00:00:00:14 - 00:00:06:16 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00:00:07:12 - 00:00:37:17 Dr. Winn Doctor Rivers, I want to first of all, thank you for joining me today. For what I am really looking forward to, or what, the things that are going on at Morehouse under your leadership. So I'd like to start off by sort of saying, you know what? Tell me a little bit about yourself. What got you into research and what got you into cancer research, and then how did you wind up as chair and the director of Morehouse Cancer Center? 00:00:37:19 - 00:01:13:13 Dr. Rivers Oh, absolutely. And Doctor Winn as always, I really appreciate your leadership. I really appreciate your, you know, your visionary, approach to the field of cancer, both on the care delivery side and on the research side, but even more so, outreach and engagement with diverse populations, which we both know are extremely important just to ensure that the scientific discoveries that we are making are beneficial for all people, but especially those who are disproportionately burdened, who may not be able to access these scientific advances, especially those funded by the National Institutes of Health and National Cancer Institute. 00:01:13:15 - 00:01:34:01 Dr. Rivers And so, as you mentioned, I'm Brian Rivers. I'm at Morehouse School of Medicine. Been here since 2015. Currently serve as director of the Cancer Health Equity Institute, as well as professor in the Department of Community Health Preventive Medicine. So let's rewind 20 years. I'm in grad school working on my master's in social and behavioral sciences 00:01:34:03 - 00:01:55:13 Dr. Rivers public health. And we were tasked to do an activity toward our final grade. And we had to do a genogram. We're really honing in on risk factors or risk stratification. So we were tasked to go and find out and learn about our family history. It was during that time that I learned that prostate cancer 00:01:55:15 - 00:02:18:23 Dr. Rivers you know, was just running through the family, right? Grandfather had some uncles that were, impacted by it. And so I'm just coming fresh out of undergrad, Vanderbilt University biology major, hard core fundamental biologist, love biology. Just had always had a knack for just, you know, studying living organisms. Right. And how they function is just as intriguing to me. 00:02:19:01 - 00:02:39:21 Dr. Rivers From animals to plants to, you know, humans. And but then I never heard of the prostate gland, let alone prostate cancer. So I did some research like any, you know, good student would do. I went over to the library at the time and started looking into it and was like, woah, this thing is serious. This thing is adversely impacting black men in this country. 00:02:39:23 - 00:03:01:06 Dr. Rivers And for reasons people weren't quite sure as to why. So I did some more research and still a lot of questions, more questions that I had, than I found answers for. And so ended up sticking with that topic. Did a master's thesis on it, realizing that, okay, what can we do now to increase awareness about it and help drive the research? 00:03:01:09 - 00:03:24:13 Dr. Rivers And so I actually did my thesis around prostate cancer screening, barriers and facilitators to prostate cancer screening. I would then go on to transition to grad school, my PhD work, at UAB School of Public Health. And I stuck with that topic because it was just so complex. Was it the biology? Was it social factors? Was it some access to care issues, or was it just one's own volition, one's own behavior? 00:03:24:13 - 00:03:42:19 Dr. Rivers I just don't know. I didn't know I need to be screened for prostate cancer. And how would you know if you're not in the swim lane? Right. And so stuck with it through grad school, ended up getting, my, you know, my PhD in health behavior. But my dissertation, again, was focused on prostate cancer screening at this time. 00:03:42:24 - 00:04:05:19 Dr. Rivers You know, I was able to leverage some data through a national, or through a federal grant at the time. Then I was going out to Texas and do my postdoc, and I continue the work out there in Texas and dealing and interfacing with, black men out there. Same issue, people just didn't have this level of awareness that was needed to really better understand why this difference occurred, and it was occurring. 