This proposal seeks to characterize the upstream conditions identified by this framework in the persistent, current, and low poverty census tracts in the Karmanos Cancer Institute (KCI) catchment area and throughout Michigan by 1) developing a data resource of variables characterizing the upstream factors (social inequities & social justice; institutional environments; and economic, physical, social, and service living environments) in the framework in the KCI catchment area and across Michigan; 2) characterizing the upstream factors of persistent, current, and low poverty census tracts using those data; and 3) evaluating associations between individual components of the framework and cancer prevention, incidence, mortality, and survivorship outcomes.