Population scientist Monica Baskin is the “Jackie Robinson” of cancer center deputy directors

As a new deputy director at UPMC Hillman Cancer Center, Monica Baskin has assumed a level of responsibility that is unusual, if not unprecedented, for a population scientist at an NCI-designated cancer center.

She is one of the trifecta of top leaders at UPMC Hillman, a population scientist working alongside the top clinician (Director Robert Ferris) and the top basic scientist (Jeremy Rich).

Though all U.S. centers are structured differently, making comparisons almost impossible, Baskin is one of the very few Black women in this position of deputy director at an NCI-designated cancer center.

“I think Dr. Baskin would be the Jackie Robinson, if you will, of this sort of approach of outreach and engaging folks, being the deputy director,” Robert A. Winn, director and Lipman Chair in Oncology at VCU Massey Comprehensive Cancer Center, and senior associate dean for cancer innovation and professor of pulmonary disease and critical care medicine at VCU School of Medicine, said in a conversation with Baskin.

Baskin is a professor of medicine at UPMC Hillman and assistant vice chancellor for community health equity at University of Pittsburgh Health Sciences.

She comes into the role during a time when the number of Black directors at NCI-designated cancer centers stands at five. From 2009 to 2019, there were no Black directors of NCI-designated centers. 

“I’m really excited about the five Black cancer center directors who exist right now,” Baskin said in a conversation with Winn and Paul Goldberg, editor and publisher of The Cancer Letter. “I see them as mentors, and they’re definitely people who have helped me throughout my career.” 

But where are the Black women NCI-designated cancer center directors?  

“I also will say, in terms of history, that there is not a Black woman NCI designated cancer center director, and I think there are many of my colleagues who have been definitely pointing that out and waiting for that glass ceiling to be broken,” she said. “In terms of why not?”  

Biases and structural issues make it difficult for women and people of color to advance into leadership roles, Baskin said. 

“I think it’s the same reason why we don’t see a tremendous amount of representation and diversity across the biomedical workforce,” she said. “Even though they may be in positions, they don’t have the opportunities to move into leadership.”

It’s important to encourage cancer center colleagues and NCI to increase diversity in leadership, Baskin said. 

“It really is important to use our voices collectively to really push upon our colleagues, NCI, and others, to recognize that the audacious goals that we have to—for example, cut the cancer mortality in half in 25 years—means we’ve got to have different people at the table than have been there in the past,” she said. 

UPMC Hillman Cancer Center Director Robert L. Ferris created a new deputy director position for Baskin, she said. 

“In order for some of these positions to exist, somebody also has to give up power and leave those positions, which I think is another way that’s very unique here in what Dr. Ferris has done with this position,” Baskin said. “It wasn’t to remove an existing deputy director, it was adding another position. It added another opportunity for someone to lead.”

How do you reach patients in Pittsburgh and the 29 counties of Western Pennsylvania, including those in rural communities? 

“What we’ve demonstrated in a lot of the work is that you can train allied health professionals, health extenders, community health workers, patient navigators, particularly as you’re talking about communities that are more distant to the cancer center itself,” she said.  

These health extenders can help establish trust between people in marginalized communities and their health care providers, Baskin said. 

“If you train people who are right there in the community, they know the cultural context,” she said. “They are the ones that are very trusted, and so, you can give a certain concentrated amount of training and they can help there.” 

As deputy director, Baskin also aims to increase representation in clinical trials.  

“They’re not in trials because we’re not asking them,” she said. “They’re not in trials because we have a bias and think that, ‘Oh, because they live in rural areas, they don’t want to do that.’ We’ve got to deal with that.’

“We also have to deal with some of the structural issues of some of the trials. Are there exclusion criteria that make no sense to safety that are eliminating some individuals from being able to get into those trials?” 

People want to be treated with respect, Baskin said. 

“They want to be treated with respect, they want to feel included, and given the resources that they need to live a healthy life,” she said. “I’m excited to have a voice, and have a senior leadership team here that is welcoming me into the fold to make those decisions, and I’m really excited about what we can do.”

Baskin and Winn agreed: Community outreach and engagement is a science. 

