In a city that in recent years has come to epitomize the growing racial divide in wealth and health outcomes, Georgetown University’s Lombardi Comprehensive Cancer Center, with help from the Ralph Lauren Corporate Foundation, is establishing a patient navigation, screening, and education center to serve historically marginalized neighborhoods.
Source for all photos in this article: Georgetown Lombardi Comprehensive Cancer
The Ralph Lauren Center for Cancer Prevention, which opened on April 17 at 1010 New Jersey Avenue Southeast, is singularly focused on reducing disparities in health care that disproportionately affect the city’s Black residents and other minorities that reside in working- and middle-class neighborhoods in the eastern quadrants of the city.
The center is also dedicated to improving access to clinical trials and increasing opportunities for historically marginalized patients to participate in research.
“The primary area is Ward 6, 7, and 8. Yes, East of the River. And definitely your H Street Corridor, for sure,” Lucile Adams-Campbell, director of the new Ralph Lauren Center, said to this reporter, referring to a historically Black, now-bustling commercial strip immediately northeast of the U.S. Capitol.
The 1.5-mile corridor burned during the 1968 riots—sparked by the killing of Rev. Martin Luther King Jr. in Memphis—a brief period of anger and violence that damaged more than 900 businesses and blighted many neighborhoods east of Rock Creek Park for 30 years, thus setting the stage for a long period of decline, skyrocketing crime rates, and persistent poverty.
“People who have money continue to get money, and people who are poor tend to continue to be poor,” said Adams-Campbell, associate director for minority health and health disparities research, senior associate dean for community outreach and engagement, and professor of oncology at Georgetown Lombardi. “When you can address the needs of the community, you can make a very, very big positive and favorable change. That’s what we do, and we’ve been doing that successfully for over 15 years.”
The Ralph Lauren Center is opening at a time when coverage for preventive services is under attack from far-right conservatives in the judiciary.
On March 30, a Texas federal judge invalidated the Affordable Care Act’s preventive care mandate, which means that half or more of the U.S. population—especially low-income and historically disenfranchised communities—are at risk of losing zero-cost-sharing coverage for cancer screening and high-value preventive services (The Cancer Letter, March 31; April 14; April 21, 2023).
Georgetown Lombardi’s new facility in Southeast DC isn’t the first Ralph Lauren Center funded by the foundation.
In 2003, Lauren worked with Harold Freeman, the father of patient navigation, to establish the first Ralph Lauren Center—a partnership between Memorial Sloan Kettering, North General Hospital, and the Ralph Lauren Corporate Foundation—to serve Harlem and surrounding neighborhoods. The center became a part of MSK in 2019.
In May 2022, the Ralph Lauren Corporate Foundation announced $25 million in grant funding—the largest single philanthropic commitment in the company’s history—to expand or establish five Ralph Lauren Centers dedicated to underserved communities (The Cancer Letter, May 13, 2022). The specific amounts granted to each center aren’t disclosed.
Lauren, a celebrated fashion designer whose estimated net worth exceeds $7 billion, has a longstanding relationship with Georgetown Lombardi. In 1989, after his friend, Nina Hyde, then-fashion editor of The Washington Post, was diagnosed with breast cancer, Lauren established the Nina Hyde Center for Breast Cancer Research.
The Ralph Lauren Center in Washington builds on an existing program, called the Capital Breast Care Center, led by Adams-Campbell, who, incidentally, is also the first African American woman to earn a PhD in epidemiology in the United States.
“This genesis, for me at least, in my journey, extends to when I first moved here 15 years ago,” Louis Weiner, director of Georgetown Lombardi and the MedStar Georgetown Cancer Institute, said to The Cancer Letter. “My first act upon being recruited to Georgetown to lead the cancer center was to recruit Lucile, who was an acknowledged superstar in the field, and somebody whose history of passion and commitment to the cause of the underserved in the District was unparalleled.