00:04:05:21 - 00:04:21:01 Dr. Rivers And so completing, rounding out my postdoc got recruited to Moffitt Cancer Center, where I joined the faculty, in the Department of, Health Outcomes and Behavior. At the time, the chair was Paul Jacobson. My mentor also transition during that time, Dr. B. Lee Green, 00:04:21:01 - 00:04:22:10 Dr. Rivers he headed up Moffitt 00:04:22:10 - 00:04:27:01 Dr. Rivers Diversity. But it was really focused on, you know, how do we 00:04:27:01 - 00:04:38:01 Dr. Rivers reach out to those populations, that are in rural areas and those populations in urban areas and not be that may not be as represented in our research studies and our clinical trials. So 00:04:38:01 - 00:04:58:15 Dr. Rivers then I was more focused as a junior faculty on developing my program of research. And I continue with prostate cancer. Right. And, was able to leverage some funding through a number of initiatives that were already going on at Moffitt. The Community Networks program had a terrific pilot grant program I was able to be a part of, as well as the American Cancer Society Institutional Review Development Grant. 00:04:58:17 - 00:05:15:20 Dr. Rivers And it was in those two initiatives that I really began to delve deeper, you know. And initially, you know, we had we started doing some novel things in the community at a Barbers Against Prostate Cancer initiative. We started working with the churches, just trying to increase awareness. Right. But then at the same time listening to the men hearing their feedback. 00:05:16:01 - 00:05:45:05 Dr. Rivers And so, you know, let's go downstream and act some prostate cancer survivors and their spouses. If you had to go through this experience again, what type of information would you have liked to have been in place to assist with the decision making process? Because there were so many unanswered, questions from screening to biopsy to even what happens once you get diagnosed, especially with early stage disease, when you can either go to a surgical route or you can go radiation on the radiation route, right? 00:05:45:09 - 00:06:22:16 Dr. Rivers There was no clinical trial at the time, and to my knowledge, I still don't think there's a clinical trial that exists that actually tested both of those early intervention strategies head on. And so it was up to the patient and their caregivers to make these decisions on their own. Now we know about decision making. I study models of decision making, informed decision making, shared decision making, and what some of those tenets entail. A lot of individuals, this one in the capacity to even understand health literacy to the degree they need it to understand what a radical prostatectomy was, or brachytherapy or a prostate specific antigen test or even a digital rectal 00:06:22:16 - 00:06:59:24 Dr. Rivers exam. And so we created some novel, innovative ways of conveying this information, pulling it out of the NCCN patient portal, you know, which is evidence based information, trusted information. And we put it in novel platforms, we developed apps. We had iPads that would go in and help with the interfacing of and the transference of evidence based information to high risk individuals, right, in community settings, because many of them weren't coming, to the cancer center for a variety of reasons, you know. And so we had to go out into the community and educate and inform them and then navigate them to our lifetime cancer screening clinic. 00:07:00:01 - 00:07:26:24 Dr. Rivers And so the messaging, you know, went forth, men became activated. We hit a bump in the road with the task force, the US Preventive Task Force, you know, giving it a very low rate, which, very which brought quite a bit of confusion to the degree that individuals in the community began to say, are you trying to do another syphilis study on us that took place at Tuskegee. And I would say, no, not in the not in the we just out here increasing awareness because of the 00:07:26:24 - 00:07:31:05 Dr. Rivers difference in how this disease manifests in one group versus another. 00:07:31:08 - 00:07:35:24 Dr. Rivers That's all we're trying to do. So, you know, we're dealing with this whole guideline on the. 00:07:36:02 - 00:07:43:15 Dr. Winn Science, right. It’s science. It’s understanding the differences between two groups and trying to bring knowledge that can then come up with future interventions. 00:07:43:17 - 00:08:08:07 Dr. Rivers Absolutely. And the way in which we communicate that I can't go out in the community and talk about the sensitivity and specificity of a screening modality. Right? Not to that degree, but we have to, you know, at at the time, the best science that was available told us to go out and increase this awareness. So, you know, did that develop a robust program of research, got some R1 funding, got PCORI funding I had the first PCORI in the state of Florida. In the PCORI, 00:08:08:07 - 00:08:29:14 Dr. Rivers we actually brought in the role of a caregiver, and we had a dyadic intervention that really delve deeper into the context in which decision making happens, right? And the role of social support. And a RO1 that was literally looking at, you know, predictors of stress and how we can perhaps do a psycho educational intervention, you know, mitigate the stress around newly diagnosed patients. 