“There is a science to community outreach and engagement, how we have to value the community members, because again, as you’ve probably heard this saying before, if the problems are out in the community, the solutions are there as well,” she said. “We just need to treat and value the expertise that is in the community in the same way that we value the expertise in the ivory tower.”

Baskin spoke with Robert A. Winn, who was guest editor of The Cancer Letter and the Cancer History Project during Black History Month, and Paul Goldberg, editor and publisher of The Cancer Letter. This conversation is also available as a video. 

Monica Baskin: Well, first, thank you so much for the time and opportunity to talk today. It’s really an honor to be here. And yeah, a bit of good news. 

I was recently appointed as the deputy director of the UPMC Hillman Cancer Center, so really excited about being one of the three leaders here for our cancer center, and really advancing work to eliminate cancer as we know it.

MB: It’s definitely not lost on me that this is extremely unique, and I think it also is a testament to the leadership here, our cancer center director, Dr. Bob Ferris, and certainly other leaders, to recognize how important population science, community outreach, and engagement is to the core mission of our cancer center.

I think bringing a unique set of skills in terms of, how do we advance population science? How do we use our behavioral techniques to disseminate and implement all the wonderful discoveries that are out there? 

I think that’s very unique in this situation and something I’m really happy to be bringing to the leadership.

Paul Goldberg: I don’t know if there’s another center—I’m sure there has to be—that has a deputy director who is an expert in outreach and engagement. Does that exist? I don’t know. I mean, this is a baseball statistics question.

PG: Is this correct? Are we both correct?

MB: I’m pretty sure it is. 

I certainly have never seen that model, and I’ve been in this space around community outreach and engagement and health equity work for a while. 

So, I’m not aware of anyone at this level of senior leadership who has that as a background.

RW: This is why this is fantastic, and this is why I thought this interview was timely. I’m going to get to your path of outreach and engagement, and from beginning to end, of how we got from A to B. We’ll get to that in a second.

PG: I love stories about how it happened. So, how did this happen? Whose idea was it, yours or was it Dr. Ferris’s?

MB: I think that it’s probably a combination. One of the things I certainly felt from day one, when I took a position here at University of Pittsburgh and the cancer center, was that there was tremendous value for what I brought to the table.

Even without a formal title, I felt that my thoughts, my ideas, were certainly very much considered in all the decision making that was happening at the very top. 

I think it was a natural thought to move to another level as I had conversations with the director about my career path and what was interesting to me.

The person who actually recruited me to the University of Pittsburgh, Dr. Taofeek Owonikoko, as he moved from Pitt over to assume a cancer center director position recently, I think there was an open spot there for us to have conversations about where the future would like for me.

It was an equally mutually agreed upon thought about, well, “What is the future for you, and how do you get there?”

We realized that people don’t typically see leaders in outreach and engagement, or even population science, really leading cancer centers. 

So, by being in this role of deputy director, it gives me more exposure to some of the things that I think will be helpful as I think about other career paths within cancer centers. 

I think it was mutually beneficial between myself and Dr. Ferris.

MB: Certainly, if we’re talking about history, I’m really excited about the five Black cancer center directors who exist right now. 

I’m super excited because I know all of them. And so, we’ve had conversations. I see them as mentors, and they’re definitely people who have helped me throughout my career.

If you train people who are right there in the community, they know the cultural context. They are the ones that are very trusted, and so, you can give a certain concentrated amount of training and they can help there.

I also will say, in terms of history, that there is not a Black woman NCI designated cancer center director, and I think there are many of my colleagues who have been definitely pointing that out and waiting for that glass ceiling to be broken. In terms of why not?

I think it’s the same reason why we don’t see a tremendous amount of representation and diversity across the biomedical workforce. 

I think that some of it is biases and structural issues that make it difficult for women and people of color to advance. Even though they may be in positions, they don’t have the opportunities to move into leadership.

They also may not be thought of in terms of, what does a leader look like? 

If the pattern has always been males, or individuals who identify as white, or white males specifically, then even when you see someone different, you don’t think that they actually belong.

I think there are a number of reasons why, but some of it is there may be structural issues that are making it difficult for people to get into those leadership roles.

