Dr. Winn joined the LUNGevity Board of Directors in June 2020. He recently spoke with Jeanne Regnante, LUNGevity’s Chief Health Equity Officer, about his lung cancer advocacy, inequities in healthcare, and what gives him hope.
How do you define health equity for patients that we serve?
I think that there are three main components of health equity. First, equity is when I have access to not just care but high-quality care, regardless if I have $10 in my pocket or $100,000 in my bank account. That’s one marker.
The second health-equity component means that not only do I have access to both health systems and treatment for my cancer, but also to those life-saving clinical trials that may be available. When we look at the diversity and equity around clinical trials, not every population has this kind of access.
The third component means that, as a community, we can impact the doctors who are treating patients — by asking questions, participating in clinical trials, and providing scientific data. Unfortunately, not every community group has the ability to sit at the table with researchers and clinicians. For me, access and health equity are a bit different. But it’s based on a person’s ability to influence the type of clinical trials, the standard of care, and the kind of research conducted. When everyone has the same opportunity to do that, we will have accomplished something great.
What disparities need to be erased in these communities for people at risk of either developing lung cancer or who have been diagnosed with lung cancer?
Well, I think the one example that jumps out to me is the disparity gap in lung cancer screening. It's just not acceptable. We know that many of the at-risk populations carry the heaviest burdens from lung cancer. So, it makes no sense that we don't have more strategies around reaching into these communities. Eradicating any disparities around screening means a lot to me.
I think Dr. Otis Brawley, distinguished professor of Oncology and Epidemiology at Johns Hopkins University, had it right when he said that typically when you advance new technologies you introduce disparities. And so, as we’re introducing new technologies to cure or screen, we recognize that it gets into one community and not the other. So, how do we reduce these gaps? How do we all sit at the table so that we can have pragmatic and innovative ways of reducing disparities?
I think we know what the problem is. I think we even have strategies on how to fix the problem. We need to have the desire to confront the issue. If I had a magic wand, I would make that my wish that we have the political will and the intestinal fortitude to stick to some of these solutions to reduce some of these disparity issues. I think that it's going to take those unsung heroes and champions to keep chipping away at this.
Why is partnering with trusted community leaders a critical part of LUNGevity’s health equity strategy?
It has become clear that advocacy starting from the community is the secret sauce to getting anything done. The reality is, as a healthcare provider or a researcher, I can come up with a lot of great ideas. But, if folks within the community don’t trust or don’t respect the information, it doesn’t matter how wonderful our therapies are. We won’t be able to have a positive impact.
It's important to remember that not everyone is science or health literate. The science community can fail to understand how to engage with the public. For example, with clinical trials, what are the trigger words that we need to know? If we talked about clinical trials as a continuum of care, we might get better traction.
We used to think of community outreach as putting up a flyer, setting up a tent, and talking to people about cancer. We now know that what is most efficient and effective is engagement. This means that not only are we giving information to the community, but we’re also receiving valuable information from the community that helps us connect with their specific needs.
Why is LUNGevity positioned to address health equity in lung cancer?
I think the reason why LUNGevity is in the best position is because we have the right leadership. It starts there. You have leaders within the LUNGevity group that not only feel passionate around this issue but are dedicated to coming up with strategies and are committed to recruiting folks who have expertise around this issue.
Dr. Winn, what gives you hope for patients with lung cancer?
If I look at the overall cancer disparities from 1999 through 2020, the difference has been reduced dramatically from 30% to about 15%. In my lifetime, I’ve seen miracle drugs on the market that are giving people with lung cancer a new lease on life. When I started, scientists told us that other than the cisplatin-based chemotherapy, treatment was mostly prayer. We now have a whole lot more in our arsenal to be able to treat lung cancer.
Related Reading:
- Publication Proposes New Framework to Address Disparities in Medically Underserved
- Meet LUNGevity’s Chief Health Equity and Diversity Officer
- Lung Cancer and COVID-19 in the African American Community
Robert Winn, M.D., is director of VCU Massey Cancer Center. In this position, he oversees a cancer center designated by the National Cancer Institute that provides outstanding cancer care, conducts groundbreaking research to discover new treatments for cancer and offers high-quality education, training and community outreach programs.
Before joining VCU Massey Cancer Center, Dr. Winn served as director of the University of Illinois Cancer Center from 2015 to 2019 and as associate vice chancellor of health affairs for community-based practice at the University of Illinois Hospital and Health Science System from 2013 to 2019. Prior to joining UIC, he spent 13 years at the University of Colorado Health Sciences Center and School of Medicine in a variety of leadership roles and clinical faculty appointments, including associate dean of admissions, vice chair of career development/diversity inclusion, and senior medical director of the pulmonary nodule clinic.