinogens through aggressive environmental regulation. Furthermore, we must work to improve economic stability, education, infrastructure and access to affordable, quality health care that largely define who develops cancer, who receives treatment and who survives.
Biden and Bloomberg are correct that there is no “silver bullet” that will end cancer, and biomedical advancements are one part of a comprehensive strategy. But unless we address the underlying social and environmental causes of this insidious disease, we will remain far from this noble goal.
Rachel Bergstein holds a master’s degree in social factors in health from the Johns Hopkins Bloomberg School of Public Health.