In order for some of these positions to exist, somebody also has to give up power and leave those positions, which I think is another way that’s very unique here in what Dr. Ferris has done with this position.

It wasn’t to remove an existing deputy director, it was adding another position. It added another opportunity for someone to lead. 

It just happens that the three of us together now, deputy director Jeremy Rich, who was previously existing in this role with a basic science and clinical science background, to be working in concert with Dr. Ferris, is a perfect match with all of our talents.

MB: Definitely. Great question. 

We’ve certainly had many conversations about how we diversify our workforce, but also how we retain and advance many populations that are currently not as representative. 

Part of it is we’re embarking in a space right now as we do our plans to enhance diversity, to get a good picture of the landscape, not only of the numbers of who do we have in those different demographics, but a look at the environment and the culture, and how people are feeling about inclusiveness, and feeling like there’s equity.

We’ve had a long history here, for example, with a women’s initiative task force that was started under Dr. Ferris and has grown, and we’ve had a number of wonderful national speakers that have come in and talked about some issues.

We’ve had frank conversations about where both current women faculty and trainees, but also individuals who are trying to recruit, what their feedback has been.

We are steadily mapping out a plan for how we address those issues. 

One of the issues, I think both of you recognize, is that sometimes the challenge is when you come in and you don’t see anyone who looks like you, you feel like this is not an environment that is welcoming of someone who might be from a diverse background.

Just being an African American woman in a senior leadership position positions us in a different way now, so, people can see, “Yes, I can go to this particular center, and they are elevating people that look like me into a position like that.” 

I think that also helps.

MB: I think there are some of us that are pretty stubborn, and they’ve reached a point in their lives, or have enough gray hairs, and are willing to stand up and really speak truth to power and talk about these issues.

I think that, again, just by having diverse perspectives in the room, the conversations are not the same, because we are there and so we will point out where you’re having conversations that may be biased towards one group or the other.

I think it really is important to use our voices collectively to really push upon our colleagues, NCI, and others, to recognize that the audacious goals that we have—for example, cut the cancer mortality in half in 25 years—means we’ve got to have different people at the table than have been there in the past.

MB: I am a community-engaged researcher. I have, for 25 years or so, focused very specifically and intentionally on engaging members of the target community as true partners in our science. 

I remember early on, as a junior faculty member, having arguments and trying to justify the work I was doing—in communities, giving talks and things of that nature—as being scholarship, and really recall some very brutal evaluations where people were saying, “You need to stop going to these churches and schools, and you need to do more of this, that, and the other.”

If the problems are out in the community, the solutions are there as well. We just need to treat and value the expertise that is in the community in the same way that we value the expertise in the ivory tower.

I’m happy to say we’ve really moved a very long way in this space, so much so that we have things like the ComPASS [Community Partnerships to Advance Science for Society] program right now, where NIH is literally funding community organizations to lead the science that’s related to some of these issues, as opposed to the academic institution.

Absolutely, I think using my platform here locally and certainly nationally to talk about the science of community outreach and engagement—I’m very happy to be with a group of colleagues, Dr. Winn, you’re aware that VCU Massey, Mayo, City of Hope, Karmanos, MD Anderson, UPMC, and UCSF, we’ve all come together to really focus on—how do we elevate this science of community outreach and engagement?

We have an inaugural conference about that coming up in May, where we’re bringing people together to talk about research methodologies that are specific to community outreach and engagement. 

How do you enroll in clinical trials and involve community outreach and engagement?

There are a lot of ways that we think we can elevate this concept around the science of community outreach and engagement, including ensuring that reviewers for CCSG site visits have that expertise. 

It’s great to have lived experience, not doubting that at all, but we need people to be actually credible in the science to be evaluating cancer centers on these issues.

PG: I would love to find out about where you were born in Atlanta, and how was your career path taking you in this direction?

MB: It certainly was not linear. I didn’t grow up thinking I wanted to be a deputy director at an NCI cancer center. But I did grow up in Atlanta, which I think is a very significant foundation for a lot of what I do.