00:08:29:16 - 00:08:55:21 Dr. Rivers And then we had some biological measures in there for, you know, biological plausibility to see if the intervention actually works. So we're looking at telomeres, and we're also looking at cortisol also just in saliva samples. And so you know, fast forward, you know, making tremendous progress. You know, having an impact start scaling nationally, got involved in some other agencies, Movember, and got involved in their men's health initiative around prostate cancer, was working with the American Cancer Society as well. 00:08:55:23 - 00:09:19:03 Dr. Rivers And then I got an invitation to come and serve on the National Advisory Council, of the National Institute of Minority Health and Health Disparities at the time led by Doctor John Ruffin, who's a tremendous leader in this field, a tremendous pioneer, a legend. Absolutely. And so I was appointed and then, to my dismay, you know, Doctor Ruffin, retired in 2013. 00:09:19:05 - 00:09:45:06 Dr. Rivers And so we're in that transition period Eliseo Perez-Stable, you know, took the helm at 2015 and then my, you know, appointment started through 2019. But during that time, I learned so much about the inner workings of the NIH and the IC’s and how NOFO’s are developed, you know. The legality of research, the business side of research, funding patterns, all the things that was sort of a black box to me as a faculty member. 00:09:45:08 - 00:09:51:08 Dr. Winn And the impact that the science has on the people within the United States that they don't even know. 00:09:51:10 - 00:10:13:13 Dr. Rivers Right. And the commission of the NIH to be the premier biomedical enterprise for all Americans. Right? Not just those who can afford it, but all Americans. It's showing that the scientific discoveries that are made at the bench are translated and are beneficial to all. Even if you kind of go into said institution, at least the discovery should inform some standard of care to ensure equality for all. 00:10:13:15 - 00:10:33:02 Dr. Winn That's right. The discoveries that are actually at the NIH and the NCI, if you look back since the 70s, have certainly made a difference for all communities. And I know, you know this, that the AACR report that we put out said that every racial group has benefited now, some to greater extent than others, but everyone has benefited from the scientific work that gets done. 00:10:33:02 - 00:10:35:20 Dr. Winn That then translates to the community as well. And so. 00:10:35:20 - 00:10:59:09 Dr. Rivers Important, extremely important work of, of this biomedical enterprise, the agency, as we call it. Right. Especially NCI and then and, and we just so, you know, indebted to many of those leaders who really blazed that trail. So, you know, who at the insight, who have the fortitude to pass the National Cancer Act, fought for the establishment of these cancer centers that we see close to 72 of them across the country. 00:10:59:09 - 00:11:01:15 Dr. Rivers Now. Incredible work has been done. 00:11:01:16 - 00:11:15:07 Dr. Winn Iincredible work. To to that end, how did you become the, what made you become the director of Morehouse? Because we going to get to the the roles. We're going to get to Morehouse and the Morehouse men in a minute about how are you making an impact on cancer at these HBCUs 00:11:15:07 - 00:11:19:14 Dr. Rivers But how did you decide to go from focused academic? 00:11:19:14 - 00:11:23:10 Dr. Winn Doing all this stuff. What drew you to the leadership role before? 00:11:23:12 - 00:11:37:14 Dr. Rivers So I got to nudge when I was at NIH on the council and I remember Doctor Ruffin said, if I go around and introduce themselves and I do not know who was in the room, remember, I'm just a little only junior faculty right, I’m an ESI. And I'm at this table and I was a big table Rob. 00:11:37:17 - 00:11:55:13 Dr. Rivers It's a big table. And so then I so I had to do it with celebrating our successes and then really talk about our passion. Got a nudge and say, you know, we need you in Atlanta. And I say, I'm sorry I, we never met. She said, Hi. My name is doctor Valerie Montgomery Rice and I'm the president CEO of Morehouse School of Medicine. 00:11:55:15 - 00:12:17:10 Dr. Rivers And I'm just starting, but I really want to address this burden of cancer. It's a passion of mine, and I really want to a cancer center develop the first one on a campus of an HBCU because we have this unique connectivity to, you know, these high risk populations. And we're not doing really anything in a coordinated fashion relative to, you know, addressing the burden of cancer. 00:12:17:10 - 00:12:34:04 Dr. Rivers And I hear it all the time about breast cancer, about prostate, about colorectal. You guys are addressing HIV and Aids. And here you're doing cardiovascular disease and you got a great neuroscience institute. What are you doing for cancer. So you know, she said how about you come in giving us a look. I’m like I I'm at Moffitt Cancer Center. 