The Honest Broker: Reimagining the Roles of Health Services Research, Community Partnership, and Policymaking to...

There has perhaps never been more urgency for health services researchers, community partners, and policymakers to work together to address inequitable cancer outcomes in the United States. In this commentary, we first sought to provide a brief overview of how health disparities research has changed over the past 50 years from descriptive studies of downstream drivers of disparities to upstream factors that have downstream impacts on disparities. Then, we used health disparities across the breast cancer care continuum as a base case to describe the interaction of individual, community, and structural factors that drive cancer outcomes. The accompanying article led by Dr. Fowler and colleagues describes the critical role that neighborhood factors, which often occur upstream of observed health outcomes, play in breast cancer mortality disparities between Black and White women in Alabama. We agree with the authors' suggestions for the health disparities research field to pursue multilevel strategies that leverage community-engaged research. By partnering with community-based organizations and policymakers, we propose that health services researchers, who are well positioned to provide rigorous and objective evaluations of social policies and programs and their impact on cancer outcomes, can play a critical role in achieving health equity. See related article by Fowler et al., p. 1740.