Statement of Purpose and Principles: Southwestern Pennsylvania Collaborative Network for Cancer Prevention and the Environment

WHAT MOTIVATES US?

All of us have been ravaged by cancer. Ourselves, loved ones, co-workers, neighbor children, patients, clients.

There is good news; rates of some cancers are going down, thanks largely to downward trends in smoking.1 But, there are many cases of cancer that will not be prevented by smoking cessation,2 and rates of some cancer types—especially those tied most strongly to chemicals and pollutants—are going up.3 Moreover, although cancer is considered a disease of old age, many cancers are rising in young adults.4

There is need for bold action in Southwestern Pennsylvania, where cancer risk from hazardous air pollutants is higher than in 98% of counties across the country;5 where some neighborhoods have higher exposures than others because they are in the shadow of polluting facilities,6 compounding other health challenges with roots in racial injustice; and where petrochemical development and a synthetic plastics future will likely increase cancer risk.7 As in other regions, consumer products, including building materials can expose people to carcinogens.8

We have come together because we believe in prevention, and we believe that reducing exposure to environmental carcinogens is an important aspect of cancer prevention that has been overlooked. Healthy air, water, food, products, workplaces are essential for cancer prevention. Controlling pollution and ensuring the conditions that allow for healthy choices by individuals require systems-level changes: changes in research priorities, policy, institutional practices and mindsets that can come about through collaboration across multiple sectors and constituencies.9 Southwestern Pennsylvania is a region with extraordinary capacity for charting a different course: an equitable transition to a future of healthy environments supported by a thriving economy that does not depend on toxic chemicals or technologies that harm people and the planet.

OUR VISION

Our vision is a future free of cancer, and an economy that doesn’t rely on hazardous materials and technologies, but instead on approaches like green chemistry and product design that emulates ideas found in nature. For Southwestern Pennsylvania, this is a future in which all people have secure well-paying jobs that do not make them sick, and live in healthy homes in healthy neighborhoods, without racial disparities in exposure to toxics and in cancer rates. We imagine local, regional and state governments that act boldly to reduce hazardous exposures before they cause disease; to dismantle policies that perpetuate inequities in social and environmental conditions which in turn affect well-being; to hold dirty industries accountable so it no longer pays to pollute, and to incentivize investments that establish Southwestern Pennsylvania as a hub of innovation for a green economy. We imagine expansion of businesses that improve air and water quality, provide nutritious foods and safe products, and maintain healthy workplaces. We imagine engaged residents who believe that everyone has a right to good health and a clean environment, and that both of these are foundations of a thriving economy. The people of Southwestern Pennsylvania respect science and are empowered to take action in their households, communities, schools and workplaces towards a bright future they help create.

WHO ARE WE?

We are a broad cross-section of people affected by cancer, including survivors, family members and friends of people whose lives have been taken by the disease.

We are community leaders, scientists, attorneys, engineers, cancer researchers, educators, clinicians and advocates. We represent organizations that conduct research, influence business and government decisions, and engage people impacted by environmental exposures that influence cancer risk. We are racially and economically diverse, and we strive to increase our diversity.

The visions and missions of our organizations are distinct, but we are clear that we share a common goal of accelerating understanding of and attention to environmental contributors to cancer and finding effective ways of reducing exposures and promoting safer alternatives. We have come together because we believe that by collaborating, we can find solutions: near-term actions that reduce exposure to environmental carcinogens, and long-term investments in an equitable economy that produces necessary goods and services without contributing to cancer and other chronic diseases. We share a commitment to policies and practices that dismantle racism as a root cause not only of environmental injustice but also of food, education and job insecurity, which contribute to poor health.

PRACTICES AND PRINCIPLES FOR OUR WORK TOGETHER

Four workgroups supported by staff design and implement projects. They meet monthly and come together quarterly to share progress, expand learning, and check-in on the synergies of the work. These workgroups are Education and Outreach; Policy; Science Support and Advisory; Community Engagement.