I grew up in a space where I saw a lot of people that looked like me who were in leadership roles, who were really galvanizing their community in order to make it a better place for them. That was really important.

I was on a different path, career-wise, in my thinking. My senior year in high school, I lost my father to colorectal cancer. He was diagnosed, late stage, stage four. 

Within a few months of the diagnosis, he had passed away. So, that had major implications for me and what I was going forward with.

I chose to choose a career in psychology, primarily because I saw what my family was experiencing in that loss, and then really didn’t see a lot of people who looked like me who were in professions of mental health, or even talked about that. 

That was not a norm in the African American community—to talk about how you go and get help when you’re having these issues.

I went to that as a career. I’m a psychologist by training and went and did that work, and really, I think, maybe unconsciously, avoided cancer. 

Then what happened was I ended up getting a position, my first faculty position at Emory in the School of Public Health, and worked with Dr. Ken Resnicow, who had just gotten a grant funded by NCI. 

He had asked me to come on board, and so, I started to learn more about the community-engaged research with a couple of trials that he had going on.

As I shifted over to the University of Alabama at Birmingham, I became connected with the cancer center director at that time, Dr. Edward Partridge. 

Ongoing NCI funding of these special population programs and community network partnerships—which is where I think Dr. Winn and I first connected— really gave me insights into how you can build a coalition, a true partnership with community organizations, where you’re sharing budgets, you’re sharing decision-making. 

I got involved in The Deep South Network for cancer control.

That really just sparked what I think was my calling—to really focus on these issues, particularly cancers where we have prevention and early detection. 

No one should die from colorectal cancer, and that, really, was something that galvanized me to really do this work.

That’s probably where I am and why I’m passionate about it. 

I think having some of those great role models to show how there is a science to community outreach and engagement, how we have to value the community members, because again, you’ve probably heard this saying before: If the problems are out in the community, the solutions are there as well.

We just need to treat and value the expertise that is in the community in the same way that we value the expertise in the ivory tower.

MB: Certainly, the inspiration from my father—typically when we talk about African American communities, we’re talking about individuals who may be lower income, not educated, and so forth.

This was a man who was middle class, college educated, had all the resources and the insurance, and the fact that he died at age 51 from a totally preventable cancer got me to think about, well, what are some of the other things that get in the way with people doing, and getting access to, that screening?

That was certainly, and is still, a very powerful motivator for me to do this work. 

Certainly, as I mentioned, Ken Resnicow, who’s in a similar outreach and engagement role at Michigan, really helped to teach me about how you can be thoughtful in communities, how you can do rigorous science with community members, and help them to craft their questions and find solutions that are really impactful.

Dr. Ed Partridge really took me under his wing. When I started as a junior faculty member, I got a diversity supplement through NCI’s CURE [Continuing Umbrella of Research Experiences] program.

He was my primary mentor, and he walked through not only the science piece of it, but I think he was one of the first to really talk about my career development.

In fact, I sent him a note recently to just thank him as I got this position, because we talked about two paths for me in leadership, the traditional academic path going on, department chair, dean, so on and so forth.

But he also talked to me about leadership within the cancer center and the NCI network. 

At the time I said, “Do you really think someone with a PhD could be a cancer center director, or could be in senior leadership?” 

And he said, “Absolutely.” 

So, we talked about that, and that was important.

Then honestly, I think Dr. Winn, you certainly were one of the people. I’ll also say, looking at your career, and how you advanced, and your passion for engagement with the community has certainly been important. 

Just one-on-one, every time I see you at a conference, your willingness to give me a few minutes of time and give me advice. I think that was important.

Dr. Selwyn Vickers, who was the dean at UAB at the time, was also a very important person who again believed in this work, and certainly was supportive of my career during that time and wanted to see me thrive at UAB, and was delighted when I got the opportunity to come here to Pittsburgh.

And then lastly, Dr. Taofeek Owonikoko, as I mentioned before, he was someone who I actually tried to recruit to UAB, but he ended up getting out of that search and came here to Pittsburgh. 

When he reached out to me, I saw in him a great deal of leadership, passion, and things that I saw that I wanted to follow. 