00:12:34:04 - 00:12:53:22 Dr. Rivers There's Clearwater Beach over there. I'm 45 minutes from Orlando. You know, I'm having fun. I'm very I'm 100% funded. You know, what more do I need? And so eventually came up, did a grand rounds. It was compelling Rob. The need. I mean, the community came out to my talk, key stakeholders came up to my talk. It wasn't just faculty coming out. 00:12:54:01 - 00:13:16:11 Dr. Rivers She invited the entire community. So when I walked in that boardroom to give my job talk, I was shocked at the leadership from around Atlanta that had came out and assembled themselves. Right. So I right then I knew this is serious. I mean, there is a burden. Then I started looking at the data for Georgia. I grew up in Atlanta, originally from Buffalo, New York, but grew up in Atlanta. 00:13:16:11 - 00:13:34:03 Dr. Rivers Moved there, moved to Atlanta when I was five. And so I grew up in Atlanta. But I didn't know the data on Atlanta especially in terms of health. Right. And so I started looking at the data. I was like, wow, Georgia's contributing 40% to the prostate cancer, cancer disparities seen nationally like, oh, we have work to do. 00:13:34:05 - 00:14:03:04 Dr. Rivers So I have some I have some experience from, you know, being a Florida of, you know, grantsmanship, publishing, you know, going out, disseminating your science and national meetings. And so I accepted the position, of director of the Cancer Health Equity Institute for our cancer center here at Morehouse School of Medicine. You know what the charge of, you know, taking a lot of that good knowledge that has been generated and really began to translate it to the benefit, not just at, on the bed at the bedside, but also in the community. 00:14:03:09 - 00:14:16:19 Dr. Rivers And then we began to just build out a structured program around, utilizing funds through the CPACH grant. And for those who don't know, that's Comprehensive Partnership to Advance Cancer Health Equity. Went to Dr. Sanya Springfields. 00:14:16:22 - 00:14:17:23 Dr. Winn Another giant 00:14:18:00 - 00:14:19:19 Dr. Rivers Huge, giant. 00:14:19:21 - 00:14:40:07 Dr. Rivers I mean, I mean, that is the reason why many of your minority serving institutions really have cancer research infrastructure because of doctor Sanya Springfield and John Ruffin with the, our CMI grants, those really helped build the infrastructure. And we were just able to come in and leverage. And, you know, as always the charge is, do good science, do good science. 00:14:40:07 - 00:14:40:22 Dr. Winn Man. 00:14:40:22 - 00:14:42:22 Dr. Winn I love what you just said. You said the 00:14:42:22 - 00:14:44:12 Dr. Winn charge. The charge 00:14:44:13 - 00:14:46:00 Dr. Winn is the do good science. 00:14:46:00 - 00:14:48:18 Dr. Rivers Do the science. Nothing more, nothing less. So here's a 00:14:48:18 - 00:15:12:12 Dr. Winn question. I know that there are now, currently, historically, for historically black, you know, colleges, universities that have a medical schools attached to them. And, you know, Howard Meharry, there’s you folks over at Charles Drew and you guys at Morehouse. Can you tell me over the last couple of years, what you guys have been doing to your charge of the science? 00:15:12:12 - 00:15:30:11 Dr. Winn What have you been doing? Any new moves, any focus, any build of infrastructures, any programmatic? Have you recruited some big hot shots? What have you been doing over the last, particularly as a cancer? And what have you guys been doing over the last several years to really start building that team in the infrastructure to drive the science, to make impact. 00:15:30:11 - 00:15:32:10 Dr. Winn And we going to talk about the impact in a minute. 00:15:32:12 - 00:15:57:22 Dr. Rivers Absolutely. And so, you know, realizing the charge before us to do good science, but then do it collaboratively, learning from each other, you know. A small institution but a mighty institution. We're celebrating 50 years this year Rob. So we're young institution. We're celebrating our 50th anniversary, you know, and it's so good that we're able to celebrate with, secretary, former secretary of health and our founding, president and director, Louis Sullivan. 00:15:57:24 - 00:16:18:06 Dr. Rivers So, you know, and so just building on those shoulders of giants, we are able to, you know, collaborate with the other black medical schools on various initiatives. The American Cancer Society put forth in the last four years, two great initiatives that really helped us, you know, further expand our infrastructure. The Diversity and Cancer Research Program provided the sub awards. 