by Angela Waller, of Elevated Survivorship; Ariel J. Thomas, Manifest Vision Partners and Shonta Chambers from the Patient Advocate Foundation
Before remission, before treatment, there must be a diagnosis. And for Black women with breast cancer in Chicago, that diagnosis often comes too late.
The flip side of the well-known maxim—”early detection saves lives”—is that later detection can have the adverse effect, leading to higher rates of invasive breast cancer and accompanying fears of the disease spreading.
We need a comprehensive, community-informed strategy to reduce breast cancer disparities and improve outcomes for Black women in Chicago. As part of the Chicago Better Together Breast Cancer Disparities Think Tank, an initiative launched to address the disproportionate impact of breast cancer mortality on Black women in Chicago’s South Side and South Suburbs, and authors of the Pinkprint: Chicago edition, we find the cancer care continuum for Black women in need of intensive care.
Screening comes first. We must demystify the screening process. While women are accessing mammography screenings, the higher rates of invasive breast cancer in some communities suggests that they may be getting screened after the disease has already spread. For instance, in neighborhoods like Pullman and Washington Heights, patients experience over 30% higher invasive cancer rates than the city average. The data presented here underscore the continued need for targeted interventions to address the root causes of health disparities and improve breast cancer outcomes in our targeted communities.
We’ve worked within the community to help families document and discuss health histories. Next, though, the medical community needs to consider structural barriers to care. Mammography centers, for instance, should identify and address barriers to access, such as long wait times and limited availability of trained staff. We are pleased to see Illinois broaden access to medically necessary mammograms just this year, by removing arbitrary age limitations and covering more screening options.
Chicago boasts some of the best healthcare facilities in the country – but access is not equitably distributed. Our legislators must fully fund the Breast Cancer Excellence in Survival and Treatment (BEST) Act (PL99-433), which mandates that all Medicaid health plans include American College of Radiology Breast Centers of Imaging Excellence and Academic Commission on Cancer Accredited centers in their networks.
Policy advancements achieved under the BEST Act could become a national model, leading to a holistic transformation of the healthcare system by prioritizing access to the highest standard of care for all – regardless of income, zip code or race. The Cancer Care Continuum Action Plan’s success, outlined in the Pinkprint, will be measured by increased screening rates, reduced healthcare access barriers, and the adoption of equitable policy solutions.
Black women, too, remain underrepresented in clinical trials. In 2020, people of color comprised only 25% of clinical trial participants, despite making up 40% of the US population.
These demographics matter. People from different racial, ethnic, and demographic backgrounds might experience different outcomes in response to treatments. Expanding representation to include more Black women in clinical trials will lead to better treatments for Black women.
Understandably, though, historical and current healthcare injustices have led many individuals and communities to question the intentions of medical research and to some degree the health ecosystem. Local trial sponsors and teams must engage with communities in the South Side and South Suburbs to understand their concerns and financial barriers that hinder clinical trial participation. Within this context, they can center Black women by addressing social drivers and offering educational resources to dismantle misconceptions and financial support to mitigate access barriers.
For us, addressing breast cancer is a deeply personal and collective commitment. We believe that every woman deserves access to the care, resources and support necessary to not just survive but thrive after a breast cancer diagnosis. By addressing the cancer care continuum head-on, we can dismantle barriers, reduce disparities and save lives.
This op-ed is the first in a series focusing on eliminating breast cancer mortality in Black women on Chicago’s Southside. The authors are part of the Chicago Better Together Breast Cancer Disparities Think Tank, an initiative launched to address the disproportionate impact of breast cancer mortality on Black women in Chicago’s Southside and South Suburbs. Together with other community leaders, they have co-authored the Pinkprint, a strategic multistep plan and call-to-action on this critical issue.
