Sarah Nash tabulates and traces the burden of cancer – an undertaking that, perhaps uncharacteristically, first began with bones buried in archaeological sites.
Nash, assistant professor in the Department of Epidemiology in the College of Public Health and researcher affiliate at the Center for Social Science Innovation (CSSI), recalls inspecting the bones, which belonged to Europeans from thousands of years ago.
An England-native, Nash was then an undergraduate at Cambridge University, studying anthropology and archaeology, and was harnessing biological markers within the bones to stitch together the diet of Europe’s past.
After voyaging across the Atlantic for graduate school, Nash continued to investigate biological markers, this time with Indigenous American populations in the present. Working directly with Indigenous populations sparked Nash’s interest in community-engaged research and led her to earn a master’s in public health from John Hopkins University, in addition to her doctorate in biological sciences from the University of Alaska Fairbanks.
When Nash took a post-doctoral position at the National Cancer Institute and later the Alaska Native Tribal Health Consortium, she was finally exposed to the labyrinth that is cancer research.
Today, at the University of Iowa, Nash continues to monitor cancer, a present-day public health challenge that began with a fascination for remnants of the past.
“It’s funny how when you look back at your life, you see a trajectory playing out that you did not see when you were in the moment,” remarks Nash.
The complexity of cancer
At the university, Nash directs research for the Iowa Cancer Registry, which is a consortium of data about cancer in the state. The data is then used by researchers and clinicians to improve population and individual-level health.
For instance, how do doctors know the number of years an individual can expect to live after their cancer diagnosis? The answer lies in the Iowa Cancer Registry’s data.
Each year, Nash and others behind the Registry put out the Iowa Cancer Report, highlighting a specific cancer concern. The 2025 Report centered around cancer survivorship and how to best support the unique needs, which include screening for disease recurrence, of this growing population.
“We really wanted to bring attention to the fact that as our rate of new cancer goes up and our mortality rate goes down, that leaves an ever-increasing gap between the two rates. This means we have an increasing number of cancer survivors,” Nash explains.
Despite the Report’s focus on survivors and their care-gaps, another variable in this equation has, arguably, gained much more headline traction: Iowa has the second highest rate of new cancer diagnoses in the country.
Nash, who chiefly focuses on documenting this problem, is collaborating with other researchers, such as the university’s Holden Comprehensive Cancer Center and Center for Health Effects of Environmental Contamination, so they can use their expertise to combat the problem.
Nash doesn’t anticipate a quick fix, however.
“Cancer is complex. There’s not one thing that if Iowans stop doing, our cancer rates will go back down,” she comments. “It’s a multitude of different things.”
Health through the eyes and voices of communities
Nash also unravels the complexity of cancer for Indigenous populations, examining how obstacles in the community’s access to cancer care contribute to their lower cancer survival compared to non-Indigenous demographics.
For instance, a recent study of hers revealed state cancer control plans often fall short of including cancer priorities and strategies that are specific to Indigenous groups. She also points out that the Indian Health Service does not offer specialty cancer care and must refer patients to other clinics.
While Nash’s research primarily documents this disparity in cancer care for Indigenous communities, she urges careful attention to the larger context behind the problem: a historical past marred by colonization and its lasting impacts on Indigenous health.
For Nash, this realm of research is not hers to grapple with.
“I am a white British academic. I have to think about my positionality when I’m doing this work and what spaces are for me and what are not. How can I be a good ally without overstepping my boundaries?” she explains. “There’s a lot of really phenomenal Indigenous scholars doing phenomenal work that addresses historical trauma.”
For Nash, being a good ally has also meant responding to the existing needs of communities, rather than barging in with outsider priorities. This philosophy is how she wound up studying differences in the burden of cancer among black Iowans, exploring how black residents of Black Hawk County experienced and perceived the healthcare system.
Ultimately, throughout all of Nash’s research on cancer and health disparities (which she has used CSSI’s methodological workshops and Grant Writers’ Circle to advance), she is attentive to the voices and priorities of the community under study.
“I don’t believe we ever will make a lasting change in the health of communities without the leadership of the community, without understanding their definitions of health, and without listening to their strengths, resiliencies, and needs,” Nash asserts.
“We can’t come in and say, ‘This is what we think is healthy.’”
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