Unfortunately, access can differ drastically depending on where someone lives. Because of this, the health behaviors that reduce cancer risk are much harder to implement for some than others. In many cases, rural communities and neighborhoods with low-income individuals or racial and ethnic minorities face added barriers to health. For example, rural residents often live miles from the nearest source of fresh, healthy food. This lack of access is one of several reasons why rural households face food insecurity at a higher rate than urban households. According to Feeding America, 9 out of 10 high food insecure counties are rural, and 8 out of 10 counties are located in the South. In comparison to neighborhoods with higher household income residents, neighborhoods with lower income residents feature fewer sports areas, parks, greenways, well-maintained sidewalks or bike paths. Rural communities lack the availability of public transit or close proximity of residential areas to everyday destinations, such as retail stores and schools, that help promote more daily physical activity in urban areas. The places people live can also impact their tobacco and alcohol use. Research shows that neighborhoods featuring an overabundance of convenience or liquor stores, and thus more advertising for alcohol and tobacco products, contribute to disparities in use rates. These retailers tend to cluster in neighborhoods with a high percentage of low-income residents or residents of color.  

While there is no one-size-fits all solution, there are a number of ways state and local governments, along with community partners, can work to reduce these disparities so everyone has the opportunity to be healthy, regardless of where they live. A few examples include: 

1. Providing support and resources for existing food retailers by assisting with food distribution challenges and establishing healthy retail programs 
2. Developing affordable and efficient transportation services for neighborhoods without convenient access to healthy food retail venues and adopting Complete Street policies to ensure streets are designed to be safely used by all
3. Supporting shared use agreements so that existing facilities, such as schools, can be used for physical activity by the broader community 
4. Decreasing the density of alcohol and tobacco outlets through licensing or zoning restrictions

By building healthier communities for all, we have the potential to make a profound impact on the health behaviors that are proven to reduce cancer risks.

Our work focuses on health disparities and working towards health equity for all. When a person’s functional needs are not addressed in their physical and social environment, this creates a barrier that can have a great impact on their day to day life. Data shows that people with disabilities are more likely to have poorer overall health, less access to adequate health care, and are at increased risk for preventable health problems. These differences in health outcomes are related to systemic disadvantages, such as socioeconomic factors, which are not primarily caused by the underlying disability. The COVID-19 pandemic has exposed further inequities as hospitals at capacity have made care decisions that discriminate against people with disabilities.

While there are many types of barriers that can affect a person’s ability to function, we are currently making efforts in our work to address communication barriers. These are experienced by people who have disabilities that affect hearing, speaking, reading, writing, and/or understanding, and who use different ways to communicate than people who do not have these disabilities.

Over the past year we have been assessing our software tools and websites and implementing changes that improve accessibility. Many local governments and organizations that we work with have adopted the federal law that requires all electronic and information technology be accessible to people with disabilities. In addition to meeting requirements, we recognize that being more inclusive is strongly tied to our stance on equity, diversity and inclusion, and celebrate that the internet was designed to create equal access for all. Tim Berners-Lee, W3C Director and inventor of the World Wide Web, stated that “The power of the Web is in its universality. Access by everyone regardless of disability is an essential aspect.”

We have already assessed our sister site, CounterTobacco.org, and are in the final stages of meeting compliance with Web Content Accessibility Guidelines (WCAG) 2.1, which defines how to make Web content more accessible to people with disabilities. Besides adhering to specific web standards, we understand that people learn in different ways, such as visual charts or graphics, data tables, or written or audio descriptions of information, and are incorporating multiple methods for understanding. Accessible web design often results in a better experience for all users, delivering a more intuitive user experience, with varied and flexible ways for users to interact with websites. We’re also aware that public health communication may use technical terms that are not accessible to everyone, including those with cognitive impairments, and are continually reevaluating language we use to share our knowledge and insights.

Besides our websites and software tools, we are also ensuring other types of materials are accessible, such as PDFs, PowerPoints, our podcast, and more. Incorporating accessibility is an important priority for us and we will continually look for ways to improve our own work and find ways to help our partners achieve their accessibility goals.