Since its inception at Memorial Sloan Kettering Cancer Center 10 years ago, the Immigrant Health and Cancer Disparities (IHCD) Service has made significant progress in addressing barriers to access to cancer treatment and other healthcare for underserved communities across New York City and beyond. Guided by social determinants of health — factors that contribute to a person’s or a community’s quality of life — the 50-plus member team works to inform local and national policy through research and advocacy and by initiating systems change to identify and address health equity-related issues to better care for the most vulnerable populations.
The team is led by Francesca Gany, MD, Chief of the IHCD Service, who has been recognized for her groundbreaking work in improving health outcomes as well as the development of long-term clinical, health policy, and programmatic changes both at MSK and beyond.
“The entire MSK community applauds Dr. Gany and the IHCD team for their unrelenting commitment to the communities they serve,” said Cynthia McCollum, Senior Vice President of Hospital Administration at MSK. “Their work has driven tremendous change across MSK and beyond, and their efforts to help improve health outcomes for our neighbors across New York City have continued despite so many challenges, especially during this past year. To say we are proud is an understatement.”
“The team has done fundamental work to address health inequity and justice over these past 10 years. I’m so proud of the heart and soul we put into this critical work and the impact the IHCD Service has had on the communities we serve,” said Dr. Gany.
Strong links between the IHCD Service and community organizations are the backbone and have allowed for such success. “Our foundational community partnerships, which include faith-based organizations, consulates, and other community-serving groups, have allowed us to help thousands of people,” said Dr. Gany. At these sites, MSK staff screen for health risks and help people obtain insurance and affordable healthcare. They can also connect people to cancer care and other health screenings. The IHCD Service has also hosted hundreds of health fairs to bring resources directly to the community. Every year, the team’s bilingual staff engages with thousands of community members, many of whom have little or no access to healthcare. In recent years, health fairs have served some of New York City’s most diverse communities, including South Asian, West African, Arab, Caribbean, and Latinx populations. Despite the pandemic, this work has continued with much of it taking place virtually and by phone.
When a community member receives a cancer diagnosis, the IHCD Service springs into action through their ICCAN (Integrated Cancer Care Access Network) program. ICCAN works alongside several “safety net” hospitals throughout New York City and Long Island to help community members navigate their care. Access facilitators help pull in needed resources to address patients’ essential needs and help them complete treatment. The program connects immigrants and other medically underserved individuals with a network of resources and services, including more than 300 community-based organizations. “One of the core aims of ICCAN is to reduce socioeconomic, cultural, and linguistic obstacles to completing cancer treatment and to decrease disparities in accessing and completing cancer care,” said Dr. Gany.
After conducting a needs assessment, facilitators link patients with essential needs and resources, such as food, housing, and financial assistance. Facilitators also help to empower patients and their caregivers to be their own advocates. “A cancer diagnosis can be overwhelming, but we’ve been able to help keep people in treatment by reducing their economic burden and by helping them navigate the healthcare system,” added Dr. Gany. “During the COVID-19 pandemic, this has been even more important. To address these enormous challenges, the team has done an extraordinary job pivoting to keep cancer patients safe while attending to their healthcare access and essential needs.”
The team has also helped secure hundreds of COVID-19 vaccine appointments. In addition, they are studying how and developing programs to address the increased use of telemedicine. In underserved communities, access to technology and the Internet can be a barrier to care. “This is a key emerging area of focus, as telemedicine services are here to stay,” added Dr. Gany.
Research also plays a pivotal role across the IHCD Service. The team conducts “actionable research,” which means the data they gather through their work helps to inform how patient care is delivered. “Financial toxicity, for example, can be a side effect of cancer treatment,” said Dr. Gany. “The team studies what contributes to a patient’s declining financial health as they go through treatment, and then we develop and test interventions to ameliorate this toxicity. Our work is already informing how patient care is delivered at MSK and safety net hospitals.” IHCD experts also address language and cultural barriers to healthcare through paradigm-shifting care models, such as remote simultaneous interpreting (UN-style), which they then study and disseminate.
The Taxi Network, a community-academic partnership between the taxi driving community, the organizations that serve them, and the IHCD Service, conducts community-based participatory research to reduce health disparities among New York City taxi drivers, who are at an increased risk of cancer and cardiovascular disease due to poor diet, sedentary lifestyle, exposure to particulate matter, and barriers to risk reduction and cancer screening. “The Taxi Network has informed legislation around the health and cancer risk of this population,” said Dr. Gany. “Through our research we aim to provide the evidence to promote program and policy change.”
MSK’s Immigrant Health and Cancer Disparities Service By the Numbers: A Decade of Progress
180 -> trainees hosted by the IHCD Service. This includes 105 undergrads and 49 master’s students. Despite the pandemic, the IHCD Service still hosted 16 interns in 2020 in a completely remote capacity.
364 -> community and faith-based partnerships
461 -> presentations made to external organizations by IHCD faculty + staff
2,500 -> People served through the African Health Initiative
2,885 -> People from underrepresented populations in MSK clinical trials
5,895 -> cancer patients served through ICCAN
6,950 -> women educated about breast cancer through the Arab Health Initiative
7,472 -> People from underrepresented populations enrolled into prospective survey + qualitative research
14,835 -> community members served through The Taxi Network
40,000 -> bags distributed through FOOD — Food to Overcome Outcome Disparities. More than 3,000 patients have been served across 13 pantry sites, including eight safety net hospital locations.
173,195 -> community members educated through Ventanilla de Salud, a program that promotes disease prevention and health awareness for Mexican Americans through the Mexican Consulate. In Spanish, this means “health window.”