As we work together, we strive to abide by these principles:

  • Active and respectful engagement, attuned to inequities. Creating impactful change requires active engagement so we all can benefit from the unique wisdom, expertise and lived experience at the table. Your work is as important as mine; I will listen to your experience and perspective and be open to changing my opinion based on what you recommend. We recognize that systemic racism and inequitable distribution of resources underlies disparities in health and well-being. We pledge to attend to ways in which these dynamics play out within our network, to encourage surfacing of them, and to work together to address them in ways that strengthen our work across difference.
  • Strategic and opportunistic focus. It is wise to focus our collective efforts on a few priorities which this particular configuration of groups has unique potential to advance. This should not impede us from also moving forward other actions that have momentum already and could benefit from new partnerships.
  • Preparing for the long road ahead. This patient and ambitious work will take time and resources. We are committed to open communication about how to structure and fund our work together so that it is equitable and sustainable.
  • Disruptive and principled agents of change. We are willing to ruffle some feathers to do the right thing for the health and sustainability of our communities. For example, the pandemic has called attention to the concentration of environmental and other risk factors in communities of color and low-income neighborhoods; we will be in the forefront of calling for bold systemic change.

WHY US?

We have a unique lens, capacity and strategic approach.

Cancer is of great concern to people and institutions in Southwestern Pennsylvania, but few cancer-focused constituencies are engaged in efforts to reduce environmental exposures that contribute to the disease. The premise of this initiative is that collaboration by these constituencies, along with others who have expertise and lived experience in environmental and social determinants of health, can stimulate action—in research, clinical practice, policy, regulatory enforcement, community programming and the marketplace —that will reduce environmental risk factors, strengthen cancer prevention and advance an equitable and health oriented economy.

Our collaborative network is grounded in systems thinking: examining roles of different organizations and dynamics among them to inform strategies, build bridges across silos and sectors, and catalyze change at the scale needed. We are also grounded in the knowledge that different perspectives and organizational capacities are critical if we are to catalyze change at the scale needed towards our common vision. We are open to new Network participants.

We believe that all people deserve a thriving economy that steadily improves well-being in our region.

Alone we can do a little; together we can do so much.

1 Thun MJ, et al. Framework for Understanding Cancer Prevention (Chapter 61). In: Thun M, Linet MS, Cerhan JR et  al. (eds). Cancer Epidemiology and Prevention. Oxford Scholarship Online. 2017.
2 Myers DJ, et al. Cancer rates not explained by smoking: a county-level analysis. Environ Health. 2020;19(1):64.  3 Clapp RW, et al. Environmental and occupational causes of cancer: new evidence 2005-2007. Rev Environ Health.  2008;23(1):1‐37.
4 Ward EM, et al. Annual Report to the Nation on the Status of Cancer, Featuring Cancer in Men and Women Age 20- 49 Years. J Natl Cancer Inst. 2019;111(12):1279‐1297.
5 Graham J. Analysis of 2014 NATA Data.
6 Symanski E, et al. Air toxics and early childhood acute lymphocytic leukemia in Texas, a population based case  control study. Environ Health.2016;15:70.
7 Elliott EG, et al. Unconventional oil and gas development and risk of childhood leukemia: Assessing the evidence.  Sci Total Environ. 2017;576:138‐147; Lin CK, et al. Residential exposure to petrochemical industrial complexes and  the risk of leukemia: A systematic review and exposure-response meta-analysis. Environ Pollut. 2020;258:113476.  8 Li D, et al. Health risks of chemicals in consumer products: A review. Environ Int. 2019;123:580‐587; Singla V.  Carcinogens in Products: Inadequate Protections Raise Cancer Risks. Trends Cancer. 2020;S2405-8033(20)30136- 9.
9 World Health Organization. An Overview of the evidence on environmental and occupational determinants of cancer. 2010. International Conference on Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention; World Health Organization. Asturias Declaration: A Call to Action. 2011.