The risk of dying from cancer is greatly influenced by your ZIP code. If you live in a poor neighborhood, you face cancer death rates that are 12% higher than if you live in a wealthy neighborhood.

Persistent poverty areas are defined as those where, for the past 30 years, 20% or more of the population has lived below the federal poverty level. In 2023, that threshold is $14,580 for individuals, $19,720 for a family of two people, and $30,000 for a four-person household.

People who live within those financial constraints have a higher incidence of cancer, experience delays in cancer diagnosis and treatment, and are more likely to die from cancer in comparison to people who do not live in poverty. However, little research has been conducted on how to improve cancer outcomes in these areas.

Physicians and researchers in UC Davis Comprehensive Cancer Center have long been aware of the cancer burden faced by poorer communities. Now cancer center researchers investigating the causes of cancer health disparities are receiving a major boost from the National Cancer Institute (NCI).

The Center for Advancing Cancer Health Equity is participating in the Persistent Poverty Initiative, the first federally funded program to address the cancer risks associated with chronic financial hardship.

NCI is coordinating the $50 million National Institutes of Health program through which five new Centers for Cancer Control Research in Persistent Poverty Areas are being created. Stanford University has been awarded $15 million to form one such center, the UPSTREAM Research Center in Northern California.

The role of UC Davis

As part of the UPSTREAM Research Center, Stanford will partner with UC Davis and UCSF researchers. The team will investigate whether and in what ways regular income supplementation affects health behaviors and cancer risk for people living in poverty in several Northern California communities.

Luis Carvajal-Carmona leads research into ways in which persistent poverty influences cancer risk. He is the study’s principal investigator at UC Davis and the head of the Center for Advancing Cancer Health Equity based at the cancer center.

“Specifically, my team will assess how state and federal programs such as guaranteed basic income or the Earned Income Tax Credit affect cancer outcomes in Latino and Vietnamese communities in the Central Valley,” Carvajal-Carmona said. “We want to see if the basic income program and the earned income tax credit promote the adoption of healthy behaviors related to reducing cancer risk.”

The researchers will investigate whether the earned income credit may diminish various risk factors for cancer as a result of reducing poverty-related stress factors by helping to pay for food, housing, transportation, other daily expenses, and health care.

The study also will examine the reasons why many people who are eligible for an earned income credit are not applying, especially among newly eligible people identified in the Latino and Vietnamese communities in Yolo and Santa Clara counties.

Understanding the cancer burden facing the poor

“This is an exciting opportunity to look at the root causes of the unfair cancer burden faced by impoverished communities,” said Carvajal-Carmona, who is also the associate vice chancellor for the Office of Academic Diversity at UC Davis. “We know that there are inequities, such as food deserts where healthy food options are not readily available, that have a disproportionately high impact on health care patterns in areas where people are experiencing persistent poverty.”

Each of the persistent poverty centers works with targeted low-income communities to implement and measure the effectiveness of interventions for cancer control and prevention, follow-up care and survivorship. These centers also will conduct research in reducing obesity, improving nutrition, increasing physical activity, helping people quit smoking, and improving living conditions through supplemental income. In addition, the centers will help train a pipeline of early-career investigators to conduct cancer research in underserved communities.