The DREAM (Disparities Research: Environment And oMics) Lab, housed in the UCSF Department of Epidemiology and Biostatistics, is a multidisciplinary research team studying and addressing health disparities at the population level, with the goal of collecting complete population-based data ranging from biological data to neighborhood and policy contextual data. The team moved to UCSF just over a year ago from the Cancer Prevention Institute of California. With this move also came the Greater Bay Area Cancer Registry, one of the earliest registries with the Surveillance, Epidemiology, and End Results (SEER) Program of the NCI.
Led by Scarlett Lin Gomez, PhD, MPH, Iona Cheng, PhD, MPH, and Salma Shariff-Marco, PhD, MPH, the team includes epidemiologists and analysts who are skilled at molecular epidemiology, “big data”, geospatial analyses, data visualization, and the design of recruitment and outreach materials, as well as bi-lingual and bi-cultural field staff.
They have developed a series of powerful resources to help pinpoint disparities and provide detailed information to inform translations and policies. Using integrative data analysis approaches, the team can merge multiple sources of data with the idea of integrating variables and factors together – creating a more complete picture ranging from genetics and biology to neighborhood social and built environment context.
The DREAM Lab believes that when it comes to health and health care disparities, social determinants of health are the primary driving forces. They seek to understand all of the complicated factors that go into social determinants, from larger institutional policies, the consequences of forced segregation, housing discrimination, gentrification, and food insecurity.
One of the lab’s many active projects, and one that illustrates the integration of data from –omics to neighborhoods, is Research on Prostate Cancer in African American Men: Defining the Roles of Genetics, Immunity and Access to Care, otherwise known as the “RESPOND” Study, is a national study recently funded by two institutes within the NIH to study prostate cancer among African American men. This population has the highest rate of disease of any racial/ethnic group within the US, with mortality rates that are double, as compared to non-Hispanic white men.
The vision is to provide insights into the mechanisms by which aggressive disease arises and use that to develop screenings to promote early detection. The team hopes this will provide more impetus for influencing changes to community, city, and state policies for improving neighborhood conditions, and stimulate conversations about disease prevention. The study is designed to address the factors associated with more aggressive tumors, and the five-year plan is to conduct data analyses and report results in aggregate in scientific venues and also via newsletters and on websites.
The investigators aim to enroll 10,000 African American men with prostate cancer into the RESPOND study. The participants will be identified primarily via the SEER Program and the Centers for Disease Control and Prevention’s National Program of Cancer Registries. In addition, this study builds on years of research collaboration involving investigators who are part of the African Ancestry Prostate Cancer (AAPC) consortium.
Investigators in the study will examine possible associations between aggressive disease and exposures to neighborhood and environmental stressors such as discrimination, early-life adversity, and segregation. They will also study DNA and tumor samples to identify gene variants associated with aggressive prostate cancer. Once researchers have identified genetic changes associated with aggressive prostate cancer, they will investigate how the social environment interacts with those genetic changes.
Participation involves completing a survey with questions about the patient’s family, health history, neighborhood, community, life experiences, prostate cancer treatment, health behaviors and lifestyle. Participation also may include providing a saliva sample. For more information about the RESPOND study, or to register, please visit: https://www.respondstudy.org/.
“We are at an exciting time in cancer research where researchers from different disciplines recognize the need and are working together to address cancer health disparities. DREAM Lab is committed to engaging with scientific and community partners to conduct this type of transdisciplinary research, which we believe is essential for addressing why and how institutional and societal stresses become embedded to produce inequities in health.” Says Scarlett Lin Gomez. You can also follow the DREAM Lab on Twitter for up-to-date information on their active projects.