00:16:18:06 - 00:16:46:17 Dr. Rivers We were able to bring in clinicians scientists Rob. Postdoctoral fellows. We were able to start our own, the first, for the first time ever, our, cancer pilot grant program, the one that I started with. Institutional Development Grant program. So it's a mechanism where you can fund these pilot grants internally for up to about $40,000 for a year and the opportunity to renew them, but it gives the faculty the chance to develop that preliminary data that's needed for these R-level grants. 00:16:46:19 - 00:17:02:20 Dr. Rivers And so we are extremely, you know, appreciative to the American Cancer Society for that investment. Then they came and said, you know, these social determinants of health are an issue as well. How about we have these CHERC’s as we call them, right. Cancer Health Equity Research Centers. And all four of the black medical schools were successful in receiving these awards. 00:17:02:20 - 00:17:27:12 Dr. Rivers And so we galvanize around that. But in addition to we have been able to attract some great, great talent Rob. I mean, I'm talking about amazing talent. I would not even in my in my wildest dreams imagine that Doctor Rick Kittles will be on this campus. And for those who don't know, phenomenal geneticists, phenomenal. Co-Founder of African Ancestry. He’s does some great work in the prostate space, right? 00:17:27:17 - 00:17:49:06 Dr. Rivers Never in my wildest dreams that I think that doctor Melissa Davis, another phenomenal geneticist. Right. Homegrown, right in Georgia, Albany, Georgia, went to Albany, State University, and then went and did great things. And then came back home to do good in the hood, neighborhood that is, right. Like, that's giving me this talent. 00:17:49:08 - 00:18:25:14 Dr. Rivers And then a Sean Kimbrough and then a John Stewart, surgical oncologist extraordinaire, did some monumental work in UIC. Sean Kimbrough was out NCCN. He came in and just took on, you know, the leadership of our RCMI grant. Amazing talent here. And then all the folks that came with them, the up and coming leaders, Doctor Jabril Johnson and Doctor Liam Burnham and all these other young scholars that are, you know, again, biting at the bit, just trying to figure out how we can, you know, equalizes this thing called cancer discovery and making sure that all Americans are benefiting from these discoveries. 00:18:25:14 - 00:18:46:16 Dr. Rivers But even more so, those that may be disproportionately impacted by certain sickness and diseases. As indicated in AACR Cancer Disparities Progress Report. As chaired, you know, this year and presented to Congress and we appreciate that because to me, it's just a meta analysis and it's our report card of how we're doing. 00:18:46:18 - 00:18:48:23 Dr. Rivers So that's the importance of that progress report. 00:18:49:03 - 00:19:25:13 Dr. Winn You know what I love about the progress report is that it says progress report in a context of, what I love about what you're doing at Morehouse. And, this centered on the charge is science. And by increasing the scientific approaches and the rigor around that science, we benefit people. I really, really appreciate, that you are contributing to, not only identifying and figuring out what's happening in the disparity field, but how do we move beyond it and the progress. And so that... 00:19:25:17 - 00:19:52:24 Dr. Winn You know, again, I thank you and your leadership for sure. So as it comes to that, when you think about the big vision of where Morehouse plays a role in improving the health of the cancer burden, and of your catchment area, the cancer burden and just general, what your vision for Morehouse as a cancer center director? And one of the major, you know, and now it sounds like you guys are getting the pieces together, the infrastructure, the focus. 00:19:53:01 - 00:20:04:18 Dr. Winn What ultimately would success look like? Or what's your vision for the future for Morehouse? And it's a it's it's impacting and reducing the burden of cancer. 00:20:04:20 - 00:20:26:03 Dr. Rivers The vision, you know, as the president, eloquently states and restates quite frequently. And of course, Doctor Kittles, you know, it's to have, you know, Rob one of those signs behind me with the little blue box that you have on that sign. I see that NCI Comprehensive Cancer Center, maybe not comprehensive, but just to be NCI designated is the vision. 00:20:26:05 - 00:20:52:03 Dr. Rivers Why? Because it's important to get that level of respect and acknowledgment in the community, saying that we are doing some highly regarded and highly respected work scientifically, and we're translating it toward the benefit to eliminate this disease burden that's taking away, you know, work hours from you and your family. That's taking away your quality of life. That's taking away years that you can live and see your grandkids and great grandkids grow and do great things. 