Those are just some of the names. I’m sure there are a lot more who I’m missing, but those are some of the ones who are really inspiring me to do this work.

MB: Dissemination and implementation science, by far. 

It’s really taking a scientific view of how you actually implement the discoveries we already have found out.

Yes, we want there to be new fabulous treatments and other kinds of procedures that are going on, but one of the things that Dr. Partridge always would say, is that if we didn’t find any other discovery, if we could just implement the ones we’ve already had and get them to the populations that are currently not being reached, then we could actually continue to eliminate those disparities, and improve the quality of life, and extend life.

Dissemination and implementation is a science to figure out what works for whom, and how can you move individuals from a behavioral standpoint. 

I’m super excited about that. I’m also excited about looking at different ways to do that dissemination.

Our traditional medical models are, you go to a physician, you might go to a nurse, but what we’ve demonstrated in a lot of the work is that you can train allied health professionals, health extenders, community health workers, patient navigators, particularly as you’re talking about communities that are sort of more distant to the cancer center itself—so, your rural populations and so forth.

What my own personal research has found is that those are credible sources. 

Issues that we bring up a lot in those marginalized communities around trust. If you train people who are right there in the community, they know the cultural context. 

They are the ones that are very trusted, and so you can give a certain concentrated amount of training and they can help there.

I’m super excited about that. The other thing I’m excited about, it’s not necessarily innovative, but it’s that we have to diversify our trials. Representation in our clinical trials is abysmal with some of our major discoveries within cancer.

And you look at who the populations are—they are not reflective. And so, I think it’s really exciting to have these conversations that move away from individuals who are minoritized, don’t want to, they’re afraid of X, Y, Z study.

That’s not one of the major reasons why people are saying that they’re not in trials. They’re not in trials because we’re not asking them. They’re not in trials because we have a bias and think that, “Oh, because they live in rural areas, they don’t want to do that.” 

We’ve got to deal with that.

We also have to deal with some of the structural issues of some of the trials. 

Are there exclusion criteria that make no sense to safety that are eliminating some individuals from being able to get into those trials?

At the cancer center level, which we are doing here, we’re starting to take a look at those trials. 

Do we have trials that are really relevant to the catchment population that we have? And if not, those are the ones we need to go after. Those are the things I’m really excited about. 

I’m excited to have a voice, and have a senior leadership team here that is welcoming me into the fold to make those decisions, and I’m really excited about what we can do.

PG: Actually, maybe I should be asking both of you this question. Well, Dr. Baskin, your expertise, the area where you’ve really focused your early work as the Deep South. You’re now in Pittsburgh. How do these disparities issues differ regionally, or do they? Is there anything to be learned in Alabama that can be applicable in say, the Bronx?

MB: Great question. What I’ve found is probably similar to the genome. We are more alike than we are different. I didn’t appreciate, until I was here several months, just the similarities between the two cities, Birmingham and Pittsburgh.

A lot of similarities, including that history of racial residential segregation, and then also about the previous economy being much more into the industrial area and steel, and now the transition over to healthcare, banking, and technology.

There are a lot of similarities there between those two. But there’s also a lot of similarities in western Pennsylvania. Our catchment area is the 29 counties of western Pennsylvania. A significant amount of that population are individuals living in rural communities. Those experiences that I had from coming from Alabama, and then the work I did in Mississippi, are very similar.

No, they’re not largely African American populations, but the issues are similar in the sense of education, and poverty, and lack of actual access to primary care providers, health literacy—those things are exactly the same.

The solution, I think, is exactly the same. That’s one where we take local individuals, we train them, we help them to become an extender of the healthcare system. That’s the same. I do find that, yeah, I need to learn a little bit more. I say “Yinz” instead of “Y’all,” but at the core of it, there’s still the basic needs.

People want to feel like they belong. They want to be treated with respect, they want to feel included, and given the resources that they need to live a healthy life.

RW: Thank you so much. I know we’re at the end. And Monica, I just want to say that we really appreciate your time to be able to share your story with us, and to really share the excitement of the advancement and the progress of the importance of outreach, and the science of outreach and engagement, and what it contributes to the overall reduction of cancer health disparities, or just cancer burden.