“One thing led to another, and it culminated with an agreement for the Ralph Lauren Foundation to provide us with support to significantly expand the scope of services offered by the Capital Breast Care Center. We renamed it, rebranded it, and fixed it up. It looks really beautiful, and it’s now the Ralph Lauren Center for Cancer Prevention.”
A conversation with Adams-Campbell and Weiner appears here.
Lauren’s philanthropy enables Weiner and Adams-Campbell to expand the center’s offerings to include comprehensive resources for the diverse populations that are disproportionately impacted by lung, colorectal, prostate, and other cancers—from screening to treatment, when necessary. The center will also include a wider array of cancer-focused services, targeted outreach and education in collaboration with MedStar Health, Georgetown’s academic health system partner.
In early conversations with Freeman about setting up the first center in Harlem, Lauren was only concerned with what the facility needed to fund its mission.
“He got 100% of the money he wanted, and it came in less than 24 hours. My dad didn’t want to see spreadsheets and facts. There was no organized philanthropy, no checking a lot of boxes. This was our mission,” David Lauren, president of the Ralph Lauren Corporate Foundation and chief branding and innovation officer of the Ralph Lauren Corporation, said to The Cancer Letter.
“We didn’t have 25 different causes. This was it: let’s keep building on cancer. And we were very focused on that. So, this made sense. We could stay targeted, and we could stay focused.”
A conversation with Lauren appears here.
Separate and unequal in the nation’s capital
To understand why Georgetown Lombardi’s Ralph Lauren Center has the potential to play an outsized role in improving health outcomes, it’s necessary to view its mission against the backdrop of economic and demographic change in Washington.
Relatively unaffected by the 2008 recession, Washington is one of the most rapidly growing major cities in the United States, thanks to the federal government and stable regional economy—and in spite of building height restrictions and a dearth of affordable housing within the 68.35 square miles that make up the District.
Over the past decade, the median household income in Washington increased by at least 50%, from around $60,000 in 2011 to $90,000 in 2021. The city’s population grew by 15% or more, from about 600,000 to more than 700,000 residents over the same period, according to city officials and the U.S. Census Bureau.
Alas, DC epitomizes unbridled gentrification and inequitable economic growth: This boom is primarily driven by households making $200,000 and up, and there is abundant evidence that, amid surging urban revival, the city is experiencing some of the worst, widespread displacement of low-income communities in the U.S., according to a 2019 study by the Institute on Metropolitan Opportunity.
As we study the social determinants of health, we know that we make a difference, we make a very positive impact when we can address the barriers. Having the Ralph Lauren name behind what we are doing is very impressive. It spreads a very good message across the nation, not just DC, but nationwide.
Lucile Adams-Campbell
From 2010 to 2020, the proportion of white residents increased by 25%, whereas African American communities shrank by 6.3%—the continuation of a trend that saw the Black population decline by nearly 30% over a half-century, from 71.1% in 1970 to 41.4% in 2020.
DC residents experience a high level of income inequality, higher than in any state in the country. Households in the top 20% of income have 29 times more income than the bottom 20%, according to a 2017 analysis by the DC Fiscal Policy Institute.
The District’s bottom fifth earns only 1.9% of the total income earned, the third lowest income share among the largest American cities. Meanwhile, its top fifth takes home 55.5% of the total income for the city, the DC Policy Center wrote in 2017.
“White households in DC have a net worth 81 times greater than Black households,” the Urban Institute wrote in a joint 2016 publication with Duke University, The New School, and the Insight Center for Community Economic Development. “In 2013 and 2014, the typical white household in DC had a net worth of $284,000. Black American households, in contrast, had a net worth of $3,500.”
Health disparities remain observable at a hyperlocal level, the result of decades of de jure and de facto segregation in Washington: Gaps in health outcomes and disease prevalence often fall along racial and socioeconomic lines in census tracts that are mere blocks apart, and sometimes in neighborhoods that are divided only by two-lane streets.
This is true for the H Street Corridor and its surrounding neighborhoods in Lower Central Northeast DC, which has been the focus of intense residential and commercial redevelopment over the past decade.
