Thursday, October 12, 2017

African-American health care being undermined

Breast cancer mortality rate remains higher for whites than blacks, new study shows

Despite strides in meds and treatments, black women are still at a much greater risk of dying from breast cancer.

A recent story on the Huffington Post website by Suzy Strutner points out that while total survival rates for the disease are improving, a new study shows a huge gap remains. 

The new report, from the American Cancer Society, finds that "breast cancer death rates declined 39 percent between 1989 and 2015" but whites have a 39 percent greater chance of survival than blacks."

The gap, the study says, "emerged in the early '80s, widened through 2015 and has remained steady since."

Why the gap?

Because of "biological differences in breast cancer tumors, along with health care policy."

Regarding the latter, Strutner's story indicates that "unequal access to preventive screenings and treatment" includes black women getting mammograms "slightly more often than white women nowadays, but they had lower screening rates in the past, which 'may be one possible reason for the difference in survival rates today,' according to the Susan G. Komen website."

Not to mention "access to follow-up care [possibly differing] among the races."

Beth Glenn, Ph.D.
The HuffPost story goes on to explain that "less screening means black women might wait longer between  mammograms, be diagnosed late or be unable to follow up altogether when a mammogram comes back abnormal," according to Beth Glenn, Ph.D. associate director for the UCLA Kaiser Permanente Center for Health Equity.

Besides, "for black women who live in poverty, clinics might be too far away," the story adds. 

Christine Ambrosone, Ph.d.
The story also quotes Christine Ambrosone, cancer prevention chair at the Roswell Park Cancer Institute, about poverty blocking black women from care: "Things like transportation for cancer treatment can be a barrier, particularly for women who need radiation therapy, a treatment that needs to be given daily, and who cannot get that time off from work."

Strutner also cites "racial discrimination in health care settings."

As to the biological differences, her HuffPost story says "black women are twice as likely to be diagnosed with triple negative breast cancer, an aggressive form that's harder to treat. And tamoxifen, a drug that's hugely responsible for the overall improvement in death rates, treats another type of breast cancer, called hormone-receptor-positive breast cancer, that black women are less likely to get."

At the same time, Strutner's story indicates, Native American, Latina and Asian women all have lower rates of breast cancer and death from the disease than white women.

It also cites the report mentioning the states of Massachusetts, Connecticut and Delaware as managing to "close the gap, likely by widening health care access so it's easier for everyone to get treatment when they need it" — including Massachusetts passing "a health care reform that requires all residents to have health insurance and offering free health insurance to poor residents who qualify."

The story quotes Glenn as saying that "in general, states with more coverage for low-income women tend to have better outcomes."

Further information on different situations for different races can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

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