00:20:52:09 - 00:21:25:03 Dr. Rivers That's ultimately the vision. You know, Doctor Kittles has come in and reorganized that research enterprise for everything to focus on, genomics. All disease, all conditions has to have some level of genomics, realizing that if we really are serious about advancing precision medicine and precision prevention, then it's going that's going to be the seed that and we've been, you know, you know, dutifully in that regard, being able, you know, leveraging different grants. RO1 level grants, U grants and then some new grants, you know, that, you know, then even the mechanisms didn't even exist. 00:21:25:05 - 00:21:44:19 Dr. Rivers Prior to that allows us to, you know, really fortify our efforts and then charge forward. And so we're extremely excited about, you know, being able to address the needs in our catchment area, with this being Black History Month and unapologetically, you know, we do focus, a lot on my lion's share of our activities, on how we look out the window and see. 00:21:44:23 - 00:22:07:23 Dr. Rivers And that's really African Americans and or Black Americans. Just given the heterogeneity of just being, within being black. And so we have some novel contributions, we think, that we can learn from the conduct of research and the advancement of science with blacks or African-Americans in this country. And then be that national and international model for doing something about it. 00:22:07:23 - 00:22:38:04 Dr. Rivers I think we did a great job, Rob, in the last 10 to 20 years, characterizing disparities, understanding some of the key drivers. And you very well know, because you have some tremendous graphical displays of some of the structural and other drivers, Rob, of of these cancer inequities or these differences and outcomes and how we can target them now, we can be very specific in our grants now, and we can develop intervention strategies to ensure that we are having equitable approaches to all individuals in this country. 00:22:38:04 - 00:22:54:00 Dr. Rivers Equitable. That's not a bad word, is it? Equitable meaning giving people what they want when they need it in the amount that they need it? We realize that this is a capitalistic framework and all things will not be equal, but at least you can give me what I need when I need it, right? And the amount that I need it. 00:22:54:04 - 00:23:04:16 Dr. Rivers That's how we envision equity. That’s health equity to us. Nothing more, and nothing less is just making sure that I'm responsible to the patient before me. Whether you need a colonoscopy. 00:23:04:18 - 00:23:06:01 Dr. Winn In the community that you serve. 00:23:06:01 - 00:23:26:10 Dr. Rivers The community that they serve. Right. And that's our contribution to American history, right? Black history is important as I shouldn't even have to state. But it gives us an identity. It gives us our culture. It gives us our contributions to the big picture. Here's what we bring to the table. Here's what we offer. And the tide rises for all. 00:23:26:14 - 00:23:54:14 Dr. Winn Ah man you know, I love what you just said, because what you just said in your frame did quite well, that by having all communities, particularly the African community, African American community, that's healthy, it actually helps us all by having rural communities that are healthy. By the way, when you think of places like Georgia and Alabama and Virginia and these places where there is a long standing history of African-Americans and others within that rural community as well. 00:23:54:16 - 00:24:16:13 Dr. Winn So what you just said is that by making sure that the science benefits of communities and by bringing, a better sense of a reduced cancer burden, a better sense of wellness and health, it actually does good for everybody. And so I really love that mission. Quick question what keeps you awake at night, though? 00:24:16:15 - 00:24:46:00 Dr. Rivers What keeps me awake is really knowing that I'm in the South. I'm in the U.S. southern corridor. When I step outside of Atlanta, Georgia is mostly rural. And there's such a huge need, Rob, in our rural areas. I mean, between blacks, whites and, like, you know, everybody. Rural is within a category of itself, right. Out of the 159 counties in the state of Georgia, the lion's share of them are rural. 00:24:46:02 - 00:25:16:23 Dr. Rivers So what keeps me up is how do we develop intervention strategies and that they're where they're sustained in the backdrop of old archaic, antiquated policies such as Jim Crow, that the remnants of it still remain in some of these rural counties. So there's a policy piece that still is at play, right? Just being in the black belt region, only a couple of counties over from where the most atrocious study in the history of the world took place, the US syphilis study that took place at Tuskegee. 