Lumbee researcher to study cancer among American Indians in NC

By Sarah Nagem

As a medical researcher and member of the Lumbee tribe, Dr. Ronny Bell has plenty of professional reasons to study cancer rates among Native Americans in North Carolina. 

But for Bell, it’s also personal. His father died of colon cancer in 2014 at the age of 82. 

Bell said his father, a retired educator with Robeson County schools who instilled in his children the importance of education, maintained a looming presence at 6 feet, 6 inches tall and 270 pounds. 

“Just a big man,” said Bell, who grew up in Robeson County. “And to see him, see how cancer ravaged his body until he passed away, it was just really hard.” 

Bell and two other cancer researchers in the state have been awarded a one-year, $225,000 grant funded by the the V Foundation for Cancer Research’s Victory Ride, which was held Saturday in Raleigh. 

The state’s three cancer centers designated by the National Cancer Institute – Duke University, the University of North Carolina and Wake Forest University – are teaming up for the project. 

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Bell is leading the charge at Wake Forest, where he serves as associate director of community outreach engagement and director of the Office of Cancer Health Equity at the Wake Forest Baptist Comprehensive Center. 

He said he reached out to his counterparts at Duke and UNC to pitch the project, which is being led by the Southeastern American Indian Cancer Health Equity.

“I said, ‘Hey, I’m American Indian by heritage. It’s important for me to reach out to this community and provide services,’” Bell recalled. “I said, ‘What if our three cancer centers work together to provide cancer services to the American Indian populations in North Carolina?'”

Ronny Bell is a professor of social sciences and health policy in the division of public health sciences
at the Wake Forest School of Medicine.
Contributed photo

Bell said he hopes the project will help researchers better understand how to encourage American Indians to get screened for cancer and to live a healthy lifestyle. 

“Most of the major cancers, we know that we can treat them if we catch them early enough,” Bell said. “So we need to make sure that people are getting screened for lung cancer and colorectal cancer and breast cancer and prostate cancer. 

“It’s a matter of increasing awareness of these issues,” Bell continued, “ensuring that people are having conversations with their doctors about making sure they’re getting screened when they need to.” 

Heart disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention.

That’s also true in North Carolina, according to data from the N.C. Department of Health and Human Services. Cancer is the second leading cause of death, including for Native Americans in the state.

North Carolina, which has the largest Native American population of any state east of the Mississippi River, is home to eight state-recognized tribes. Only one of them – the Eastern Band of Cherokee Indians in western North Carolina – is federally recognized, meaning it gets money from Washington for health care initiatives.

“They have a wonderful health care service there,” Bell said of the Eastern Band of Cherokee. “They have their own public health services facilities.” 

The Lumbee tribe, which is based in Robeson County and has about 60,000 members, has been pushing for more than a century for full recognition. 

Tribal Chairman John Lowery previously told the Border Belt Independent he anticipates Lumbees would get up to $300 million a year if the tribe gets full federal recognition. He said the money could be used to establish a treatment center for people struggling with opioid misuse

“Our people need a place for when they’re ready to get clean,” Lowery said. “And it needs to be somewhere near home.” 

Robeson County ranked last in North Carolina in the 2022 annual County Health Rankings, which uses measures such as access to clinical care and social and economic factors to determine the overall health of residents. 

Bell pointed to the county’s unemployment rate and the percentage of uninsured adults in the county as some of the health care challenges. 

The county had a jobless rate of 6.2% in March, compared to 3.8% statewide. 

In Robeson, 19% of adults under 65 are uninsured, according to the health rankings, which used data from 2019. The statewide figure is 13%.

The cancer study will have three main components. The first, Bell said, will involve compiling data “to try to get some understanding of the true impact of cancer among Native Americans in our state.”

Researchers will analyze the number of cancer-related deaths, hospitalizations, screenings and more, Bell said. 

Another component will include “talking circles” in which researchers talk to community members and leaders of the Coharie, Haliwa-Soponi and Lumbee tribes. 

The Coharie are based in Sampson County, and the Haliwa-Soponi are mostly in Halifax and Warren counties. 

The final part of the project will involve “community asset mapping” to determine what services are currently available, Bell said. 

“What are the gaps? What are the areas where we need to provide some emphasis?” Bell said the researchers will ask. 

A year from now, Bell hopes to present all the findings to tribal leaders across the state. Then, he said, the goal will be to help tribes come up with a strategy to reduce cancer risks and rates. 

“They’re the ones that know what works best in their community,” Bell said. “So we’re here to help facilitate that process.” 

Follow Sarah Nagem on Twitter: @sarah_nagem