Last month, The Washington Post shared results of a new study revealing that thousands of African American women are dying needlessly from breast cancer because of psychosocial, cultural and economic barriers. As the District’s only stand-alone cancer support organization, we at Smith Center for Healing and the Arts applaud the coverage of this important issue. The report’s timing however, is ironic as funding for programs that directly address these disparities is being dramatically reduced.
Diagrams of different procedures and treatments available at a breast cancer center in Lanham. (Marvin Joseph/The Washington Post)
The study, published by the Sinai Urban Health Institute in Chicago, confirms what those of us working in the underserved community already knew: Black women often don’t have information and access to proper care, in no small part because of a culture of fear and hopelessness. In other words, poverty, silence and racial inequities — not genetics — are responsible for high mortality rates.
Smith Center responded in 2007 to the District’s daunting breast cancer statistics by launching an innovative breast cancer awareness and Community Navigation Program to address the specific challenges facing low-income African American women. The program, which is the only one of its kind, has allowed us to serve over 12,000 medically underserved D.C. residents with targeted education and direct cancer support.
Through research conducted in collaboration with the Center for Urban Progress at Howard University, we concluded early on that fear and deeply entrenched psychosocial and cultural barriers to seeking care were as isolating as the physical barriers such as poverty and geographical division. These findings shaped all of our subsequent program efforts and drove home the critical need to end the silence around cancer, to keep the topic visible in the community and to offer women concrete ways to become more invested in their health and well-being.
Our research also led us to expand what began as an exclusively hospital-based program (we brought the first breast cancer patient navigator into Howard Cancer Center in 2006) into neighborhoods, greatly increasing the impact of our efforts by partnering with churches and community organizations to serve people where they live. We trained and employed navigators, all of whom were African American breast cancer survivors, to provide education, outreach and individual support. The navigators’ main focus is to provide access to appropriate cancer treatment services and information and resources on wellness, diet and nutrition, stress reduction and early detection. Smith Center’s integrative approach also directly addresses fear, social issues and other non-medical aspects of cancer by including elements of psychosocial support and holistic lifestyle practices
As part of our ongoing outreach efforts, we recently developed a video on the wisdom of survivors to encourage women to prioritize and speak openly about their own health. We are now widely disseminating this tool to help decrease fear and silence with culturally sensitive and personal advice from survivors who have faced the same challenges.
The Sinai Urban Health Institute study calls for a public commitment to ensure that quality breast health care, from screening to treatment, is available to all women, regardless of their ability to pay.
To do this, there must also be a commitment to addressing the psychosocial and societal barriers that prevent many from receiving necessary treatments. Yet, at this very moment, major reductions in private grant funding for the coming year are now forcing Smith Center to find new, private support or begin dismantling the Community Navigation program. Intensifying the ramifications of this loss, Mayor Gray’s 2013 budget proposes the elimination of the D.C. Healthcare Alliance’s insurance coverage for hospital care, which acts as a safety net for many of the women we serve.
If we truly hope to reduce these very real barriers to screening, treatment and recovery that are leading to an astonishing number of unnecessary deaths among black women in our own community, we must prioritize funding for programs that address them directly and where these disparities occur. Otherwise, we will be leaving our most vulnerable sisters on their own in the fight against breast cancer.
Shanti Norris is co-founder and executive director of Smith Center for Healing and the Arts. Carole O’Toole is Smith Center’s director of integrative patient navigation.
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