Note: Written by NBCF Chief Program Officer, Douglas Feil
Though breast cancer is still a leading cause of death for women in the U.S., the mortality rate has dropped by 40% over the last three decades. Some estimate that nearly 400,000 additional lives have been saved as a result of this progress.
Lower mortality rates could be attributed to a number of factors – improvements in treatment, early detection, and even awareness about the disease and the importance of screening. The good news is that we know what we need to do to continue this trend.
The bad news is that declining breast cancer deaths have not been equal for everyone. According to a new study published in Cancer Epidemiology, Biomarkers, & Prevention, black women are dying of breast cancer at twice the rate of white women. Though this study is new, the disparity is not. For decades, black women have been dying of breast cancer at a higher rate than white women. Hispanic women (lower incidence rate) diagnosed with breast cancer also have a higher risk of dying of the disease than white women.
The numbers don’t lie. It is clear that race and ethnicity are major factors in the survivability of breast cancer. Though some research suggests biological factors could play a small role, the overwhelming cause is a lack of access to quality care and socio-economic inequalities.
HealthyPeople.gov defines health disparities as “a health difference that is closely linked with social, economic, or environment disadvantage.”
How does National Breast Cancer Foundation reduce health disparities in breast cancer?
Some say knowing is half the battle, but when it comes to breast cancer disparities, knowing without acting is a battle lost every time. Action is paramount.
The National Breast Cancer Foundation (NBCF) is committed to reducing health disparities in breast cancer by offering evidence-based programs proven to increase access to care and reduce mortality.
Expand Education & Outreach
Educating about the importance of early detection of breast cancer and empowering women to take control of their breast health is critical to combating health disparities.
Information about breast health is not readily available in underserved and minority communities or for people in low socioeconomic status brackets in the U.S. Women in these communities are often unaware of the importance of early detection of breast cancer or that services are available to help them navigate the complex healthcare system.
Studies have shown that individuals who are uninformed about their health are less likely to take advantage of early detection services like mammograms. As a result, these women are at a higher risk of dying from breast cancer because they are diagnosed at a later stage when the disease is harder to treat.
That’s why NBCF is reaching these communities and equipping them with education about breast cancer and connecting them to life-saving resources.
Each year, NBCF partners with Convoy of Hope, an organization with a driving passion to feed the world, provide resources to underserved communities, and bring relief in times of disaster. Through this partnership, NBCF hosts outreach events in areas of low income and offers breast health education and connects tens of thousands of women to free, local resources that offer screening and breast health services. 47% of women served at these events are African American and 37% are Hispanic.
We know that interventions only work if people know about them, so we are determined to extend our reach into communities with health disparities and offer education, resources, and easier access to care.
Increase Access to Screening
Awareness and education about a problem is a first step. We know early detection saves lives, and we know the best way to find breast cancer early is mammography. But, there are still millions of women across the U.S. that are uninsured or underinsured and can’t afford the cost of annual screening mammography. That’s why NBCF funds free screening and diagnostic tests in hospitals across the U.S. Since 2010, NBCF has provided over 305,000 screening and diagnostic breast care services. NBCF funds hospitals that prioritize patients facing health disparities.
One of NBCF’s top screening partners, Parkland Hospital, serves uninsured patients in Dallas, TX. 79% of Parkland’s patients are black or Hispanic. Recently, Parkland identified two zip codes with the highest rate of late stage breast cancer in Dallas County and are now targeting these areas with education, outreach, screening, and follow-up care with the goal of increasing regular screening and finding breast cancers early. By providing funding for free screenings, NBCF is playing a vital role in this project and helping eliminating the barrier of cost.
Provide Patient Navigation for All
When Dr. Harold Freeman, the pioneer of patient navigation, started working as a surgeon at Harlem Hospital in the late 1960’s, he was overwhelmed by how many patients presented with late stage disease. Most of his patients were African American, and he realized that inequality in access to care accounted for this disparity. He dedicated his entire career in medicine to overcoming disparities in healthcare.
Dr. Freeman launched the first patient navigation program in the early 1990’s, with the purpose of eliminating barrier to timely cancer screening, diagnosis, treatment, and supportive care.
Today, navigators are trained and equipped to also address the social determinates of health. Patient navigators help translate breast cancer information for patients with language barriers. They help them find transportation and childcare, one of the main reasons for missed appointments. Patient navigators also help access financial assistance for uninsured and underinsured patients. The financial burden of a breast cancer diagnosis can be debilitating, but there is help for those willing to put in the time to find it.
NBCF funds patient navigation programs in hospitals across the U.S. with the goal to increase screening, reduce wait times, and ensure access to timely care. Since starting the patient navigation program in 2010, NBCF has provided 1.7 million patient navigation services to women in need.
A few years ago, we reached out to one of our patient navigators in Flint, Michigan. Flint residents were still reeling from the water crisis, so it required the patient navigator to go above and beyond to find solutions. When asked how we could help her current situation, the patient navigator said, “A mattress. I need a mattress.” The patient navigator was navigating a metastatic breast cancer patient sleeping on a perforated air mattress. She said the patient was having to wake up several times a night to fill the deflated mattress with air. This was causing a lack of sleep and made it hard for her to continue life-extending treatment. Finding a suitable place to sleep may not be in the clinical job description of a patient navigator, but it is a reality of working with patients in need of help and dignity.
A disparity can sometimes be environment, like the inability to get a good night’s sleep which is critical to a patient’s outcome.
NBCF is helping, but can more be done?
Like the disease, disparities in breast cancer are bigger than any one organization. The problem and solution require all of us. Tune into our next blog post to learn about what we must do to achieve health equity.
National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.