Memphis Model Addresses Largest Racial Disparity in Breast Cancer Mortality Rates of Major U.S. Cities

October 23, 2012 - October is Breast Cancer Awareness month, and it’s top of mind for healthcare providers in Memphis, Tenn., for a very pressing reason. Across national studies, black women die more from breast cancer than white women, and that's more true in Memphis than in any of the nation's other largest cities. In fact, in Memphis, a black woman is more than twice as likely to die from breast cancer as a white woman.

A study published in Cancer Epidemiology in April 2012 examined racial disparity in breast cancer mortality rates. Of the 25 largest cities in the country, Memphis topped the list with the greatest racial disparity: the ratio of black women to white women who die of breast cancer in Memphis is 2.09. The study was conducted by Sinai Urban Health Institute in Chicago with funding from the Avon Foundation.

The study’s details show that on average, one African American woman a week dies in Memphis due to racial disparities. Leaders from Methodist Healthcare and The West Clinic in Memphis recently met with authors of that study to discuss the issue and brainstorm solutions.

Dr. Steve Whitman, PhD, from Sinai Urban Institute who co-authored the study came to the meeting to explore ways to address the issues. He said, “Methodist Healthcare and its partnership with the West Clinic are in a good position to address the disparity issues because of deep ties already established with African American churches.”

These ties are established by Memphis’ Congregational Health Network (CHN). The CHN is a community partnership program based on covenant relationships between Methodist Healthcare and roughly 500 congregations.

While overall, the impact of the CHN on Memphian health is moving in the right direction, (CHN patient data shows that there is a 50% reduction in mortality, a 20% reduction in hospital readmissions, and a savings of over $4 million dollars to the hospital in costs) Methodist Healthcare is still trying to get at the root of the disparity issues in Memphis, especially when it comes to staggering statistics like the difference in breast cancer mortality. Issues such as prevention, education, access and connection to services, and most importantly building trust between patients and healthcare providers are intimately addressed through the web of the CHN.

A Susan G. Komen Foundation grant supported Methodist Healthcare in hiring a specialty navigator, Carole Dickens, to manage the connection between the CHN and The West Clinic. Dickens coordinates with Methodist’s ten navigators, as well as CHN pastors and liaisons to visit congregations where she coordinates education seminars and arranges for low income women to get mammograms and further testing if breast cancer indicators are identified.

“It’s really about connecting woman-to-woman, and it would be impossible to organize it effectively if not for the trusted relationships established through the CHN. Many of the women living in the shadow of racial disparity are hard to reach, and most are reluctant to get help, frightened of the healthcare system and the costs associated with treatment. Some would rather not know they have cancer because the solutions seem out of reach for them. Some believe they are 'too young' to get breast cancer or that it doesn’t run in their family so they won’t be affected. Most don’t get regular mammograms or seek care when they feel a lump in their breast,” said Dickens.

“We have to give them information, a reason to hope, to know that there is help and to trust that we will do whatever it takes to give them their best shot at beating breast cancer.”

Teresa Cutts, Ph.D., director of research and innovation for faith and health, who manages the research and evaluation data for Methodist Healthcare, said that the Komen grant has enabled them to reach more women, decrease time between screening and diagnosis, and/or diagnosis and treatment, and increase the percentage of people who enter, stay in, or progress through the continuum of care.

“By penetrating deeper into under-served zip codes and neighborhoods through our Congregational Health Network (CHN) partnership, we’ve been able to educate women about breast cancer prevention and offer the screening resources through the churches. Based on data from our screenings, we are reaching more women in the top zip codes for breast cancer mortality as reported last in 2010.  Our top numbers of participants aligned almost perfectly with the highest mortality zip codes for African American women," said Cutts.

This initial work has set the stage for Phase II of Methodist Healthcare’s work, intentionally partnering with The West Clinic to offer subsidies to help defray treatment costs with small micro-grants and further establish a more seamless continuum of education, prevention and care efforts (if needed). The partnership between Methodist Healthcare and The West Clinic is gaining ground on turning the tide of breast cancer survival rates. The West Clinic has conducted a large number of clinical trials and continues to develop trials to offer its patients.

Dr. Kurt Tauer, chief of staff at The West Clinic, said, “Dr. Whitman brings not only enthusiasm but also nuts and bolts, specific tools to be applied in Memphis, data to coincide with our own hospital data so we don’t have to reinvent the wheel. Between that and our partnership with Methodist and the CHN, I think we are in an excellent position to get into these communities to solve the problem and turn a terrible rate of breast cancer survival into a more positive outcome for women in Memphis.”

Source: Memphis’ Congregational Health Network (CHN).