00:25:16:23 - 00:25:45:04 Dr. Rivers So we're still dealing with the multi-generational effects of that. So we focus a lot on bioethics in our in our approaches to engage communities. Right. And then realizing that the health systems in the rural spaces are constantly changing for a variety of reasons, but they're closing their doors, Rob, for variety of reasons. But then if you overlay that with data from the dynamic progress reports that you've been a part of, that you've led for the AACR, both the progress report and the disparities. 00:25:45:06 - 00:26:13:24 Dr. Rivers If you look at the data from the American Cancer Society, facts and figures. Right. That Southern Belt, I used to call it the chronic disease belt, Rob. Where almost every condition possible. You see black Americans fairing the worst. That's what keeps me up at night. That's why we need a cancer center on a HBCU because we have that connectivity uniquely to these individuals and our catchment area and throughout the state of Georgia. 00:26:13:24 - 00:26:42:10 Dr. Rivers That's what we were charged to do to increase the representation of primary care, realizing that it all starts with primary care, just increasing access to primary care. That's what we're trying to do as an institution. That's why Doctor Louis Sullivan helped establish this institution. So but how do we get that into the rural space and how do we make value as opposed to that rural cancer patient having to travel three hours one way and get stuck in Atlanta traffic just for chemo every day? 00:26:42:12 - 00:27:08:12 Dr. Winn I think you're making a really good point. And, you know, I, I do think that one of the things that I've, really have come to admire, about Morehouse is your, focus, keen focus of treating people where they are and having to think bigger and bolder and reimagine. How do we make sure that our rural communities are also benefiting from the science progress that we are making, and we are making progress? 00:27:08:14 - 00:27:42:04 Dr. Winn You know, and that report, black, white deaths. The difference between blacks and whites in the context of their cancer deaths in the 90s was 33%. That's now down to 11%. Absolutely. I tell people that that just didn't happen because we started eating more kale. Right. Or just because, you know, people started hitting the gym more. I mean, it really is a combination of behavior factors, more knowledge, but it really is the fact that the science that, taxpayers have invested in has resulted in molecules that have become medicines. 00:27:42:06 - 00:28:06:02 Dr. Winn And then we also, you and I both agree that once we talk about and this is from Harold Freeman, so we're ripping them off, you know, just, you know, because he's the man as well, especially during this month, that there is an issue of being able to focus on discovery science. But discovery science will only be as good as we are able to connect it to the delivery sciences and the implementation. 00:28:07:02 - 00:28:27:00 Dr. Winn In, in the time that we have left. Can you talk about Morehouse’s role in the context of be focused on the genomics and the genetics? Is there a role in the context of the, the implementation scientists, that Morehouse is also focused on? And what and how are you leading it as its director? 00:28:27:02 - 00:28:55:23 Dr. Rivers Absolutely. And so, you know, and that's my background, the latter, the implementation and dissemination science, you know, developing interventions and collaboration with key stakeholders, community members, looking at a multi-level, multi-sectoral approaches, you know, to standing up these interventions based on those scientific discoveries. That's what we're after now, and that's how we're going to probably advance health equity without a shadow, of a doubt, you know. Being able to take those findings and then translate them to meaningful interventions in our zip codes. 00:28:55:23 - 00:29:18:04 Dr. Rivers Right. Oh, yeah. As you all, as you coined the phrase, our ZNA. Understanding and being able to interrogate but then mitigate on our ZNA is extremely important. Realizing that it's this unique interplay of biology, behavior and environment. Why we see the outcomes, why they are good or bad is based on the how those three factors, you know, our, interacting. 00:29:18:06 - 00:29:39:22 Dr. Rivers And so we have to continue to, you know, push forth that model. But then at the same time continue to make discoveries, but realizing that, you know, the discoveries have to go beyond just a publication or a presentation, but they have to go to meaningful benefit for all Americans, right? Especially those that are disproportionately burdened. And and I think that's the intrigue. 00:29:39:24 - 00:29:58:21 Dr. Rivers I think that's what, Harold Freeman envisioned when he came up with the patient navigation model. And now CMS is covering elements of navigation. And we've seen so many different iterations. I mean, you talking about a genius, Rob. I mean, you know, these black women, you know, are coming in and getting diagnosed with cancer up there in Harlem at the, Ralph Lauren Cancer Center. 