Compared to their neighbors in recently gentrified, majority-white communities, residents of majority-Black neighborhoods on average experience higher prevalence of coronary heart disease (2 times higher), chronic obstructive pulmonary disease (2.35 times higher), and obesity (1.5 times higher), according to 2017 data from the Centers of Disease Control and Prevention.
Across the District, disparities in cancer mortality rates echo the aforementioned numbers: Averaged across four common groups of cancers—lung, breast, prostate, and colorectal—Black Washingtonians are about 2.5 times more likely to die from these cancers, compared to their white counterparts. This number increases to nearly 3.3 times for breast cancer alone, according to 2015-2019 data from the U.S. Cancer Statistics Working Group.
Cancer Mortality disparities in the nation’s capital
Mortality rates, per 100,000. (2015-2019)
“Black life expectancy in Washington, DC, was the lowest among all races at an average of 72.7 years. This compared unfavorably with an average of 88 years for white people, 88.3 years for Latinos, and 88.9 years for Asians,” Brookings Institution experts wrote in a 2022 analysis. “In 2019, Black people in Washington, DC, experienced the highest unemployment rate, 4.8%, of any of the jurisdictions we reviewed. The largest percentage of Black residents living below the poverty line, 21.6%, lived in Washington, DC.”
The Ralph Lauren Center for Cancer Prevention, located one block away from the Navy Yard-Ballpark metro station in Ward 8, is designed to be accessible to communities that carry a disproportionate burden of disease—in particular, legacy redlined neighborhoods east of the Anacostia River that continue to experience the greatest racial disparities in life expectancy, income, unemployment, and poverty in the District, according to the Brookings report.
But the enduring primary motivation of this work is to help our neighbors, to give them the care they need when they need it so they have the best possible chance for a good outcome, and where that involves participation in a clinical trial, great. But first and foremost, we’re here to help.
Louis Weiner
“I think [the Ralph Lauren Center is] a wonderful thing to bring to East of the River in Washington, DC, where you have more underserved, uninsured, underinsured minority populations,” Georgetown’s Adams-Campbell said to The Cancer Letter. “It’s also very fortuitous for us to be in this position at this time.
“As we study the social determinants of health, we know that we make a difference, we make a very positive impact when we can address the barriers. Having the Ralph Lauren name behind what we are doing is very impressive. It spreads a very good message across the nation, not just DC, but nationwide.”
The Ralph Lauren Corporate Foundation is working with Conquer Cancer, the ASCO Foundation, to identify three more NCI-designated cancer centers that serve communities in need, where a Ralph Lauren Center can have the greatest impact.
“Los Angeles is one of those communities. Part of this process includes an expert advisory panel, composed of leading oncologists, patient navigation, and health equity experts who have assisted in evaluating proposals from potential centers,” officials at Ralph Lauren Corporate Foundation said to The Cancer Letter. “We have not yet disclosed the specific location of the next new center but hope to share an update soon.”
Qualifying hospitals are invited to participate in an RFP process. Applicants’ proposals must clearly outline three key components:
- The hospital’s qualifications and historic commitment to cancer care equity and preventive services;
- Its catchment area and the area’s demonstrated need for increased access to cancer screenings, prevention and treatment services; and
- A clear plan, grounded in community partnerships, to address social and economic barriers that create disparities in cancer care.
“Knowing the critical need we anticipate the centers will meet in each community, applicants will be asked to provide sustainability blueprints to demonstrate how each center plans to continue the Ralph Lauren Centers’ operations, services and mission,” foundation officials said.
Weiner said he is thrilled to see his vision come to fruition.
“We are thrilled about the ability to provide research-inspired cancer care to everybody, including our underserved neighbors,” Weiner said to The Cancer Letter. “We are thrilled to be able to conduct research, which is what cancer centers like to do and need to do.
“But the enduring primary motivation of this work is to help our neighbors, to give them the care they need when they need it so they have the best possible chance for a good outcome, and where that involves participation in a clinical trial, great.
“But first and foremost, we’re here to help. And that’s really near and dear to my heart.”
