FARAI CHIDEYA, host:
How important is that kind of support? Well, an ongoing study from the University of Chicago suggests that women who don't have strong social support could be more prone to breast cancer.
Sarah Gehlert is leading the study. She's the director of the university's Center for Interdisciplinary Health Disparities Research.
Ms. SARAH GEHLERT (Director, Center for Interdisciplinary Health Disparities Research, University of Chicago): We're basing our work with women on a laboratory animal model that Martha McClintock developed, in which she varied the social conditions of laboratory animals and found spontaneous mammary cancers in the animals, especially when they were socially isolated.
So we're looking at women on the South Side of Chicago and in Gary, Indiana who've been newly diagnosed with breast cancer. And we are looking at factors in the social environment that might cause these sporadic or spontaneous mutations. So we construct a quarter-mile buffer zone around each woman's dwelling and literally count the number of violent crimes.
So we think that if women are living in high crime areas where there's a threat and they're living in housing where they're not safe, that they have to be sort of attuned to what's going on in their environments all the time. And we know from the animal studies that this causes a stress response that's abnormal. And in the animals, we can trace from the social conditions through the stress response to the development of tumors.
CHIDEYA: What other kinds of stressors are looking at in this study?
Ms. GEHLERT: We're looking at health behaviors. We're certainly looking at whether women smoke, their diets. We're looking at exercise. We're looking at whether they've had mammograms. But we're also looking at many factors in the social environment. We know where the Superfund sites are, the hazardous wastes sites in Chicago.
We are also aware of access to healthcare. We'll know the percent of poverty around each woman's dwelling. We'll know her insurance status. And we, from our focus groups with the 503 people in the neighborhood, got some idea of women's perceptions of the quality of healthcare. So we're trying to put this all together.
Recently in the press, there've been studies that looked at access to healthcare alone, which couldn't really explain the difference between black and white mortality from breast cancer. Others looked at genetics alone. And the reason that the National Institute of Environmental Health Sciences and the National Cancer Institute funded our study is that they realize that for the first time you've got to put scientist from all these disciplines, all these backgrounds together in the same room from the beginning, that it really is complex.
No one factor explains health disparities, and it's a complex interplay. You know, we used to think that genes sort of determined how you behave for the rest of your life, and now we're realizing that the social environment actually can change your genes.
CHIDEYA: So give me an example of a woman, you know, just a hypothetical of one of your typical women in the study. What kind of life is she leading? What kind of stress does she have? What are we really talking about?
Ms. GEHLERT: We've got a range of backgrounds on women, and a lot of it has to do with what she wants from her environment and what she gets. And I guess the worst case scenario would be a woman who lives in a neighborhood in which there's a lot of crime, and she's on the first floor of a house with no bars o the window, certainly no alarm systems, so she really has to - can't even sleep without keeping one ear open, as we say.
She's not able because of the environment around her house - which we're also looking at, I didn't mention that - to really get out and interact with people in the neighborhood. There aren't open areas that are safe. There might be a lot of vacant buildings that pose a threat. So she might be a prisoner in her own home.
And if she's of African ancestry and has a propensity toward the early form of breast cancer, that might mean that her body's naturally ability to repair mutations for breast cancer genes is turned off, and she then has an earlier form of breast cancer. Let's say she's 35, she develops breast cancer and it's faster growing. This is not a good picture, especially if she doesn't have good healthcare.
CHIDEYA: What do you do then? I mean you are someone who's studying these issues, but what you're talking about really is putting breast cancer in a matrix of all sorts of different environmental, biological factors. What kind of recommendations would you urge to better help people?
Ms. GEHLERT: Well, it's a multimodal approach. I would tell researchers to talk to people from other disciplines, so you can't just look through your own disciplinary lens. I would put the early form of breast cancer among women of African ancestry on the radar screen so insurance companies would pay to have mammograms for women before age 40. I would also try to make neighborhoods safer. We've got neighborhoods of our inner cities that have just pretty much been written off.
CHIDEYA: Sarah Gehlert, thank you.
Ms. GEHLERT: Thank you very much for having me on your show.
CHIDEYA: Sarah Gehlert is director of the Center for Interdisciplinary Health Disparities Research at the University of Chicago. She joined us from the university's radio station.
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CHIDEYA: Coming up, Latino immigrants send $60 billion to their native countries, and the Army is checking credit ratings to decide who to send overseas. We'll discuss these topics and more on our Roundtable next.
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