Researchers have noticed neighborhood design, even down to the sidewalks and billboards can affect rates of everything from cancer to diabetes

For many people in Houston, staying healthy is a matter of buying the right foods at the grocery store and getting in some exercise at the local park or gym, but often health outcomes vary between neighborhoods.

For Houston researchers, those disparities are a problem.

“There are studies that are showing that zip code determines more about your life expectancy than actually biology,” said Lorna McNeill, a health disparities researcher at MD Anderson.

She and other researchers have noticed neighborhood design, even down to the sidewalks and billboards can affect rates of everything from cancer to diabetes.

“There’s a strong role for the environment in terms of whether or not who gets a disease or whether or not you’re cured from those diseases,” McNeill said.

Often, the neighborhoods people live in are shorthand for talking about race, and income level.

For instance, in Harris County, cancer rates are higher among Black communities. And state data shows the county's diabetes death rates among Black and Hispanic communities are nearly double those of whites and other races. If you're poor, regardless of race, health disparities only get worse.

Teaching students to recognize disparities

In an effort to reverse some those trends, Lorna McNeill is leading a new program with MD Anderson and the University of Houston, called UHAND, teaching UH students interested in the field about these cancer disparities, involving them in research targeting specific Houston neighborhoods.

“There’s increasing understanding that most of the research focuses on everyone. There are very few people that are trained in the area of disparities and then very few research dollars are actually going to addressing the problem,” McNeill said.

The hope: Once UH students complete the program, they'll be more sensitive to how environment, race, and income affect people's health.

Paulina Linares Abrego is a student in that program, helping with research on tobacco cessation, and she wants to bring what she has learned back to her own community.

“One of the surprising things that I found out is that only 10 percent of cancer is passed down genetically,” Abrego said. “If you think about that and then you think about all the people that you know in your own community that have cancer it’s like, well that’s not it. It’s not because we’re Hispanic. That’s not the case, and we’re learning more and more and it’s a lot of environmental factors,” she said.

Competing with fast food

Melissa Edwards heads the American Diabetes Association in South Central Texas. She says for a lot of people, the only nearby food sellers are convenience stores and fast food.

“We are competing with access to food that might be really inexpensive but for the American Diabetes Association, it's not the best food and the best choices,” Edwards said.

The ADA recently partnered with the City of Houston to post 23 billboards around the city, in both English and Spanish, specifically in neighborhoods facing disparities.

Edwards says food banks when people don’t have access to the proper foods in grocery stores, food banks don't always have the right foods to pick up the slack. Even when people do cook at home, serving traditional meals, they're still not getting the best nutrition.

“We know that eating together and family, no matter what culture you belong to, that's a tradition, so how can we take that traditional moment that you have with your family and make it a little bit healthier for you,” Edwards said.

Edwards says for that reason the ADA is doing more outreach work, meeting people on their level.

Building trust

Lorna McNeill, the disparities researcher, says a dialog with the community is needed to make interventions successful.

“As providers, we need to understand people’s cultural backgrounds and understand the way they want to interact with the healthcare provider and the health care system and should try to provide care and that culturally competent way,” McNeill said.

McNeil says you can't expect people to be on board if you come in just telling them how to change. She says listening to communities, understanding what they need, is especially important as many communities facing health disparities were left behind by researchers in the past.

The first step in correcting disparities and designing healthier neighborhoods, she says, is building trust.

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