As a health marketer, I design culturally focused communication interventions to help people prevent and control disease and injury while living their best quality of life. I appreciate and rely on cultural insights so that I may engage America’s and the world’s diverse persons in the most relevant and respectful ways.

Why use this approach to communication? Because culture drives all behavior. What does that mean? According to “The Cultural Framework for Health,” a study by the National Institutes of Health, culture recognizes and incorporates the geographic, historical, social, and political realities of diverse communities. Simply, culture is a mix of where you’re from; the history of your ethnic nationality and race; the local, national and international politics of governments that affect your life; and the rules, habits, and customs of the groups to which you belong.

So what does culture have to do with cancer? A lot more than you might think. Understanding your cultural background can help you prevent cancer or control it. For example, the foods you eat, how physically active you are, how close you are to a doctor’s office—even religious and spiritual beliefs—can either make it more or less likely that you may get cancer in your lifetime. As I share my culture story of the men and cancer in my family, I encourage you to think about your culture and how you became the person you are. Why do you behave and believe as you do? The answers may surprise you—and give you clues to watch for as you work to reduce your cancer risk and live a healthy life.

Facing the Reality of Cancer Early

I grew up in the 1960s in Gastonia, North Carolina. It was a small city of about 60,000. My neighbors came from many different ethnic backgrounds: Japanese, European, African, Christians, Buddhists and Jews. By the time I was 9 years old, most of my neighborhood was African American, like me. As an African American, the two main cultural factors that influenced my health and wellness were racism and politics. The men of my family and I endured the historical legacies of enslavement and systemic racism. We had a segregated and inferior health care system compared to whites. We often had no health insurance, preventing us from seeing the doctor regularly.

The way I saw my family and friends treated in society made me choose to study political science in college. I hoped to make a difference in the world by influencing public policy. That thinking eventually brought me to public health. Now it’s 2018, and we still have a long way to go. African American men have the highest rates of cancer compared to other racial or ethnic groups. They get some of the most common cancers—prostate, lung, and colorectal cancer—and are more likely to die from them.

I was 13 when my great grandfather, Evans P. Parker, died from colorectal cancer at age 85. He was the most influential person in my early life. Literally, he got his 40 acres and not just a mule but several mules. (Forty acres and a mule is a phrase that refers to a promise from the U.S. government to former enslaved African-American farmers.) My great grandfather, who knew his formerly enslaved grandparents, managed a successful South Carolina farm. He produced and sold fruits, grains, milk, sugar cane, pork, and cotton to local merchants.

Like many rural Americans in the 1950s and ’60s, my great grandfather lacked access to high-quality health care. It was especially dismal for African Americans because the culture of the time upheld segregation laws that prevented them from using the major hospitals. Although my great grandfather lived a long life, he suffered unnecessarily because of poor access to quality care. This is a health equity issue that we still face today.

Cultural Choices Matter

Many of my relatives used tobacco, even after we learned that it isn’t safe. Family members brought their habits, like smoking cigars, dipping snuff and chewing tobacco, from the country to the city. I remember them telling me: “Demetrius, don’t you ever do this!”

I was lucky that obeying and respecting ‘my elders’ was part of my culture, because I listened to them. My parents created a culture of health for me, too, by choosing not to use tobacco like their parents, aunts, and uncles. Sadly, men on both sides of my family have died from lung cancer because of their smoking habits.

Of course, what you do affects your risk for cancer just as much as what you don’t do. I grew up eating fresh fruits and vegetables and whole grains long before the organic food craze. My mother taught me that as long as my plate is colorful with vegetables, I’m doing fine. I had a supportive community and spiritual faith. Religious and spiritual faith lowers stress and helps me to be emotionally healthy.

It was a family tradition for the adults to play sports with the children. Our frequent baseball games, pitching horseshoes and dodge ball games inspired my lifelong participation in sports and physical activity. People who eat nutritious foods, who get involved with others, and who stay physically active can avoid being overweight or obese and have a lower risk of cancer than those who don’t.

Your Culture, Your Story

Now, it’s your turn. Think about the men in your family and about yourself. What element of culture most influences your health? Is it ethnicity, nationality, gender, sexual orientation, faith? What are the favorite foods and drinks of your family? Are doctors trusted? Are natural remedies a cultural preference? Do you love being in the sun? Which is more important to your family and you: how dark you can tan, or protecting your skin? Is physical activity part of your culture? Do any family members use tobacco or drink too much alcohol? Are they overweight? Do they see the doctor regularly and discuss appropriate cancer screening tests?

Regardless of race, ethnicity or nationality, when we consider the cultural element of gender, men are more likely than women to get cancer. Men are also more likely than women to die from cancer. Every year, more than 300,000 men in the United States lose their lives to cancer, and many of these cancers could be prevented. Men, let’s encourage each other to take time and think about the connection between our cultural heritage and the activities our families enjoy. Do these activities raise our cancer risks or lower them? This is how understanding our culture can help us take steps to prevent cancer.

We can use elements of our culture to teach family, friends, and neighbors about lowering their cancer risk. Share information about sun protection at the family reunion. Encourage local leaders to make public places smoke-free. Work with community-based organizations and neighbors to help watch children or provide transportation so people can get to their doctor’s appointments. Start a nutrition and fitness group in your church, temple, synagogue, or mosque.

Our cultures are different, yet they connect us. We can adopt healthy behaviors from each other’s cultures and make them part of our own. Remember, culture drives behavior.

Demetrius M. Parker is a health communication, marketing and media strategist for the Centers for Disease Control and Prevention.

This article was originally published on October 23, 2018, by the Centers for Disease Control and Prevention. It is republished with permission.