00:29:58:23 - 00:30:14:17 Dr. Rivers And then, you know, they, they they came back for their, you know, late for their initial course of, you know, treatment. And they were scratching their head like, what is going on? Is it stress, is it fear? What is it? So he developed this navigation model, piece of navigation model. NCI actually developed a, program around it. 00:30:14:21 - 00:30:42:16 Dr. Rivers And now you're seeing so many different iterations clinical trials, navigators, nurse navigators, genomic navigators, community navigator. I mean, he was ingenious in that approach. But that strategy is what we used to go out and do, the implementation and dissemination science to go and interrogate our community. And, you know, that model is sustainable as well. And it's elements of trust and trustworthiness in it is elements of helping us overcome the bioethical sequelae that we often have to address in our research, especially here in the South. 00:30:42:22 - 00:30:52:08 Dr. Rivers So the navigator, so that's just one example. You know, how we're taking those discoveries and then putting them toward meaningful benefit and how we design intervention strategies? 00:30:52:08 - 00:31:21:13 Dr. Winn That's awesome. So we're going to wrap this interview up. I'm going to ask you one last question. So it is Black History Month. And so if you had to and I know there are hundreds and thousands of, you know, heroes, with huge impact. But if you had to choose one that comes to the top of mind of a African-American, researcher and, clinician, whatever, during this month, who comes to mind for you and why, 00:31:21:15 - 00:31:23:16 Dr. Rivers Who's living or? 00:31:23:18 - 00:31:27:11 Dr. Winn Living or dead, doesn’t matter, you know. 00:31:27:13 - 00:31:52:02 Dr. Rivers I say, you know, I'm I'm gonna answer it in two ways, okay? Because, For the living black historian, I would say it has to be Doctor Winn. And I'm not saying that because you're before me. But, Rob, I have been able to labor and vinyard with you, you know, humbly over the last decade. And I've seen the strides that you have made. 00:31:52:04 - 00:32:14:11 Dr. Rivers I've seen the attacks that you have endured. I've seen how you continue to face the fire in spite of how hot it was. And so to me, that's inspirational. And I always tell you this and I always text you this, and I'm saying it to your face, you know, all be it, via zoom that, you know, you are one of my black historians that I like. 00:32:14:17 - 00:32:43:06 Dr. Rivers You know, that I highly esteem the trailblazing that you've made being, one of the first black cancer center directors, but even more so, an incredible clinician scientist giving you work back in Colorado. Given your work in Chicago. Now in Virginia, they're blessed to have you. Now for those individuals, for my other historian, I'll be remiss if I did not name Frederick Douglass because I actually graduated from Frederick Douglass High School the same year as 00:32:43:06 - 00:33:07:06 Dr. Rivers Killer Mike, also known as Michael Render, the one who just swept the Grammys last year with three Grammys. And yes, Frederick Douglass was a tremendous leader, right? A tremendous, abolitionist and advocate. And he advocated for all sectors of society to be health, but not just in the sense of the absence of sickness and disease, but complete mental, physical, social, economic, and spiritual well-being. 00:33:07:08 - 00:33:14:24 Dr. Rivers And so doctor Rob Winn and Frederick Douglass, happy Black History Month, everyone. 00:33:15:01 - 00:33:42:07 Dr. Winn We have the end it of that. But listen, Dr. Rivers, it has been my pleasure. And I just want to again, thank you so much for taking time out of what I know is a very busy schedule to share with us some of your insights, your wisdom, and your vision, for what you are doing as the cancer center director at Morehouse, we'll keep our eyes on and, keep our fingers crossed. 00:33:42:09 - 00:33:45:02 Dr. Winn And we'll continue to look for your progress. So. 00:33:45:02 - 00:33:45:23 Dr. Rivers Absolutely. And thank. 00:33:45:23 - 00:33:46:11 Dr. Winn You so much. 00:33:46:12 - 00:34:02:02 Dr. Rivers Rob. Thank you for your leadership. And just thank you to the cancer research and care community. I just want to shout out Marge Foti and AACI for all the work they continue to do and the forums that they give us, just, you know, being able to have this, you know, dialogue. And so thank you Cancer letters again. 00:34:02:02 - 00:34:04:18 Dr. Rivers Doctor Rob Winn, really appreciate you, brother. 00:34:04:18 - 00:34:05:07 Dr. Winn Appreciate you. 00:34:05:07 - 00:34:05:18 Dr. Rivers Man.