Research

Researcher: Qasim Hussaini, MD, MS

Program Description: Persistent poverty census tracts have experienced long-term neglect and underinvestment. These areas often have lower levels of wealth, homeownership, and educational attainment, along with limited access to high-paying jobs and health insurance. Residents are more likely to encounter environmental conditions that negatively affect health and have fewer resources that support well-being. Infrastructure, including transportation and specialized health services, is frequently insufficient. Creating opportunity in these communities requires sustained investment and the circulation of local capital. Expanding access to mortgage financing and providing housing assistance are both important strategies for supporting economic advancement and social mobility.

Project Aims:

• Establish aggregate measure of contemporary mortgage denial in persistent poverty areas.
• Investigate association between mortgage denial or malpractice and outcomes across the cancer care continuum in persistent poverty areas.
• Evaluate impact of providing housing assistance on cancer outcomes in persistent poverty areas.

Researcher: Patricia Ajayi-Fox, MD

Program Description: Colorectal cancer is a leading cause of cancer-related deaths in the U.S., but regular screening can help catch it early and save lives. Unfortunately, people with lower incomes often face more barriers to getting screened, including problems with preparing for a colonoscopy. This project focuses on understanding how health literacy—how well people understand health information—affects their ability to properly prepare for a colonoscopy at a county health facility. By identifying the challenges patients face, especially around understanding instructions, we aim to improve preparation success and ultimately reduce colon cancer rates in our community.

Project Aims:

• To determine the current rates of inadequate bowel preparation in our county facility and compare to patients from our academic facility.
• To determine the health literacy levels of patients undergoing colonoscopies in the county and academic facility setting.
• To determine the facilitators and barriers to adequate bowel preparation among patients undergoing colonoscopies.

Researcher: Lucia Juarez, PhD, UAB and Larkin Strong, PhD, MD Anderson

Program Description: Physical activity is essential for staying healthy and preventing diseases like cancer. However, extreme heat—especially in urban areas known as “heat islands”—may discourage people from being active, particularly in low-income neighborhoods. This study will explore how rising temperatures affect physical activity in communities in Alabama and Texas, with a focus on areas facing persistent poverty. By combining temperature data with community surveys and activity tracking, researchers aim to understand how environmental and social factors influence people’s ability to stay active. The goal is to design future programs that help people stay healthy and active, even as the climate changes.

Project Aims:

• To examine the association between proximity to heat islands and self-reported physical activity levels in a community-based cohort in Birmingham, AL.
• To examine the cross-sectional associations between proximity to heat islands with self-reported and objective PA levels in two community-engaged studies in Houston, TX.

Researcher: Chloe Taub, PhD, UAB and Pauline Long, PharmD, MedsPLUS Consulting

Program Description: People living in poverty, especially in rural areas of Alabama, often face more health problems like diabetes and high blood pressure, which can increase their risk of cancer. This project is testing a program called 360Care that helps patients manage these conditions from home using remote monitoring tools and support from trusted local pharmacists and community health workers. The goal is to make it easier for people to track their health, stay on top of medications, and get help early—without needing to travel far for care. Researchers will study how well the program works and how patients and providers feel about it. The long-term aim is to improve health and reduce cancer risk in communities that need it most.

Project Aims:

• To test feasibility and acceptability of the 360Care Program in a PP setting at the levels of the patient and relevant providers.
• To explore pre-post changes in patient outcomes relevant to the 360Care Program.

Researcher: Courtney Williams, DrPH

Cancer can cause serious financial strain, especially for people living in poverty, with many losing their life savings during treatment. This project will test a program called “Life Over Debt,” which helps cancer survivors manage financial stress through credit unions offering financial counseling, short-term loans, and loan relief. The goal is to see how well this program works for people in low-income communities and whether it can be expanded to help more survivors across the country. Researchers will talk to patients, credit union staff, and counselors to understand what works and what needs improvement. The ultimate aim is to reduce financial barriers to cancer care and improve health outcomes for those most in need.

Project Aims:

• Explore barriers and facilitators to the “Life Over Debt” intervention for credit union members with cancer living in areas of persistent poverty.
• Evaluate feasibility and preliminary impact of the pilot “Life Over Debt” intervention.

Researcher: Mackenzie Fowler, Ph.D., MPH

Program Description: This project will provide greater understanding of how our built environment and personal social and economic characteristics affect known differences in mortality from gastrointestinal (GI) cancers between persistent poverty (PP) and non-PP areas in Alabama. Ultimately, future studies will seek to implement interventions aimed at addressing these findings and eliminating the existing difference in GI cancer mortality between PP and non-PP areas.

Project Aims:

• Examine the extent that area level-built environment factors differ between PP and non-PP areas and decompose differences in GI cancer-related mortality by PP using factors associated with the built environment in AL.

Researcher: Soumya Niranjan, PhD

Program Description: This pilot project will develop a sustainable program that improves lung cancer screening adherence rates in areas with persistent poverty in Jefferson County, Alabama, through increased awareness of and concordance with screening guidelines. Assessments of the perspectives of individuals screened eligible for lung cancer screening regarding screening can improve the development and delivery of a culturally and geographically tailored education. Group Concept Mapping will be used to engage communities and explore complex health issues.

Project Aims:

• Identify barriers and facilitators of screening for lung cancer among residents of persistent poverty areas.
• Develop and pilot-test message approaches and communication channels that are effective in improving knowledge of and attitudes toward LCS among residents of PP Areas.

Researcher: Maria Pisu, PhD

Program Description: This project seeks to understand the challenges in access to medical care in persistent poverty areas. We will use the Penchansky and Thomas Access to Care Framework to understand the challenges in each domain to guide appropriate effective sustainable interventions and increase access and utilization of cancer screening and detection, diagnosis, treatment, and survivorship care.

Project Aims:

• Identify challenges to access to care from the perspective of residents in PP vs. other urban Census tract in Jefferson County, AL.
• Identify challenges related to access to care and participation in cancer-related research from the perspective of health care providers practicing in urban persistent poverty areas and other areas of Jefferson County, AL.