In 1986, the National Cancer Institute's National Cancer Advisory Board (NCAB), recognizing the significant disparity in cancer incidence and mortality between blacks and whites, approved a special initiative to reach African Americans. Thus, the National Black Leadership Initiative on Cancer (NBLIC) was launched as the first minority outreach project of the National Cancer Institute. Under the leadership of Louis W. Sullivan, M.D., then a NCAB member, NBLIC was to elicit "the interest, support, and participation of the nation's black leaders and to reach the black community with information and strategies to prevent cancer.
The effort had a successful beginning in six U.S. cities serving as hubs for what would soon be formalized as NBLIC's Southeastern, Southwestern, Western, Midwestern, Northeastern, and Mid-Atlantic regions. A series of meetings - the first in Atlanta, November 20, 1987, and the last in Houston, September 30, 1988, initiated the organization process. On October 11, 1988, the regional chairs met in Bethesda, Maryland to summarize progress and determine future action. The priorities they set focused on the areas of: 1) dissemination of health information; 2) smoking cessation; 3) dietary modification; 4) cancer screening and early detection; 5) improving access to care; and 6) advocacy.
With participants expressing considerable concern that momentum would be lost without follow-up, a full-time coordinator was assigned to each of the regions. The regional coordinators were to identify public and private resources available for screening programs, identify other local groups or interests that could be marshaled as part of NBLIC's efforts, and help organize cadres of volunteers. The coordinators would also network with each other and provide feedback to NCI on activities and required resources.
In 1989, funds awarded to the Drew/Meharry/Morehouse Consortium Cancer Center Core Grant provided three years of support for full-time coordinators for the NBLIC regions.
The initiative began its work of creating regional directories of local groups and enlisting these groups to collaborate on cancer prevention efforts; identifying available public and private screening resources, maintaining an adequate supply of consumer and professional information, and providing feedback to NCI on the relevance and value of these materials, establishing working relationships with American Cancer Society volunteers, identifying facilities where black patients could enroll in clinical trials; organizing support groups; and networking across regions with NCI.
The six regions soon comprised a total of 55 volunteer coalitions in 38 states, with a potential target population of more than 12 million African Americans in the cities where coalitions were based. Coalition membership in each region equaled: Southeastern - 181; Southwestern - 233; Western - 192; Midwestern - 210; Northeastern -164; and Mid-Atlantic - 78.
By 1995, the ratio of active NBLIC volunteer coalitions relative to the African American community was one out of every 500,000, based on 1990 U.S. Census Data. Considerable variation among the regions - from one out of every 944,481 in the Southeast to one out of every 175,070 in the Southwest - reflected African American residential patterns, with the densest population in the Southeast and the sparsest in the Southwest.
Based on these patterns, states with minimal black populations -- Maine, New Hampshire, Vermont, North Dakota, South Dakota, Idaho, Montana and Wyoming -would no longer be targeted for NBLIC activities. Already active coalitions in the states would be maintained, but no new recruitment efforts would be made. Conversely, the Initiative began making special efforts to establish volunteer coalitions in rural areas with the largest African American population (defined as 280,000 or more), all in the South. States targeted for these efforts included Alabama, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Virginia. Reflecting these population trends, NBLIC reconfigured itself into four regions in 1996.
This same year, Morehouse School of Medicine (MSM) became the new grantee for NBLIC funding. During this time, the Initiative emphasized stronger cancer control coalitions, improved intervention strategies, and more effective programs. While the majority of NBLIC's volunteer coalitions addressed multiple cancer-related issues, several focused solely on women and breast cancer, smoking cessation, prostate cancer, or other specific areas.
By 1997, 68 volunteer coalitions had become part of the NBLIC network, targeting 98% of the nation's African American population, in 42 states and the District of Columbia. Program growth resulted in more than 1,700 participant contacts that year. At the same time, project objectives were revised to meet NBLIC's goal of increasing cancer survival rates as early as 1999, by developing knowledge, understanding, and positive practices among African Americans. Emphasis shifted to education on breast, colorectal, lung and prostate cancers, as well as improved nutritional practices. Additionally, NBLIC sought to demonstrate its considerable impact through comprehensive process and outcome assessments.
NBLIC's efforts have continually expanded and been strengthened through capacity building, identifying social networks, establishing community-based alliances, and securing federal support. Now, as part of NCI's Special Population Networks for Cancer Awareness Research and Training, NBLIC II, a re-launch and streamline of NBLIC, can further marshal the outreach and research efforts needed to close the gap in cancer morbidity and mortality for African Americans.
The NBLIC II National Office is housed at Morehouse School of Medicine (MSM) in Atlanta, Georgia. Dr. Louis Sullivan, MSM President Emeritus and former Secretary of the U.S. Department of Health and Human Services "passed the torch" of leadership to NBLIC's present Principal Investigator, Dr. David Satcher, MSM Interim President and former Surgeon General of The United States.
